Influence of written form on reading comprehension in aphasia

Processing of self-related kinematic information embedded in static handwritten characters

Handwritten characters are generated by our own motor actions, and previous studies have shown that the manner in which such characters are perceived and generated is related. However, the temporal course of the neural activation involved in the processing of self-related kinematic information embedded in static handwritten characters remains to be identified. We applied event-related potential (ERP) recording while participants judged whether handwritten characters were self- or non-self-generated. To test the effects of the self-related kinematic characteristics of static handwritten characters, we conducted two experiments in which the styles or familiarity of characters were manipulated. The ERP results indicated differences in brain activation between self- and non-self-written characters for the P250 component (250-350ms after stimulus onset) in right posterior regions and for the late positive component (LPC; 350-500ms after stimulus onset) in anterior midline regions; this was the case even when the handwritten characters were not generated in their usual form or were written for the first time. Therefore, our data indicate that self-information embedded in handwritten characters involves both right-lateralized brain activation associated with bodily self-processing and anterior midline brain activation related to self-referential processing.

Brain activation patterns resulting from learning letter forms through active self-production and passive observation in young children

Although previous literature suggests that writing practice facilitates neural specialization for letters, it is unclear if this facilitation is driven by the perceptual feedback from the act of writing or the actual execution of the motor act. The present study addresses this issue by measuring the change in BOLD signal in response to hand-printed letters, unlearned cursive letters, and cursive letters that 7-year-old children learned actively, by writing, and passively, by observing an experimenter write. Brain activation was assessed using fMRI while perceiving letters-in both cursive and manuscript forms. Results showed that active training led to increased recruitment of the sensori-motor network associated with letter perception as well as the insula and claustrum, but passive observation did not. This suggests that perceptual networks for newly learned cursive letters are driven by motor execution rather than by perceptual feedback.

What differs in visual recognition of handwritten vs. printed letters? An fMRI study

In models of letter recognition, handwritten letters are considered as a particular font exemplar, not qualitatively different in their processing from printed letters. Yet, some data suggest that recognizing handwritten letters might rely on distinct processes, possibly related to motor knowledge. We applied functional magnetic resonance imaging to compare the neural correlates of perceiving handwritten letters vs. standard printed letters. Statistical analysis circumscribed to frontal brain regions involved in hand-movement triggering and execution showed that processing of handwritten letters is supported by a stronger activation of the left primary motor cortex and the supplementary motor area. At the whole-brain level, additional differences between handwritten and printed letters were observed in the right superior frontal, middle occipital, and parahippocampal gyri, and in the left inferior precentral and the fusiform gyri. The results are suggested to indicate embodiment of the visual perception of handwritten letters.

Aphasia friendly written health information: content and design characteristics

People with aphasia need communicatively accessible written health information. Healthcare providers require knowledge of how to develop printed education materials (PEMs) in formats that people with aphasia prefer and can read. This study aimed to explore formatting characteristics considered to be barriers and facilitators to reading PEMs. Semi-structured in-depth interviews were conducted with 40 adults with aphasia who were selected using maximum variation sampling across aphasia severity, reading ability, and time post-stroke. Participants were shown stroke and aphasia PEMs obtained from the recruiting stroke services, asked to rank them from most liked to least liked, and comment on factors that made the PEMs easier and harder to read. The majority of participants ranked the aphasia friendly stroke (56.4%, n = 22) and aphasia (87.2%, n = 34) PEMs as most liked. Forty-five facilitator and 46 barrier codes were identified using qualitative content analysis and grouped into two categories; (1) content characteristics and (2) design characteristics. Findings support many of the recommendations found within the literature for developing best practice PEMs and accessible information for other patient groups. Routine consideration of the facilitators and barriers identified will contribute to making written information more accessible to people with aphasia.

Reading words, seeing style: the neuropsychology of word, font and handwriting perception

The reading of text is predominantly a left hemisphere function. However, it is also possible to process text for attributes other than word or letter identity, such as style of font or handwriting. Anecdotal observations have suggested that processing the latter may involve the right hemisphere. We devised a test that, using the identical stimuli, required subjects first to match on the basis of word identity and second to match on the basis of script style. We presented two versions, one using various computer fonts, and the other using the handwriting of different individuals. We tested four subjects with unilateral lesions who had been well characterized by neuropsychological testing and structural and/or functional MRI. We found that two prosopagnosic subjects with right lateral fusiform damage eliminating the fusiform face area and likely the right visual word form area were impaired in completion times and/or accuracy when sorting for script style, but performed better when sorting for word identity. In contrast, one alexic subject with left fusiform damage showed normal accuracy for sorting by script style and normal or mildly elevated completion times for sorting by style, but markedly prolonged reading times for sorting by word identity. A prosopagnosic subject with right medial occipitotemporal damage sparing areas in the lateral fusiform gyrus performed well on both tasks. The contrast in the performance of patients with right versus left fusiform damage suggests an important distinction in hemispheric processing that reflects not the type of stimulus but the nature of processing required.