Ideographic Alexia without Involvement of the Fusiform Gyrus in a Korean Stroke Patient: A Serial Functional Magnetic Resonance Imaging Study

The Korean orthographic system consists of both phonograms (Hangul) and ideograms (Hanja). Hangul is a phonetic alphabet comprised of consonants and vowels that are grouped together to form syllables that generally exhibit regular correspondences between graphemes and phonemes. On the other hand, Hanja is derived from complex Chinese characters with distinct meanings. In this respect, Hanja and Hangul are similar to Kanji (ideograms) and Kana (phonograms), respectively, of the Japanese language. Many Japanese language studies have described dissociations between the neural substrates involved in the reading of Kanji and Kana. For example, difficulty in Kana reading has been associated with lesions of the left angular gyrus, adjacent lateral occipital gyri, deep perisylvian temporoparietal area, and posterior superior temporal gyrus, whereas lesions involving the fusiform gyrus and left posterior inferior temporal cortex have been identified in individuals with difficulty in Kanji reading.1-4 The results of some Korean studies on the dissociation between Hangul and Hanja reading have concurred with previous Japanese findings.5-7 However, the exact brain regions involved in the processing of Hangul and Hanja reading have not been firmly established.8-10 The authors conducted serial functional magnetic resonance imaging (fMRI) to identify the areas of the brain associated with Hanja reading by investigating a patient exhibiting Hangul/Hanja reading dissociation after an acute ischemic stroke. Ideographic Alexia without Involvement of the Fusiform Gyrus in a Korean Stroke Patient: A Serial Functional Magnetic Resonance Imaging Study