Disruption of posterior brain systems for reading in children with developmental dyslexia.

BACKGROUND: Converging evidence indicates a functional disruption in the neural systems for reading in adults with dyslexia. We examined brain activation patterns in dyslexic and nonimpaired children during pseudoword and real-word reading tasks that required phonologic analysis (i.e., tapped the problems experienced by dyslexic children in sounding out words). METHODS: We used functional magnetic resonance imaging (fMRI) to study 144 right-handed children, 70 dyslexic readers, and 74 nonimpaired readers as they read pseudowords and real words. RESULTS: Children with dyslexia demonstrated a disruption in neural systems for reading involving posterior brain regions, including parietotemporal sites and sites in the occipitotemporal area. Reading skill was positively correlated with the magnitude of activation in the left occipitotemporal region. Activation in the left and right inferior frontal gyri was greater in older compared with younger dyslexic children. CONCLUSIONS: These findings provide neurobiological evidence of an underlying disruption in the neural systems for reading in children with dyslexia and indicate that it is evident at a young age. The locus of the disruption places childhood dyslexia within the same neurobiological framework as dyslexia, and acquired alexia, occurring in adults.     

The neurobiology of dyslexia

Within the last two decades overwhelming evidence from many laboratories has converged to indicate the cognitive basis for dyslexia: dyslexia represents a disorder within the language system and more specifically within a particular subcomponent of that system, phonological processing. Recent advances in imaging technology and the development of tasks which sharply isolate the subcomponent processes of reading now allow the localization of phonological processing in brain, and, as a result, provide for the first time, the potential for elucidating a biological signature for reading and reading disability. Converging evidence from a number of laboratories using functional brain imaging indicates a pattern of brain organization in dyslexia different from that seen in nonimpaired readers; specifically these studies show a disruption of left hemisphere posterior brain systems in adult dyslexic readers while performing reading tasks with an additional suggestion for an associated increased reliance on frontal lobe circuits. The discovery of neural systems serving reading has significant implications. At the most fundamental level, it is now possible to investigate specific hypotheses regarding the neural substrate of dyslexia, and to verify, reject or modify suggested cognitive models. From a more clinical perspective, the identification of neural systems for reading offers the promise for more precise identification and diagnosis of dyslexia in children, adolescents and adults.     

Similar alterations in brain function for phonological and semantic processing to visual characters in Chinese dyslexia

Dyslexia in alphabetic languages has been extensively investigated and suggests a central deficit in orthography to phonology mapping in the left hemisphere. Compared to dyslexia in alphabetic languages, the central deficit for Chinese dyslexia is still unclear. Because of the logographic nature of Chinese characters, some have suggested that Chinese dyslexia should have larger deficits in the semantic system. To investigate this, Chinese children with reading disability (RD) were compared to typically developing (TD) children using functional magnetic resonance imaging (fMRI) on a rhyming judgment task and on a semantic association judgment task. RD children showed less activation for both tasks in right visual (BA18, 19) and left occipito-temporal cortex (BA 37), suggesting a deficit in visuo-orthographic processing. RD children also showed less activation for both tasks in left inferior frontal gyrus (BA44), which additionally showed significant correlations with activation of bilateral visuo-orthographic regions in the RD group, suggesting that the abnormalities in frontal cortex and in posterior visuo-orthographic regions may reflect a deficit in the connection between brain regions. Analyses failed to reveal larger differences between groups for the semantic compared to the rhyming task, suggesting that Chinese dyslexia is similarly impaired in the access to phonology and to semantics from the visual orthography.     

Neural systems for compensation and persistence: young adult outcome of childhood reading disability.

BACKGROUND: This study examined whether and how two groups of young adults who were poor readers as children (a relatively compensated group and a group with persistent reading difficulties) differed from nonimpaired readers and if there were any factors distinguishing the compensated from persistently poor readers that might account for their different outcomes. METHODS: Using functional magnetic resonance imaging, we studied three groups of young adults, ages 18.5-22.5 years, as they read pseudowords and real words: 1) persistently poor readers (PPR; n = 24); 2) accuracy improved (compensated) readers (AIR; n = 19); and 3) nonimpaired readers (NI, n = 27). RESULTS: Compensated readers, who are accurate but not fluent, demonstrate a relative underactivation in posterior neural systems for reading located in left parietotemporal and occipitotemporal regions. Persistently poor readers, who are both not fluent and less accurate, activate posterior reading systems but engage them differently from nonimpaired readers, appearing to rely more on memory-based rather than analytic word identification strategies. CONCLUSIONS: These findings of divergent neural outcomes as young adults are both new and unexpected and suggest a neural basis for reading outcomes of compensation and persistence in adults with childhood dyslexia.     

