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Neural Mechanisms Underlying Learning Following Semantic Mediation Treatment in a Case of Phonologic Alexia

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Abstract

Patients with phonologic alexia can be trained to read semantically impoverished words (e.g., functors) by pairing them with phonologically-related semantically rich words (e.g, nouns). What mechanisms underlie success in this cognitive re-training approach? Does the mechanism change if the skill is “overlearned”, i.e., practiced beyond criterion? We utilized fMRI pre- and post-treatment, and after overlearning, to assess treatment-related functional reorganization in a patient with phonologic alexia, 2 years post left temporoparietal stroke. Pre-treatment, there were no statistically significant differences in activation profiles across the sets of words. Post-treatment, accuracy on the two trained sets improved. Compared with untrained words, reading trained words recruited larger and more significant clusters of activation in the right hemisphere, including right inferior frontal and inferior parietal cortex. Post-overlearning, with near normal performance on overlearned words, predominant activation shifted to left hemisphere regions, including perilesional activation in superior parietal lobe, when reading overlearned vs. untrained words.

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Notes

  1. Post-hoc analysis of a fourth pre-treatment baseline test revealed that YCR could read four words from each set of to-be-trained word lists (ITU and ITP). These words were therefore modeled as a nuisance variable in the following fMRI analyses.

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Acknowledgements

We are grateful to Nora Watson for acquisition of the behavioral data and to Elizabeth Lacey for editorial comments. We thank the two anonymous reviewers for their insightful and constructive criticism. This work was supported by NIH Grants R01 HD036019 and R01 DC007169 to the PI (RBF). Anne Sperling contributed to this research while a post-doctoral fellow at GUMC; she is now at the National Institute of Mental Health (NIMH). The views expressed in this article do not necessarily represent the views of the NIMH.

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Authors and Affiliations

  1. Department of Neurology, Georgetown University Medical Center (GUMC), Washington, DC, USA

    Jacquie Kurland, Carlos R. Cortes, Anne J. Sperling, Susan N. Lott, Malle A. Tagamets, John VanMeter & Rhonda B. Friedman

  2. Department of Communication Disorders, University of Massachusetts, Amherst, USA

    Jacquie Kurland

  3. Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA

    Carlos R. Cortes & Malle A. Tagamets

  4. Department of Pediatric Neurology, University Children’s Hospital, Tubingen, Germany

    Marko Wilke

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  1. Jacquie Kurland
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Correspondence to Jacquie Kurland.

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Kurland, J., Cortes, C.R., Wilke, M. et al. Neural Mechanisms Underlying Learning Following Semantic Mediation Treatment in a Case of Phonologic Alexia. Brain Imaging and Behavior 2, 147–162 (2008). https://doi.org/10.1007/s11682-008-9027-2

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