Functional recovery from pure dyslexia with preservation of subcortical association fiber networks

•Pure dyslexia recovered after cortical damages.•Preservation of subcortical networks could compensate the cortical damages.•Structural change of the networks is suspected.

A 28-year-old right-handed woman with seizures underwent a two-stage surgical excision of a glioma that was located in the posterior basal region of her left temporal brain. After each surgery, she developed transient pure dyslexia with complete recovery in several months. Around the surgeries, the two major lexico-semantic network pathways, i.e., the inferior fronto-occipital fasciculus (IFOF) and inferior longitudinal fasciculus (ILF) could be visualized by diffusion tensor imaging (DTI) tractography. Interestingly, routes of IFOF and ILF shifted after the 1st-stage surgery. To the best of our knowledge, this case suggests, for the first time, that pure dyslexia could be reversed even when the cortical functional region is perturbed, through possible structural change and preservation of the association fiber networks.