Neural regions essential for reading and spelling of words and pseudowords.
OBJECTIVE
To identify dysfunctional brain regions critical for impaired reading/spelling of words/pseudowords by evaluating acute stroke patients on lexical tests and magnetic resonance imaging, before recovery or reorganization of structure-function relationships.


METHODS
A series of 106 consenting patients were administered oral reading and spelling tests within 24 hours of left supratentorial stroke onset. Patients underwent diffusion- and perfusion-weighted magnetic resonance examination the same day to identify regions of hypoperfusion/infarct of 16 Brodmann areas.


RESULTS
Simultaneous logistic regression analysis demonstrated that dysfunction of left Brodmann areas 40 (supramarginal gyrus) and 37 (posterior-inferior temporal/fusiform gyrus) best predicted impairment in reading words (odds ratio [OR], 6.20 [95% confidence interval (CI), 1.54-24.96] and 2.71 [95% CI, 0.87-8.45], respectively), reading pseudowords (OR, 39.65 [95% CI 3.9-400.78] and 4.41 [95% CI, 1.1-17.51], respectively), spelling words (OR, 14.11 [95% CI 1.37-144.93] and 7.41 [95% CI, 1.48-37.24], respectively), and spelling pseudowords (OR, 4.84 [95% CI, 0.73-32.13] and 7.74 [95% CI, 1.56-38.51], respectively). Whole-brain voxel-wise analyses demonstrated voxel clusters within these regions that were most strongly associated with task deficits.


CONCLUSIONS
Results indicate that a shared network of regions including parts of left Brodmann areas 37 and 40 is necessary for reading and spelling of words and pseudowords. Further studies may define the precise roles of these brain regions in language. Identification of any neural regions specific to one of these tasks or one type of stimuli will require study of more patients with selective deficits.
Philipose
Lisa E
LE
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Gottesman
Rebecca F
RF
Newhart
Melissa
M
Kleinman
Jonathan T
JT
Herskovits
Edward H
EH
Pawlak
Mikolaj A
MA
Marsh
Elisabeth B
EB
Davis
Cameron
C
Heidler-Gary
Jennifer
J
Hillis
Argye E
AE
D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000502:physiology*; D001931:Brain Mapping / Q000379:methods; D006801:Humans; D007802:Language; D007807:Language Tests; D008875:Middle Aged; D009415:Nerve Net / Q000502:physiology; D011932:Reading; D020521:Stroke / Q000150:complications / Q000473:pathology