Structural imaging in dyslexia: the planum temporale

Auditory Cortex Asymmetry Associations with Individual Differences in Language and Cognition

A longstanding cerebral lateralization hypothesis predicts that disrupted development of typical leftward structural asymmetry of auditory cortex explains why children have problems learning to read. Small sample sizes and small effects, potential sex-specific effects, and associations that are limited to specific dimensions of language are thought to have contributed inconsistent results. The large ABCD study dataset (baseline visit: N = 11,859) was used to test the hypothesis of significant associations between surface area asymmetry of auditory cortex and receptive vocabulary performance across boys and girls, as well as an oral word reading effect that was specific to boys. The results provide modest support (Cohen's d effect sizes ≤ 0.10) for the cerebral lateralization hypothesis.

Bridging the Divide: Brain and Behavior in Developmental Language Disorder

Developmental language disorder (DLD) is a heterogenous neurodevelopmental disorder that affects a child's ability to comprehend and/or produce spoken and/or written language, yet it cannot be attributed to hearing loss or overt neurological damage. It is widely believed that some combination of genetic, biological, and environmental factors influences brain and language development in this population, but it has been difficult to bridge theoretical accounts of DLD with neuroimaging findings, due to heterogeneity in language impairment profiles across individuals and inconsistent neuroimaging findings. Therefore, the purpose of this overview is two-fold: (1) to summarize the neuroimaging literature (while drawing on findings from other language-impaired populations, where appropriate); and (2) to briefly review the theoretical accounts of language impairment patterns in DLD, with the goal of bridging the disparate findings. As will be demonstrated with this overview, the current state of the field suggests that children with DLD have atypical brain volume, laterality, and activation/connectivity patterns in key language regions that likely contribute to language difficulties. However, the precise nature of these differences and the underlying neural mechanisms contributing to them remain an open area of investigation.

Cortical asymmetries at different spatial hierarchies relate to phonological processing ability

The ability to map speech sounds to corresponding letters is critical for establishing proficient reading. People vary in this phonological processing ability, which has been hypothesized to result from variation in hemispheric asymmetries within brain regions that support language. A cerebral lateralization hypothesis predicts that more asymmetric brain structures facilitate the development of foundational reading skills like phonological processing. That is, structural asymmetries are predicted to linearly increase with ability. In contrast, a canalization hypothesis predicts that asymmetries constrain behavioral performance within a normal range. That is, structural asymmetries are predicted to quadratically relate to phonological processing, with average phonological processing occurring in people with the most asymmetric structures. These predictions were examined in relatively large samples of children (N = 424) and adults (N = 300), using a topological asymmetry analysis of T1-weighted brain images and a decoding measure of phonological processing. There was limited evidence of structural asymmetry and phonological decoding associations in classic language-related brain regions. However, and in modest support of the cerebral lateralization hypothesis, small to medium effect sizes were observed where phonological decoding accuracy increased with the magnitude of the largest structural asymmetry across left hemisphere cortical regions, but not right hemisphere cortical regions, for both the adult and pediatric samples. In support of the canalization hypothesis, small to medium effect sizes were observed where phonological decoding in the normal range was associated with increased asymmetries in specific cortical regions for both the adult and pediatric samples, which included performance monitoring and motor planning brain regions that contribute to oral and written language functions. Thus, the relevance of each hypothesis to phonological decoding may depend on the scale of brain organization.

Plasticity of the language system in children and adults

The language system is perhaps the most unique feature of the human brain's cognitive architecture. It has long been a quest of cognitive neuroscience to understand the neural components that contribute to the hierarchical pattern processing and advanced rule learning required for language. The most important goal of this research is to understand how language becomes impaired when these neural components malfunction or are lost to stroke, and ultimately how we might recover language abilities under these circumstances. Additionally, understanding how the language system develops and how it can reorganize in the face of brain injury or dysfunction could help us to understand brain plasticity in cognitive networks more broadly. In this chapter we will discuss the earliest features of language organization in infants, and how deviations in typical development can-but in some cases, do not-lead to disordered language. We will then survey findings from adult stroke and aphasia research on the potential for recovering language processing in both the remaining left hemisphere tissue and in the non-dominant right hemisphere. Altogether, we hope to present a clear picture of what is known about the capacity for plastic change in the neurobiology of the human language system.

The Prenatal Origins of Human Brain Asymmetry: Lessons Learned from a Cohort of Fetuses with Body Lateralization Defects

Knowledge about structural brain asymmetries of human fetuses with body lateralization defects-congenital diseases in which visceral organs are partially or completely incorrectly positioned-can improve our understanding of the developmental origins of hemispheric brain asymmetry. This study investigated structural brain asymmetry in 21 fetuses, which were diagnosed with different types of lateralization defects; 5 fetuses with ciliopathies and 26 age-matched healthy control cases, between 22 and 34 gestational weeks of age. For this purpose, a database of 4007 fetal magnetic resonance imagings (MRIs) was accessed and searched for the corresponding diagnoses. Specific temporal lobe brain asymmetry indices were quantified using in vivo, super-resolution-processed MR brain imaging data. Results revealed that the perisylvian fetal structural brain lateralization patterns and asymmetry indices did not differ between cases with lateralization defects, ciliopathies, and normal controls. Molecular mechanisms involved in the definition of the right/left body axis-including cilium-dependent lateralization processes-appear to occur independently from those involved in the early establishment of structural human brain asymmetries. Atypically inverted early structural brain asymmetries are similarly rare in individuals with lateralization defects and may have a complex, multifactorial, and neurodevelopmental background with currently unknown postnatal functional consequences.

