Simulating the spectrum, not the syndrome: Large scale individualized modeling of oral reading in stroke aphasia

Computational models are a linchpin in our understanding of the neurocognitive basis of reading. These models can simulate idealized profiles of alexia syndromes, but in reality, individuals with alexia present with a wide range of mixed deficits rather than idealized syndromes. To provide a complete cognitive theory of reading, computational models must be able to account for this individual variation. However, this has never been demonstrated. We test oral reading and non-reading phonological and semantic processing in 83 left-hemisphere stroke survivors. We show that individual alexia profiles can be simulated by applying graded phonology and semantic lesions to an artificial neural network model of reading, creating "matched models" that represent individual stroke survivors. The severity of damage to the semantic and phonological layers of the matched models was highly correlated with directly-measured semantic and phonological processing deficits. However, we also identify systematic ways in which the models fail to simulate the reading performance of their matched stroke survivors. Our results support theories of alexia that rely on process-based deficits, demonstrate the feasibility of large-scale individualized modelling of alexia, and suggest ways to further improve the correspondence of models and human reading behavior.