Objectives: Even if left hemisphere damage occurs, aphasia may not be present if languagerelated areas are not involved. The change in cognitive ability due to brain damage may lead to alexia and agraphia, even in the absence of aphasia. The study examines the effects of aphasia on the performance capability and error aspects of reading and writing in patients with cerebral infarction. Methods: Twenty-four patients with cerebral infarction and 15 normal adults were enlisted to perform 60 reading tasks and 45 writing tasks. Results: First, aphasic patients showed significantly lower performance in reading (irregular and non-words) and writing (regular, irregular, and non-words) tasks than non-aphasic patients and normal subjects. Second, non-aphasic patients showed significantly lower performance in writing (non-words) tasks than the normal group. Conclusion: It appears that patients with cerebral infarction exhibit difficulty with reading and writing, which reveals a written language impairment. In particular, the non-word performance capability of both aphasic and non-aphasic patients was low in writing tasks in comparison with normal adults. This is the result of the fact that writing tasks involve more complex and higher order processes than reading tasks. Non-words are mostly processed through the phonological route, so this result implies the possibility that brain damage affects the phonological route; that is, a grapheme-to-phoneme conversion, regardless of the presence or absence of aphasia.
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