White matter alterations and tract lateralization in children with dyslexia and isolated spelling deficits

The present study investigated whether children with a typical dyslexia profile and children with isolated spelling deficits show a distinct pattern of white matter alteration compared with typically developing peers. Relevant studies on the topic are scarce, rely on small samples, and often suffer from the limitations of conventional tensor-based methods. The present Constrained Spherical Deconvolution study includes 27 children with typical reading and spelling skills, 21 children with dyslexia and 21 children with isolated spelling deficits. Group differences along major white matter tracts were quantified utilizing the Automated Fiber Quantification software and a lateralization index was calculated in order to investigate the structural asymmetry of the tracts. The two deficit groups mostly displayed different patterns of white matter alterations, located in the bilateral inferior longitudinal fasciculi, right superior longitudinal fasciculus, and cingulum for the group with dyslexia and in the left arcuate fasciculus for the group with isolated spelling deficits. The two deficit groups differed also with respect to structural asymmetry. Children with dyslexia did not show the typical leftward asymmetry of the arcuate fasciculus, whereas the group with isolated spelling deficits showed absent rightward asymmetry of the inferior fronto-occipital fasciculus. This study adds evidence to the notion that different profiles of combined or isolated reading and spelling deficits are associated with different neural signatures.

Atypical Structural Asymmetry of the Planum Temporale is Related to Family History of Dyslexia

Research on the neural correlates of developmental dyslexia indicates atypical anatomical lateralization of the planum temporale, a higher-order cortical auditory region. Yet whether this atypical lateralization precedes reading acquisition and is related to a familial risk for dyslexia is not currently known. In this study, we address these questions in 2 separate cohorts of young children and adolescents with and without a familial risk for dyslexia. Planum temporale surface area was manually labeled bilaterally, on the T1-weighted MR brain images of 54 pre-readers (mean age: 6.2 years, SD: 3.2 months; 33 males) and 28 adolescents (mean age: 14.7 years, SD: 3.3 months; 11 males). Half of the pre-readers and adolescents had a familial risk for dyslexia. In both pre-readers and adolescents, group comparisons of left and right planum temporale surface area showed a significant interaction between hemisphere and family history of dyslexia, with participants who had no family risk for dyslexia showing greater leftward asymmetry of the planum temporale. This effect was confirmed when analyses were restricted to normal reading participants. Altered planum temporale asymmetry thus seems to be related to family history of dyslexia.

Asymmetric development of the nervous system

The human nervous system consists of seemingly symmetric left and right halves. However, closer observation of the brain reveals anatomical and functional lateralization. Defects in brain asymmetry correlate with several neurological disorders, yet our understanding of the mechanisms used to establish lateralization in the human central nervous system is extremely limited. Here, we review left-right asymmetries within the nervous system of humans and several model organisms, including rodents, Zebrafish, chickens, Xenopus, Drosophila, and the nematode Caenorhabditis elegans. Comparing and contrasting mechanisms used to develop left-right asymmetry in the nervous system can provide insight into how the human brain is lateralized. Developmental Dynamics 247:124-137, 2018. © 2017 Wiley Periodicals, Inc.

Cortical thickness abnormalities associated with dyslexia, independent of remediation status

Abnormalities in cortical structure are commonly observed in children with dyslexia in key regions of the "reading network." Whether alteration in cortical features reflects pathology inherent to dyslexia or environmental influence (e.g., impoverished reading experience) remains unclear. To address this question, we compared MRI-derived metrics of cortical thickness (CT), surface area (SA), gray matter volume (GMV), and their lateralization across three different groups of children with a historical diagnosis of dyslexia, who varied in current reading level. We compared three dyslexia subgroups with: (1) persistent reading and spelling impairment; (2) remediated reading impairment (normal reading scores), and (3) remediated reading and spelling impairments (normal reading and spelling scores); and a control group of (4) typically developing children. All groups were matched for age, gender, handedness, and IQ. We hypothesized that the dyslexia group would show cortical abnormalities in regions of the reading network relative to controls, irrespective of remediation status. Such a finding would support that cortical abnormalities are inherent to dyslexia and are not a consequence of abnormal reading experience. Results revealed increased CT of the left fusiform gyrus in the dyslexia group relative to controls. Similarly, the dyslexia group showed CT increase of the right superior temporal gyrus, extending into the planum temporale, which resulted in a rightward CT asymmetry on lateralization indices. There were no group differences in SA, GMV, or their lateralization. These findings held true regardless of remediation status. Each reading level group showed the same "double hit" of atypically increased left fusiform CT and rightward superior temporal CT asymmetry. Thus, findings provide evidence that a developmental history of dyslexia is associated with CT abnormalities, independent of remediation status.

Structural asymmetry of anterior insula: behavioral correlates and individual differences

The current study investigated behavioral correlates of structural asymmetry of the insula, and traditional perisylvian language regions, in a large sample of young adults (N=200). The findings indicated (1) reliable leftward surface area asymmetry of the anterior insula, (2) association of this asymmetry with divided visual field lateralization of visual word recognition, and (3) modulation of the correlation of structural and linguistic asymmetry by consistency of hand preference. Although leftward asymmetry of cortical surface area was observed for the anterior insula, pars opercularis and triangularis, and planum temporale, only the anterior insula asymmetry was associated with lateralized word recognition. We interpret these findings within the context of recent structural and functional findings about the human insula. We suggest that leftward structural lateralization of earlier developing insular cortex may bootstrap asymmetrical functional lateralization even if the insula is only a minor component of the adult language network.

