Impact of cerebellar stroke on established and emergent reading skills: Evidence of alexia

This study examined the impact of cerebellar stroke on both well-established reading skills and emergent literacy abilities using a combination of static and dynamic assessments. The static component involved a lexical decision task featuring novel orthographic forms (pseudowords) followed by tests of orthographic memory. The dynamic component employed a training protocol in an artificial orthography, requiring participants to learn new grapheme-phoneme correspondences and read in a novel script. Participants included individuals with cerebellar stroke (n = 13) and demographically matched controls (n = 13). Results indicated that cerebellar damage impairs phonological decoding processes, disrupting both reading of novel forms in a familiar orthography and the acquisition of new orthographic-phonological mappings. Notably, five of the 13 cerebellar patients met criteria for phonological alexia, though no clear relationship emerged between symptom severity and lesion characteristics. These findings underscore the cerebellum’s role in phonological decoding and its contribution to both established and emergent aspects of reading.