Disrupted white matter connectivity underlying developmental dyslexia: A machine learning approach

Developmental dyslexia has been hypothesized to result from multiple causes and exhibit multiple manifestations, implying a distributed multidimensional effect on human brain. The disruption of specific white‐matter (WM) tracts/regions has been observed in dyslexic children. However, it remains unknown if developmental dyslexia affects the human brain WM in a multidimensional manner. Being a natural tool for evaluating this hypothesis, the multivariate machine learning approach was applied in this study to compare 28 school‐aged dyslexic children with 33 age‐matched controls. Structural magnetic resonance imaging (MRI) and diffusion tensor imaging were acquired to extract five multitype WM features at a regional level: white matter volume, fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. A linear support vector machine (LSVM) classifier achieved an accuracy of 83.61% using these MRI features to distinguish dyslexic children from controls. Notably, the most discriminative features that contributed to the classification were primarily associated with WM regions within the putative reading network/system (e.g., the superior longitudinal fasciculus, inferior fronto‐occipital fasciculus, thalamocortical projections, and corpus callosum), the limbic system (e.g., the cingulum and fornix), and the motor system (e.g., the cerebellar peduncle, corona radiata, and corticospinal tract). These results were well replicated using a logistic regression classifier. These findings provided direct evidence supporting a multidimensional effect of developmental dyslexia on WM connectivity of human brain, and highlighted the involvement of WM tracts/regions beyond the well‐recognized reading system in dyslexia. Finally, the discriminating results demonstrated a potential of WM neuroimaging features as imaging markers for identifying dyslexic individuals. Hum Brain Mapp 37:1443‐1458, 2016. © 2016 Wiley Periodicals, Inc.     

Reading in the brain of children and adults: A meta‐analysis of 40 functional magnetic resonance imaging studies

We used quantitative, coordinate‐based meta‐analysis to objectively synthesize age‐related commonalities and differences in brain activation patterns reported in 40 functional magnetic resonance imaging (fMRI) studies of reading in children and adults. Twenty fMRI studies with adults (age means: 23–34 years) were matched to 20 studies with children (age means: 7–12 years). The separate meta‐analyses of these two sets showed a pattern of reading‐related brain activation common to children and adults in left ventral occipito‐temporal (OT), inferior frontal, and posterior parietal regions. The direct statistical comparison between the two meta‐analytic maps of children and adults revealed higher convergence in studies with children in left superior temporal and bilateral supplementary motor regions. In contrast, higher convergence in studies with adults was identified in bilateral posterior OT/cerebellar and left dorsal precentral regions. The results are discussed in relation to current neuroanatomical models of reading and tentative functional interpretations of reading‐related activation clusters in children and adults are provided. Hum Brain Mapp 36:1963–1981, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. .     

Understanding the time variant connectivity of the language network in developmental dyslexia: new insights using Granger causality

The reading process takes place in a neuronal network comprising the inferior frontal, posterior dorsal and posterior ventral brain areas. It is suggested that developmental dyslexia is caused by a disruption of the two posterior network areas. What remains debatable is whether these areas are affected in their functionality or whether the neuronal networking (connectivity) of these areas suffer from a disturbed information transfer. Thus, it is of major interest to investigate the time flow of the directed information transfer (time variant connectivity) within the neuronal reading network of dyslexic subjects. We investigated adolescents with dyslexia and normal-reading controls with functional magnetic resonance imaging and electroencephalography (EEG) with a paradigm addressing basic visual, orthographic and phonological processing. EEG data were analyzed with the time variant Granger causality index (tvGCI) to investigate the temporal order of the directed information transfer (time variant causal connectivity: which network node passes when information to which network node) during reading in dyslexic readers. Results show that the reading network of dyslexic readers comprises the same brain areas as identified in normal-reading subjects. The tvGCI analysis of the network profiles of dyslexic readers indicates that dyslexics show a difference in timing and localization of connectivity within this reading network compared to normal readers. Dyslexic readers use right hemisphere language areas to counterbalance posterior left hemisphere processing deficits. The compensatory involvement of homologue right hemisphere brain areas for the reading process may be the neurobiological background for the significantly longer reading times by dyslexics.     