White matter lateralization and interhemispheric coherence to auditory modulations in normal reading and dyslexic adults

Neural activation of slow acoustic variations that are important for syllable identification is more lateralized to the right hemisphere than activation of fast acoustic changes that are important for phoneme identification. It has been suggested that this complementary function at different hemispheres is rooted in a different degree of white matter myelination in the left versus right hemisphere. The present study will investigate this structure-function relationship with Diffusion Tensor Imaging (DTI) and Auditory Steady-State Responses (ASSR), respectively. With DTI we examined white matter lateralization in the cortical auditory and language regions (i.e. posterior region of the superior temporal gyrus and the arcuate fasciculus) and white matter integrity in the splenium of the corpus callosum. With ASSR we examined interhemispheric coherence to slow, syllabic-rate (i.e. 4 Hz) and fast, phonemic-rate (i.e. 20 Hz) modulations. These structural and functional techniques were applied in a group of normal reading adults and a group of dyslexic adults for whom previously reduced functional interhemispheric connectivity at 20 Hz has been reported (Poelmans et al. (2012). Ear and Hearing, 33, 134-143). This sample was chosen since it is hypothesized that in dyslexic readers insufficient hemispheric asymmetry in myelination might relate to their auditory and phonological problems. Results demonstrate reduced white matter lateralization in the posterior superior temporal gyrus and the arcuate fasciculus in the dyslexic readers. Additionally, white matter lateralization in the posterior superior temporal gyrus and white matter integrity in the splenium of the corpus callosum related to interhemispheric coherence to phonemic-rate modulations (i.e. 20 Hz). Interestingly, this correlation pattern was opposite in normal versus dyslexic readers. These results might imply that less pronounced left white matter dominance in dyslexic adults might relate to their problems to process phonemic-rate acoustic information and to integrate them into the phonological system.

Cerebral asymmetry and language development: cause, correlate, or consequence?

In most people, language is processed predominantly by the left hemisphere of the brain, but we do not know how or why. A popular view is that developmental language disorders result from a poorly lateralized brain, but until recently, evidence has been weak and indirect. Modern neuroimaging methods have made it possible to study normal and abnormal development of lateralized function in the developing brain and have confirmed links with language and literacy impairments. However, there is little evidence that weak cerebral lateralization has common genetic origins with language and literacy impairments. Our understanding of the association between atypical language lateralization and developmental disorders may benefit if we reconceptualize the nature of cerebral asymmetry to recognize its multidimensionality and consider variation in lateralization over developmental time. Contrary to popular belief, cerebral lateralization may not be a highly heritable, stable characteristic of individuals; rather, weak lateralization may be a consequence of impaired language learning.

The genetics of reading disabilities: from phenotypes to candidate genes

This article provides an overview of (a) issues in definition and diagnosis of specific reading disabilities at the behavioral level that may occur in different constellations of developmental and phenotypic profiles (patterns); (b) rapidly expanding research on genetic heterogeneity and gene candidates for dyslexia and other reading disabilities; (c) emerging research on gene-brain relationships; and (d) current understanding of epigenetic mechanisms whereby environmental events may alter behavioral expression of genetic variations. A glossary of genetic terms (denoted by bold font) is provided for readers not familiar with the technical terms.

Dyslexia

Developmental dyslexia (DD) is a specific and persistent disability affecting the acquisition of written language. Prevalence is estimated to be between 5% and 17% of school-aged children; it therefore represents a major public health issue. Neurological in origin, its causes are unknown, although there is a clear genetic component. Diagnosis rests upon the use of standardized tests and tools to assess reading and spelling, as well as phonological skills. The importance of early diagnosis cannot be overemphasized and much current research is focusing on screening and prediction, particularly through use of objective imaging techniques (e.g., EEG/MEG), which have implicated cortical abnormalities in central auditory processing (Giraud et al., 2005, 2008). Remediation should be intensive, begin as early as possible, and be tailored to the individual. Phonics based treatments are most effective and several variants, incorporating temporal auditory, articulatory, or multisensory training exercises, have been developed or proposed. Clinical improvements in phonological skills and reading with such treatments have been shown to correlate with changes in the brains of dyslexic children in several functional imaging studies.

Newborn event-related potentials predict poorer pre-reading skills in children at risk for dyslexia

Earlier results from the Jyväskylä Longitudinal Study of Dyslexia showed that newborn event-related potentials (ERPs) of children with and without familial risk for dyslexia were associated with receptive language and verbal memory skills between 2.5 and 5 years of age. We further examined whether these ERPs (responses to synthetic consonant-vowel syllables /ba/, /da/, /ga/; presented equiprobably with 3,910-7,285 ms interstimulus intervals) predict later pre-reading skills measured before the onset of school (6.5 years of age). In line with our earlier results, the at-risk children (N = 11) with atypical speech processing in the right hemisphere (a slower shift in polarity from positivity to negativity in responses to /ga/ at 540-630 ms) scored significantly lower in phonological skills, rapid naming, and letter knowledge than the control children (N = 10) without enhanced right hemispheric speech processing. These results further extend our earlier findings of newborn ERPs in predicting poorer language skills. These consistent differences in ERPs to speech sounds may have applications in the future for the early identification of children at risk for developmental language problems. This would facilitate well-directed intervention even before reading problems are typically diagnosed.

