Dissociation between Selecting and Orienting Attentional Reading Deficits: A Study in Adults with Epilepsy

Word reading requires a range of spatial attention processes, such as orienting to a specific word and selecting it while ignoring other words. This study investigated whether deficits of these spatial attention processes can show dissociations after hemispheric lesions. Thirty-nine patients with left or right focal epilepsy and 66 healthy participants had to read aloud four-letter words presented in the left and right visual hemifields. There were three successive blocks of presentation: in the unilateral block, a single word was presented in one of the visual hemifields; in the bilateral block, two words were presented simultaneously, one in each visual hemifield; in the cued block, two words were also presented, but only the cued word had to be reported. Twenty-one patients, twelve with a left and nine with a right hemisphere lesion, showed a word reading deficit. Four had specific difficulties in the cued block, suggesting an attentional selection reading deficit. Twelve patients had an asymmetric reading deficit, suggesting an attention orientation or a visual field deficit. Five patients had more complex deficits. The visual field presentation procedure may help to reveal different types of reading disorders in patients with epilepsy and to dissociate orienting and selecting deficits.