Do patients with pure alexia suffer from a specific word form processing deficit? Evidence from 'wrods with trasnpsoed letetrs'.

It is widely accepted that letter-by-letter reading and a pronounced increase in reading time as a function of word length are the hallmark features of pure alexia. Why patients show these two phenomena with respect to underlying cognitive mechanisms is, however, much less clear. Two main hypotheses have been proposed, i.e. impaired discrimination of letters and deficient processing of word forms. While the former deficit can easily be investigated in isolation, previous findings favouring the latter seem confounded. Applying a word reading paradigm with systematically manipulated letter orders in two patients with pure alexia, we demonstrate a word form processing deficit that is not attributable to sublexical letter discrimination difficulties. Moreover, pure alexia-like fixation patterns could be induced in healthy adults by having them read sentences including words with transposed letters, so-called 'jumbled words'. This further corroborates a key role of deficient word form processing in pure alexia. With regard to basic reading research, the present study extends recent evidence for relative, rather than precise, encoding of letter position in the brain.