Brain imaging findings in dyslexia

Dyslexia is a brain-based disorder that has been intensively studied in the Western world for more than a century because of its social burden. However, affected individuals in Chinese communities are neither recognized nor formally diagnosed. Previous studies have concentrated on the disadvantages of reading deficits, and few have addressed non-linguistic skills, which are included in the symptoms. In addition, certain dyslexics possess visual spatial talents that have usually been ignored. In this review, we discuss the available information regarding brain imaging studies of dyslexia based on studies in Caucasian subjects. Gray matter deficits have been demonstrated in dyslexics using structural magnetic resonance imaging. Reduced neural activities in the left temporal and left parietal cortices, and diffuse widespread activation patterns in the cerebellum could be detected using functional magnetic resonance imaging. Changes in lactate levels, N-acetylaspartate/choline-containing compounds and N-acetylaspartate/creatine ratios, and phosphomonoester peak area were detected in magnetic resonance spectroscopy studies. Lower fractional anisotropy values in bilateral white matter tracts have been demonstrated by diffusion tensor imaging. Abnormal Broca's area activation was found using positron emission tomography imaging. Increased activities in the right frontal and temporal brain regions were detected using electroencephalography. Reduced hemispheric asymmetry and increased left inferior frontal activation were reported following magnetoencephalography. Although these imaging modalities are not currently diagnostic or prognostic, they are able to provide information on the causes of dyslexia beyond what was previously provided by behavioral or cognition studies.

The pars triangularis in dyslexia and ADHD: A comprehensive approach

Limited research has been conducted on the structure of the pars triangularis (PT) in dyslexia despite functional neuroimaging research finding it may play a role in phonological processing. Furthermore, research to date has not examined PT size in ADHD even though the right inferior frontal region has been implicated in the disorder. Hence, one of the purposes of this study was to examine the structure of the PT in dyslexia and ADHD. The other purposes included examining the PT in relation to overall expressive language ability and in relation to several specific linguistic functions given language functioning often is affected in both dyslexia and ADHD. Participants included 50 children: 10 with dyslexia, 15 with comorbid dyslexia/ADHD, 15 with ADHD, and 10 controls. Using a 2 (dyslexia or not) x 2 (ADHD or not) MANCOVA, findings revealed PT length and shape were comparable between those with and without dyslexia. However, children with ADHD had smaller right PT lengths than those without ADHD, and right anterior ascending ramus length was related to attention problems in the total sample. In terms of linguistic functioning, presence of an extra sulcus in the left PT was related to poor expressive language ability. In those with adequate expressive language functioning, left PT length was related to phonological awareness, phonological short-term memory and rapid automatic naming (RAN). Right PT length was related to RAN and semantic processing. Further work on PT morphology in relation to ADHD and linguistic functioning is warranted.

A dual DTI approach to analyzing white matter in children with dyslexia

Using voxel-based (VBA) and region-of-interest (ROI) diffusion tensor imaging (DTI) analyses, we examined white matter (WM) organization in seven children with dyslexia and six age-matched controls. Both methods demonstrated reduced fractional anisotropy (FA) in the left superior longitudinal fasciculus (SLF) and abnormal orientation in the right SLF in dyslexics. Application of this complementary dual DTI approach to dyslexia, which included novel analyses of fiber orientation, demonstrates its usefulness for analyzing mild and complex WM abnormalities.

The relationship between cerebral hemisphere volume and receptive language functioning in dyslexia and attention-deficit hyperactivity disorder (ADHD)

Because poor comprehension has been associated with small cerebral volume and there is a high comorbidity between developmental dyslexia, attention-deficit hyperactivity disorder (ADHD), and specific language impairment, the goal of this study was to determine whether cerebral volume is reduced in dyslexia and attention-deficit hyperactivity disorder in general, as some suggest, or whether the reduction in volume corresponds to poor receptive language functioning, regardless of the diagnosis. Participants included 46 children with and without dyslexia and attention-deficit hyperactivity disorder, aged 8 to 12 years. Our results indicated that cerebral volume was comparable between those with and without dyslexia and attention-deficit hyperactivity disorder overall. However, when groups were further divided into those with and without receptive language difficulties, children with poor receptive language had smaller volumes bilaterally as hypothesized. Nonetheless, the relationship between cerebral volume and receptive language was not linear; rather, our results suggest that small volume is associated with poor receptive language only in those with the smallest volumes in both dyslexia and attention-deficit hyperactivity disorder.

