Phonological activation in pure alexia

Pure alexia is a reading impairment in which patients appear to read letter -by-letter. This disorder is typically accounted for in terms of a peripher al deficit that occurs early on in the reading system, prior to the activat ion of orthographic word representations. The peripheral interpretation of pure alexia has recently been challenged by the phonological deficit hypoth esis, which claims that a postlexical disconnection between orthographic an d phonological information contributes to or is responsible for the disorde r. Because this hypothesis was mainly supported by data from a single patie nt (IH), who also has surface dyslexia, the present study re-examined this hypothesis with another pure alexic patient (EL). In contrast to patient IH , EL did not show any evidence of a phonological deficit. Her pattern of pe rformance in naming was not qualitatively different from that of normal rea ders; she appeared to be reading via a mode of processing resulting in stro ng serial and lexical effects, a pattern often observed in normal individua ls reading unfamiliar stimuli. The present results do not obviously support the phonological hypothesis and are more consistent with peripheral interp retations of pure alexia. The peripheral and the phonological accounts of p ure alexia are discussed in light of two current models of visual word reco gnition.