title: Progressive peripheral agraphia.
abstract: We describe RW, a patient who presented with writing difficulty that deteriorated over time. While her graphemes were typically legible, her writing was extremely slow, and her letters were written in an inconsistent and heterogeneous manner (e.g. each "a" in the word "banana" was produced in a different way). Her mental imagery of letters was impoverished, and she also produced allographic errors in her writing. She had some spelling errors as well, but many of these were due to omissions, perseverations, and motor operations. A positron emission tomography scan demonstrated superior parietal occipital and superior frontal defects that were more evident on the left than the right. Our observations are consistent with the hypothesis that RW has a deficit retrieving physical letter forms as manifested by her heterogeneous and slow production of letter forms. This disruption of grapheme retrieval is associated with interruption of a superior frontal-parietal system in the left hemisphere.
authors.affiliation: Department of Neurology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA. mgrossma@mail.med.upenn.edu
authors.forename: M
authors.initials: M
authors.lastname: Grossman
authors.forename: D J
authors.initials: DJ
authors.lastname: Libon
authors.forename: X S
authors.initials: XS
authors.lastname: Ding
authors.forename: B
authors.initials: B
authors.lastname: Cloud
authors.forename: J
authors.initials: J
authors.lastname: Jaggi
authors.forename: D
authors.initials: D
authors.lastname: Morrison
authors.forename: J
authors.initials: J
authors.lastname: Greenberg
authors.forename: A
authors.initials: A
authors.lastname: Alavi
authors.forename: M
authors.initials: M
authors.lastname: Reivich
mesh_terms: D000368:Aged; D000381:Agraphia / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006236:Handwriting; D006801:Humans; D007807:Language Tests; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D011214:Practice, Psychological; D011597:Psychomotor Performance / Q000502:physiology; D013028:Space Perception / Q000502:physiology; D014055:Tomography, Emission-Computed