Dichotic listening deficits in children with dyslexia

Several auditory processing deficits have been reported in children with dyslexia. In order to assess for the presence of a binaural integration type of auditory processing deficit, dichotic listening tests with digits, words and consonant-vowel (CV) pairs were administered to two groups of right-handed 11-year-old children, one group diagnosed with developmental dyslexia and an age-matched control group. Dyslexic children performed more poorly than controls from their left ears when listening to digits and words and from their right ears when listening to CVs. Direction of ear advantage varied across individuals in both groups when tested with digits and CVs, but ear advantage was stable with words. Several factors that may have contributed to inconsistencies in direction of ear advantage are discussed. When the children were tested in a directed response mode, degree of ear advantage differed significantly between groups with both words and digits. More dyslexic than control children demonstrated clinically significant reductions in dichotic listening performance, but no uniform pattern of deficit emerged. Only the double correct score and the left ear score with CV pairs were predictive of word recognition performance in dyslexic children. Binaural integration deficits are present in some children with dyslexia. Auditory processing disorder assessment may help delineate factors that underlie or are associated with reading impairment in this population.

Neuropsychology and genetics of speech, language, and literacy disorders

The authors review the neuropsychology, brain bases, and genetics of three related disorders of language development: reading disability, or developmental dyslexia (RD); language impairment (LI); and speech sound disorder (SSD). Over the past three decades, cognitive analysis has demonstrated that the reading difficulties of most children who have RD result from phonologic impairments (difficulties processing the sound structure of language). Although understanding of LI and SSD is somewhat less developed, both disorders are also associated with phonologic impairments, which may account for their comorbidity with RD. Research across levels of analysis is progressing rapidly to promote understanding not only of each disorder by itself but also of the relationships of the three disorders to each other.

Étude de l’impact du contrôle postural associé au port de verres prismatiques dans la réduction des troubles cognitifs chez le dyslexique de développement

PURPOSE

To evaluate the consequences of proprioception changes induced by a postural treatment on cognitive disturbances in children suffering from developmental dyslexia.

MATERIAL

and methods: Twenty male dyslexic children were treated with prisms within their spectacles and a postural treatment. A control group of dyslexics (n=13) only received spectacles without prisms. All participants were evaluated at the beginning of the study and 6 months later with reading impairment tests and postural examinations.

RESULTS

Mean age was 11 years and 5 months in the treated group and 11 years and 7 months in the control group. Four children were excluded from the 6-month analysis because of poor compliance. All dyslexic children presented with a postural deficiency syndrome. In 13 out of 16 treated children, dyslexia was improved at 6 months, especially for the global leximetric test and the reading of regular and irregular words. However, the treatment did not allow a complete recovery of reading ability when compared with age-matched individuals.

CONCLUSION

Our results show that postural modifications may favorably influence some clinical signs associated with developmental dyslexia. Further studies with a larger sample and with a longer follow-up period are required to better assess the role of postural treatment in developmental dyslexia.

Converging evidence for triple word form theory in children with dyslexia

This article has 3 parts. The 1st part provides an overview of the family genetics, brain imaging, and treatment research in the University of Washington Multidisciplinary Learning Disabilities Center (UWLDC) over the past decade that points to a probable genetic basis for the unusual difficulty that individuals with dyslexia encounter in learning to read and spell. Phenotyping studies have found evidence that phonological, orthographic, and morphological word forms and their parts may contribute uniquely to this difficulty. At the same time, reviews of treatment studies in the UWLDC (which focused on children in Grades 4 to 6) and other research centers provide evidence for the plasticity of the brain in individuals with dyslexia. The 2nd part reports 4 sets of results that extend previously published findings based on group analyses to those based on analyses of individual brains and that support triple word form awareness and mapping theory: (a) distinct brain signatures for the phonological, morphological, and orthographic word forms; (b) crossover effects between phonological and morphological treatments and functional magentic resonance imaging (fMRI) tasks in response to instruction, suggestive of cross-word form computational and mapping processes; (c) crossover effects between behavioral measures of phonology or morphology and changes in fMRI activation following treatment; and (d) change in the relationship between structural MRI and functional magnetic resonance spectroscopy (fMRS) lactate activation in right and left inferior frontal gyri following treatment emphasizing the phonological, morphological, and orthographic word forms. In the 3rd part we discuss the next steps in this programmatic research to move beyond word form alone.

Planum temporale volume in children and adolescents with autism

Previous research has revealed a lack of planum temporale (PT) asymmetry in adults with autism. This finding is now extended to children and adolescents with the disorder. MRI scans were obtained from 12 children with autism and 12 gender, handedness and age-matched comparison participants. The volume of gray matter in the PT and Heschl's gyrus (HG) in both hemispheres was measured. PT volume was larger in the left hemisphere than in the right in the comparison, but not the autism group. This specifically reflected reduced volume of the left PT in the autism group. There were noted differences in the overall morphological appearance of the right Sylvian fissure in the autism group, but no volumetric difference in the right PT. No differences in HG volumes were observed between the two groups. Lack of PT asymmetry may suggest an early neurodevelopmental disturbance in autism.

Dyslexia--a molecular disorder of neuronal migration: the 2004 Norman Geschwind Memorial Lecture

For 25 years now, there has been a serious attempt to get at the fundamental cause(s) of dyslexia in our laboratory. A great deal of research has been carried out on the psychological and brain underpinnings of the linguistic dysfunctions seen in dyslexia, but attempts to get at its cause have been limited. Initially, observations were made on the brains of persons with dyslexia who had died and their brains donated for research. These observations were modeled in animal models in order to better understand the full extent of anatomical and developmental brain characteristics. More recently, models have begun to employ genetic manipulations in order to close the gap between genes, brain, and behavior. In this article based on a lecture given in memory of Dr. Norman Geschwind to the International Dyslexia Association assembly in Philadelphia in 2004, I outline the history of the research leading up to the most recent findings. These findings consist of experiments using methods that interfere with the function of DNA, using as constructs genes that have been implicated in dyslexia, which cause developmental problems of neuronal migration in rats, secondary brain changes in response to the migration problems, and abnormal processing of sounds.

