Primary progressive aphasia: a patient with stress assignment impairment in reading aloud

Surface dyslexia is a pattern of reading impairment which has been seldom d escribed in Italian native speakers. We report the case of a female Italian patient, RM, suffering from primary progressive aphasia (PPA) of the fluen t type, who presented stress assignment errors in reading aloud. In Italian these errors are considered to be strongly suggestive of surface dyslexia. We studied RM's reading performance in light of existing cognitive models on reading. Since the first assessment, she presented multi-level impairmen t involving pre-semantic, lexical-semantic and post-semantic stages. Her st ress assignment errors have been interpreted as a generalisation of the mos t frequent tendency in Italian language: namely to assign stress to the pen ultimate syllable. In agreement with previous studies, our case suggests th at surface dyslexia in PPA is not a monolithic entity but, on the contrary, that it may arise from impairment at various stages of the reading process .