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Poster D27, Thursday, November 9, 6:15 – 7:30 pm, Harborview and Loch Raven Ballrooms

How does iReadMore therapy change the reading network connectivity in patients with central alexia?

Sheila Kerry1, Zoe Woodhead2,3, Oscar Aguilar1,4,5, Jenny Crinion1, Will Penny4, Yean-Ong Hoon4, Alex Leff1,3,4;1Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London, WC1N 3AR, UK, 2Department of Experimental Psychology, University of Oxford, UK, 3Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, UK, 4Wellcome Trust Centre for Neuroimaging, University College London, 12 Queen Square, London, WC1N 3BG, UK, 5Facultad de Psicología, Pontificia Universidad Javeriana, Bogotá, Carrera 7, No. 40 – 62, Colombia.

Introduction: Central alexia is an acquired reading disorder co-occurring with a generalised language deficit (aphasia). We investigated the effects of a reading training App, called iReadMore, designed to improve word reading accuracy on the reading network of patients with Central Alexia. Methods: 23 patients with central alexia in the chronic post-stroke phase participated in the study. Participants completed a four-week therapy block in which they attended three 40 minute face-to-face sessions per week and completed a total of 35 hours of training at home. Before and after therapy, word reading accuracy for trained words and a matched list of untrained words was assessed and an MEG scan was conducted. During each MEG scan participants were presented with trained and untrained words. Variational Bayes Equivalent Current Dipole 1 source localisation identified subject specific dipoles in the following locations: left and right occipital regions (OCC), ventral occipitotemporal regions (vOT) and inferior frontal gyrus (IFG). DCM 2 modelled the modulation in effective connectivity for reading trained items after therapy compared to before therapy, in the first 300ms of word processing. A random effects Bayesian Model Averaging analysis was conducted to identify significantly modulated connection strengths. The relationship between reading network modulation and percentage change in word reading accuracy was investigated using Automatic Linear Modelling. Results Participants reading accuracy improved by on average 9.2%, Cohen’s d =1.29 (large). The following were stronger for trained words following therapy: i) left and right IFG self-connections ii) left and right OCC self-connections ii) from left OCC to left vOT iv) from left OCC to left IFG v) from left OCC to right OCC and vi) left to right IFG. The ALM identified a significant positive correlation between improvement in reading accuracy and modulation of the right OCC self-connection (p<0.05) and the connection from the right OCC to left OCC (p<0.05). The modulation of the backwards connection from left vOT to left OCC and from right IFG to right vOT was significantly negatively correlating with improvements in word reading accuracy for trained items. Conclusion Overall, a strengthening of left hemisphere, feed forward connections were observed for trained words. This is interpreted as the representations of these words being updated in the left IFG. Larger therapy gains were associated with greater strengthening of the right OCC self-connection and the lateral connection from right OCC to left OCC, suggesting that patients who processed the left-side (prefix) of words well and integrated this information across hemispheres did better than those who did not.

Topic Area: Language Disorders

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