Dyslexics are impaired on implicit higher-order sequence learning, but not on implicit spatial context learning

Developmental dyslexia is characterized by poor reading ability and impairments on a range of tasks including phonological processing and processing of sensory information. Some recent studies have found deficits in implicit sequence learning using the serial reaction time task, but others have not. Other skills, such as global visuo-spatial processing may even be enhanced in dyslexics, although deficits have also been noted. The present study compared dyslexic and non-dyslexic college students on two implicit learning tasks, an alternating serial response time task in which sequential dependencies exist across non-adjacent elements and a spatial context learning task in which the global configuration of a display cues the location of a search target. Previous evidence indicates that these implicit learning tasks are based on different underlying brain systems, fronto-striatal-cerebellar circuits for sequence learning and medial temporal lobe for spatial context learning. Results revealed a double dissociation: dyslexics showed impaired sequence learning, but superior spatial context learning. Consistent with this group difference, there was a significant positive correlation between reading ability (single real and non-word reading) and sequence learning, but a significant negative correlation between these measures and spatial context learning. Tests of explicit knowledge confirmed that learning was implicit for both groups on both tasks. These findings indicate that dyslexic college students are impaired on some kinds of implicit learning, but not on others. The specific nature of their learning deficit is consistent with reports of physiological and anatomical differences for individuals with dyslexia in frontal and cerebellar structures.

Reading development and impairment: behavioral, social, and neurobiological factors

What are the cognitive and neurobiological building blocks necessary for children to acquire literacy, a skill that is crucial for academic and life achievement? In this review we discuss the behavioral and neurobiological evidence concerning the bases of reading development and impairment. The means by which reading achievement may be influenced by the background and experiences that a child brings to the classroom are discussed. Finally, we review a series of experimental studies that have examined the cognitive and neurobiological response prior to and following reading intervention in struggling readers. The importance of appropriate control groups is stressed, as well as the ultimate goal of designing reading interventions that target individual needs.

Anatomical signatures of dyslexia in children: unique information from manual and voxel based morphometry brain measures

Thirteen male control and thirteen male dyslexic children (age, 121-152 months) were studied to determine if voxel based morphometry (VBM) could identify anatomical differences in the right cerebellar anterior lobe, and right and left pars triangularis that were identified with manual measures of the same children. VBM demonstrated significant gray and white matter differences in these three brain regions. In contrast to the manual results, these differences were not significant after controlling for brain volume, suggesting the manual measures captured additional important variance that distinguished the groups. Post-hoc VBM comparisons demonstrated white matter volume differences in a left temporal-parietal region that are consistent in location with results from diffusion tensor imaging studies of dyslexia. The VBM analyses also identified, gray matter volume differences in the left and right lingual gyrus, left inferior parietal lobule and cerebellum, areas that had not been examined with manual methods. We conclude that manual and automated methods provide valuable and complementary approaches to the search for functionally significant neurobiological characteristics of dyslexia.

Gray matter alteration in dyslexia: converging evidence from volumetric and voxel-by-voxel MRI analyses

Affecting up to 4-10% of the population, dyslexia is a highly prevalent, childhood onset developmental disorder adversely influencing multiple domains of adaptive functioning throughout the lifespan. The present brain imaging study was conducted in order to investigate the neuroanatomical correlates of developmental dyslexia. The MRI brain scans of 10 males with dyslexia and 14 matched controls were analyzed with (1) a classical volumetric method measuring gray and white matter lobar volumes and (2) a voxel-by-voxel method. The voxel-by-voxel method identifies changes in tissue density and localizes morphologic alterations without limiting the analyses to predefined regions. Subsequent correlations between gray matter density and neuropsychological performance on specific phonological processing tasks (rhyme judgment) were conducted. Volumetric analyses revealed significantly reduced gray matter volumes in both temporal lobes in dyslexic individuals. The voxel-by-voxel analyses further localized changes to the left temporal lobe, revealing reduced gray matter density in the middle and inferior temporal gyri. Conversely, increased gray matter density was found in the precentral gyri bilaterally. As a combined group, the dyslexic and control subjects demonstrated positive correlations between performance on the rhyme judgment tasks and gray matter density in the middle and inferior frontal gyri, and the middle temporal gyri bilaterally. The current study indicates that dyslexia is associated with a structural gray matter deficit involving a complex fronto-temporal network implicated in phonological processing.

Brain Event-Related Potentials (ERPs) Measured at Birth Predict Later Language Development in Children with and Without Familial Risk for Dyslexia

We report associations between brain event-related potentials (ERPs) measured from newborns with and without familial risk for dyslexia and these same children's later language and verbal memory skills at 2.5, 3.5, and 5 years of age. ERPs to synthetic consonant-vowel syllables (/ba/, /da/, /ga/; presented equiprobably with 3,910-7,285 msec interstimulus intervals) were recorded from 26 newborns at risk for familial dyslexia and 23 control infants participating in the Jyväskylä Longitudinal Study of Dyslexia. The correlation and regression analyses showed that the at-risk type of response pattern at birth (a slower shift in polarity from positivity to negativity in responses to /ga/ at 540-630 msec) in the right hemisphere was related to significantly poorer receptive language skills across both groups at the age of 2.5 years. The similar ERP pattern in the left hemisphere was associated with poorer verbal memory skills at the age of 5 years. These results demonstrate that ERPs of newborns may be valid predictors of later language and neurocognitive outcomes.