Development of left occipitotemporal systems for skilled reading in children after a phonologically- based intervention

Background

A range of neurobiological investigations shows a failure of left hemisphere posterior brain systems to function properly during reading in children and adults with reading disabilities. Such evidence of a disruption in the normal reading pathways provides a neurobiological target for reading interventions. In this study, we hypothesized that the provision of an evidence-based, phonologically mediated reading intervention would improve reading fluency and the development of the fast-paced occipitotemporal systems serving skilled reading.

Methods

Functional magnetic resonance imaging was used to study the effects of a phonologically based reading intervention on brain organization and reading fluency in 77 children aged 6.1-9.4 years (49 with reading disability and 28 control subjects). Children comprised three experimental groups: experimental intervention (n = 37), community intervention (n = 12), and community control subjects (n = 28).

Results

Immediately after the year-long intervention, children taught with the experimental intervention had made significant gains in reading fluency and demonstrated increased activation in left hemisphere regions, including the inferior frontal gyrus and the middle temporal gyrus; 1 year after the experimental intervention had ended these children were activating bilateral inferior frontal gyri and left superior temporal and occipitotemporal regions.

Conclusions

These data indicate that the nature of the remedial educational intervention is critical to successful outcomes in children with reading disabilities and that the use of an evidence-based phonologic reading intervention facilitates the development of those fast-paced neural systems that underlie skilled reading.     

Dyslexia-specific brain activation profile becomes normal following successful remedial training

OBJECTIVES: To examine changes in the spatiotemporal brain activation profiles associated with successful completion of an intensive intervention program in individual dyslexic children. METHODS: The authors obtained magnetic source imaging scans during a pseudoword reading task from eight children (7 to 17 years old) before and after 80 hours of intensive remedial instruction. All children were initially diagnosed with dyslexia, marked by severe difficulties in word recognition and phonologic processing. Eight children who never experienced reading problems were also tested on two occasions separated by a 2-month interval. RESULTS: Before intervention, all children with dyslexia showed distinctly aberrant activation profiles featuring little or no activation of the posterior portion of the superior temporal gyrus (STGp), an area normally involved in phonologic processing, and increased activation of the corresponding right hemisphere area. After intervention that produced significant improvement in reading skills, activity in the left STGp increased by several orders of magnitude in every participant. No systematic changes were obtained in the activation profiles of the children without dyslexia as a function of time. CONCLUSIONS: These findings suggest that the deficit in functional brain organization underlying dyslexia can be reversed after sufficiently intense intervention lasting as little as 2 months, and are consistent with current proposals that reading difficulties in many children represent a variation of normal development that can be altered by intensive intervention.     

Neural initialization of audiovisual integration in prereaders at varying risk for developmental dyslexia

Learning letter‐speech sound correspondences is a major step in reading acquisition and is severely impaired in children with dyslexia. Up to now, it remains largely unknown how quickly neural networks adopt specific functions during audiovisual integration of linguistic information when prereading children learn letter‐speech sound correspondences. Here, we simulated the process of learning letter‐speech sound correspondences in 20 prereading children (6.13–7.17 years) at varying risk for dyslexia by training artificial letter‐speech sound correspondences within a single experimental session. Subsequently, we acquired simultaneously event‐related potentials (ERP) and functional magnetic resonance imaging (fMRI) scans during implicit audiovisual presentation of trained and untrained pairs. Audiovisual integration of trained pairs correlated with individual learning rates in right superior temporal, left inferior temporal, and bilateral parietal areas and with phonological awareness in left temporal areas. In correspondence, a differential left‐lateralized parietooccipitotemporal ERP at 400 ms for trained pairs correlated with learning achievement and familial risk. Finally, a late (650 ms) posterior negativity indicating audiovisual congruency of trained pairs was associated with increased fMRI activation in the left occipital cortex. Taken together, a short (<30 min) letter‐speech sound training initializes audiovisual integration in neural systems that are responsible for processing linguistic information in proficient readers. To conclude, the ability to learn grapheme‐phoneme correspondences, the familial history of reading disability, and phonological awareness of prereading children account for the degree of audiovisual integration in a distributed brain network. Such findings on emerging linguistic audiovisual integration could allow for distinguishing between children with typical and atypical reading development. Hum Brain Mapp 38:1038–1055, 2017. © 2016 Wiley Periodicals, Inc.