Facilitating text reading in posterior cortical atrophy

Neurology. 2015 Jul 28;85(4):339-48. doi: 10.1212/WNL.0000000000001782. Epub 2015 Jul 2.

Abstract

Objective: We report (1) the quantitative investigation of text reading in posterior cortical atrophy (PCA), and (2) the effects of 2 novel software-based reading aids that result in dramatic improvements in the reading ability of patients with PCA.

Methods: Reading performance, eye movements, and fixations were assessed in patients with PCA and typical Alzheimer disease and in healthy controls (experiment 1). Two reading aids (single- and double-word) were evaluated based on the notion that reducing the spatial and oculomotor demands of text reading might support reading in PCA (experiment 2).

Results: Mean reading accuracy in patients with PCA was significantly worse (57%) compared with both patients with typical Alzheimer disease (98%) and healthy controls (99%); spatial aspects of passages were the primary determinants of text reading ability in PCA. Both aids led to considerable gains in reading accuracy (PCA mean reading accuracy: single-word reading aid = 96%; individual patient improvement range: 6%-270%) and self-rated measures of reading. Data suggest a greater efficiency of fixations and eye movements under the single-word reading aid in patients with PCA.

Conclusions: These findings demonstrate how neurologic characterization of a neurodegenerative syndrome (PCA) and detailed cognitive analysis of an important everyday skill (reading) can combine to yield aids capable of supporting important everyday functional abilities.

Classification of evidence: This study provides Class III evidence that for patients with PCA, 2 software-based reading aids (single-word and double-word) improve reading accuracy.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alzheimer Disease / complications
  • Alzheimer Disease / pathology
  • Atrophy / complications
  • Atrophy / pathology
  • Brain Diseases / complications
  • Brain Diseases / pathology
  • Brain Diseases / physiopathology
  • Brain Diseases / therapy*
  • Case-Control Studies
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology
  • Dyslexia, Acquired / complications
  • Dyslexia, Acquired / physiopathology
  • Dyslexia, Acquired / therapy*
  • Eye Movements / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Therapy, Computer-Assisted*