MRI Inquiry into the Anatomic Aspects of Alexia Without Agraphia

We reviewed brain MRI imaging in patients with alexia without agraphia (AWA) to better classify the pathophysiology of AWA as a disconnection syndrome or as a word form agnosia. AWA is primarily thought of as a disconnection syndrome in which a left occipital lobe lesion affects the callosal fibers of the splenium and disrupts access between the right striate cortex and the language regions for reading (Geschwind N 1965). Disconnection may also occur in unusual lesion combinations. Other authors have suggested that AWA may be word form agnosia from left fusiform gyrus damage (Warrington and Shallice 1980; Beversdorf et al 1997). The only systematic study of the neuro-anatomy of these lesions in a larger series of 16 patients with AWA was CT based (Damasio 1983).