Cortical differentiation of speech and nonspeech sounds at 100 ms: implications for dyslexia

Neurophysiological measures indicate cortical sensitivity to speech sounds by 150 ms after stimulus onset. In this time window dyslexic subjects start to show abnormal cortical processing. We investigated whether phonetic analysis is reflected in the robust auditory cortical activation at approximately 100 ms (N100m), and whether dyslexic subjects show abnormal N100m responses to speech or nonspeech sounds. We used magnetoencephalography to record auditory responses of 10 normally reading and 10 dyslexic adults. The speech stimuli were synthetic Finnish speech sounds (/a/, /u/, /pa/, /ka/). The nonspeech stimuli were complex nonspeech sounds and simple sine wave tones, composed of the F1+F2+F3 and F2 formant frequencies of the speech sounds, respectively. All sounds evoked a prominent N100m response in the bilateral auditory cortices. The N100m activation was stronger to speech than nonspeech sounds in the left but not in the right auditory cortex, in both subject groups. The leftward shift of hemispheric balance for speech sounds is likely to reflect analysis at the phonetic level. In dyslexic subjects the overall interhemispheric amplitude balance and timing were altered for all sound types alike. Dyslexic individuals thus seem to have an unusual cortical organization of general auditory processing in the time window of speech-sensitive analysis.

Neuroanatomical markers for dyslexia: a review of dyslexia structural imaging studies

A neuroanatomical description of dyslexia has been elusive, due in part to the complex cognitive nature of dyslexia. People with dyslexia have varying degrees of impairment in reading skills that engage oral and written language (reading) neural networks. Although findings for the inferior parietal lobule, inferior frontal gyrus, and cerebellum have been relatively consistent across studies, these studies also demonstrate that anatomical patterns of results vary according to the reading skills that characterize dyslexia. The number and likelihood of atypical anatomical findings in oral and/or written language systems appears to be related to the pattern of impairments in measures of phonology, orthography, and fluency. A comprehensive neurobiological understanding of dyslexia will depend on studies of dyslexic individuals with homogeneous perceptual, cognitive, and genetic backgrounds.

Reduced brain size and gyrification in the brains of dyslexic patients

Dyslexia is a specific learning disability that affects the way in which a person acquires reading skills. The pathologic substrate of the condition has been debated in the literature. Conclusions from postmortem studies remain controversial because series have been based on few and often ill-characterized cases. The present article expands on one of the reported neuropathologic findings in dyslexia, that is, wider minicolumns. Measurements were made of magnetic resonance images in a series of 16 dyslexic and 14 age- and sex-matched controls. Dyslexic patients had significantly smaller total cerebral volume (P = .014) and reduced gyrification index (P = .021). No changes were noted in cortical thickness, the ratio of gray to white matter, or the cross-sectional areas of the corpus callosum and medulla oblongata. The findings, although not conclusive, are in keeping with a minicolumnar defect in dyslexia. The decreased gyrification and preserved cortical thickness can alter the information processing capacity of the brain by providing a greater degree of cortical integration at the expense of a slower response time. The article also emphasizes the contrast between findings in dyslexia and in autism.

The development of reading impairment: a cognitive neuroscience model

This review discusses recent cognitive neuroscience investigations into the biological bases of developmental dyslexia, a common disorder impacting approximately 5 to 17 percent of the population. Our aim is to summarize central findings from several lines of evidence that converge on pivotal aspects of the brain bases of developmental dyslexia. We highlight ways in which the approaches and methodologies of developmental cognitive neuroscience that are addressed in this special issue-including neuroimaging, human genetics, refinement of cognitive and biological phenotypes, neural plasticity and computational model-can be employed in uncovering the biological bases of this disorder. Taking a developmental perspective on the biological bases of dyslexia, we propose a simple cascading model for the developmental progression of this disorder, in which individual differences in brain areas associated with phonological processing might influence the specialization of visual areas involved in the rapid processing of written words. We also discuss recent efforts to understand the impact of successful reading interventions in terms of changes within cortical circuits associated with reading ability.

Atypical cerebral laterality in adults with persistent developmental stuttering

BACKGROUND

Two of the most consistent anatomic asymmetries found in the human brain are a larger right than left prefrontal and left than right occipital lobe. Reduced or reversed asymmetries of these regions are considered markers of atypical cerebral laterality, and atypical cerebral laterality has been proposed to increase neural risk for developmental stuttering.

OBJECTIVE

S: To learn if atypical prefrontal and occipital lobe asymmetries are more common in adults who stutter vs fluent control subjects and to determine whether lobar size or asymmetry patterns are associated with stuttering severity or language abilities.

METHODS

Adults with persistent developmental stuttering (n = 16) and matched control subjects (n = 16) had language and stuttering assessments. Subjects were also studied with volumetric MRI scans. Total hemisphere, prefrontal, and occipital lobe regions were measured, and volumes were calculated proportionally to hemisphere volume.

