This is a prospective, within- and between-subjects study of the functional and the neuroanatomic bases for acquired disorders of reading and related functions, such as naming. The opportunity for this study occurs because patients having medically-necessary surgical resections of cerebral tissue in certain brain regions sometimes (about 15-25%) develop problems with reading or related functions that persist for weeks to months. Subjects will be tested before surgery for the status or relevant functions as stipulated by current theories of reading. Relevant clinical data on their functional-neuroanatomic organization will also be collected. They will then be studied extensively at frequent intervals after surgery, and also will have high-quality MRI scanning (early and late) for neuroanatomic analyses, including 3D reconstructions. This subjects with deficits in reading and related functions offer an opportunity for a sensitive, within-subjects identification of which specific functional impairments underlie their observed deficits. The subjects without overt deficits after surgery will serve as case controls for the significance of any identified functional deficits. The neuroanatomic association of the observed deficits will also be determined, by several approaches: within-subjects correlations: comparisons across subjects by deficit; and comparisons across subjects by site(s) of structural damage. As subjects with deficits improve over time, they will have additional intensive testing to determine whether the underlying component processes are changing quantitatively or qualitatively, using both within-subjects and between- subjects comparisons. These data will therefore provide further tests of the basis for their disorders of reading and related functions, and of the neuroanatomic correlates of the underlying processes. Research on this unique patient population is expected to provide a highly detailed specification of the underlying processing deficits responsible for impairments in reading and related functions in these individuals, and of the neuroanatomic associations of any specific processing deficits. Because it is a prospective study of patients with surgical lesions, deficits and neuroanatomic associations will be delineated with greater precision, less confounding by compensatory mechanisms, and less reporting bias than in previous studies. The data obtained should also be valuable for understanding how reading and related functions are normally accomplished by the brain.