RESULTS

Hemisphere and total brain volumes did not differ between the groups. Control subjects had the expected larger right than left prefrontal and larger left than right occipital lobe volume. In contrast, the adults who stutter did not have these asymmetries. Stuttering severity was not associated with specific anatomic configurations, whereas language-processing deficits in adults who stutter were associated with prefrontal and occipital volume reduction.

CONCLUSIONS

Developmental stuttering is associated with atypical prefrontal and occipital lobe asymmetries. In addition, deficits in language processing were associated with some anatomic measures in the adults who stutter.

Diminished auditory mismatch fields in dyslexic adults

Electroencephalographic studies have demonstrated smaller auditory responses to infrequent deviances of speech and nonspeech sounds in dyslexic than normal-reading subjects. We used a whole-scalp neuromagnetometer to study selectively reactivity of the auditory cortices to sound deviances in 8 dyslexic and 11 normal-reading adults. Within a monotonous sequence of 50-millisecond 1000 Hz binaural tones, tones of 920 and 1080 Hz occurred with 7% probability each. Magnetic mismatch fields, elicited by the stimulus deviances, were diminished in the left hemisphere of the dyslexic subjects. The results indicate deficient change detection in the left auditory cortex of right-handed dyslexic adults.

Anatomical risk factors that distinguish dyslexia from SLI predict reading skill in normal children

These studies investigated whether anatomical measures could separate phonologically-based reading disability (PD) from nonphonologically-based learning disabilities such as specific language impairment (SLI). In a previous study. four brain measures (cerebral asymmetry. summed planum temporale and parietale asymmetry, anterior cerebellar asymmetry, and a duplicated left Heschl's gyrus) distinguished a group of PD adults from reading disabled adults without specific phonological deficits (URD). Study 1 found that these measures did not distinguish 14 reading disabled children from 21 children with SLI. Instead, differences were found in cerebral volume, planum temporale asymmetry, and the size of a single left Heschl's gyrus. Study 2 demonstrated that including all seven measures in a discriminant analysis separated the adults and children into two groups: one with 100% of the PD adults and 75% of the reading disabled children and the other with 72% of the SLI children and 75% of the URD adults. Study 3 demonstrated that an anatomical risk factor index (ARF7) generated from the discriminant function with seven brain measures predicted reading in normal children. Children with ARF7 near 0 (normal anatomy) had superior verbal ability and phonological decoding scores that improved with age. Normal children with negative ARF7 the relatively s mall symmetrical structures that characterize SLI)had deficits in verbal ability. Children with positive ARF7 (the asymmetrical structures that characterize PD) had phonological decoding scores that decreased with age. These results suggest that PD and SLI are qualitatively different disorders associated with anatomical deviations in opposite directions from the population mean.

LEARNING OUTCOMES

As a result of this activity, the participant will be able to: (1) distinguish the neuroanatomical features that characterize PD and SLI; (2) recognize that PD is associated with large asymmetrical brain structures while SLI is associated with smaller symmetrical brain structures; (3) understand that children with moderate sized brains and whose anatomy is intermediate between symmetry and extreme asymmetry have an enhanced probability of developing good verbal ability; (4) understand that reading disabilities depend on the interaction of neurodevelopment and the environment.

Pure severe dyslexia after a perinatal focal lesion: evidence of a specific module for acquisition of reading

A child with a small, residual "localized" perinatally acquired left hemisphere temporal tip lesion is described. He presents with pure and severe dyslexia and average to high-average cognitive skills, which are usually in the low-average range in patients with developmental dyslexia. A highly circumscribed deficit of rote auditory verbal memory was the only deficit other than the dyslexia; his verbal semantic memory and visuospatial memory were intact. Two previously reported cases present a similar functional profile and lesion locus. This profile indicates that there may exist, at birth, a localized neural network dedicated to "reading acquisition" and that the layout of this network may differ from the systems identified as defective in developmental dyslexia, as well as in cases of acquired dyslexia in adults.

The epigenesis of planum temporale asymmetry in twins

Variation in hemispheric asymmetry of the planum temporale (PT) has been related to verbal ability. The degree to which genetic and environmental factors mediate PT asymmetry is not known. This study examined the heritability for planar asymmetry in 12 dizygotic (DZ) and 27 monozygotic (MZ) male twin pairs who were between 6 and 16 years of age. There was weak but positive evidence for heritability of planar asymmetry. Co-twin similarity for planar asymmetry and Sylvian fissure morphology increased when excluding twins discordant for writing hand and when excluding twins exhibiting birth weight differences >20% from the analyses. Birth weight differences were also related to twin differences in total cerebral volume, but not central sulcus asymmetry. These results suggest that exogenous perinatal factors affect the epigenesis of planar asymmetry development.

Auditory cortical responses to speech-like stimuli in dyslexic adults

Auditory cortical processing of speech-like sounds was studied in 9 dyslexic and 11 normal-reading adults. Noise/square-wave sequences, mimicking transitions from a fricative consonant to a vowel, were presented binaurally once every 1.1 sec and the cortical responses were recorded with a whole-scalp neuromagnetometer. The auditory cortices of both hemispheres were less reactive to acoustical changes in dyslexics than in controls, as was evident from the weaker responses to the noise/square-wave transitions. The results demonstrate that dyslexic adults are deficient in processing acoustic changes presented in rapid succession within tens to hundreds of milliseconds. The observed differences could be related to insufficient triggering of automatic auditory attention, resulting, for instance, from a general deficiency of the magnocellular system.