Effect of corpus callosum agenesis on the language network in children and adolescents

Verbal training can improve neurocognitive and reading performance by increasing white matter integrity and grey matter volume

INTRODUCTION

Dementia and mild cognitive impairment (MCI) present both health and economic challenges on a global scale, thus affecting millions of people, and is projected to increase significantly by the year 2050. Early language processing deficits are evident in those diagnosed with Alzheimer's disease and MCI. Recent advances in pharmacologic and non-pharmacologic interventions, including cognitive rehabilitation and training, show promising effects on cognitive functions. Articulation training, particularly, is highlighted for its potential in addressing the communication difficulties which those experiencing dementia and MCI face, based on the transmission deficit hypothesis. This study aimed to perform a voxel-wise comparison of morphological changes in grey matter volume as well as white matter integrity to represent the plastic changes in response to articulation training among older, healthy Japanese adults.

METHODS

Forty older, healthy Japanese adults were randomized into either a cognitive training group or a control group. The study involved comprehensive behavioral assessments, neuroimaging (including 3D anatomy, fMRI and Diffusion Tensor Imaging), and a structured verbal articulation training regimen. The training included reading tasks which focused on enhancing both articulation and phonological skills. Neuroimaging data were acquired using a 3 Tesla Siemens MR scanner, with the FSL tool being used for white matter analysis and the CAT12 toolbox for grey matter analysis.

RESULTS

Significant increases in grey matter volume were observed in certain regions, including the left Supplementary motor area, Postcentral gyrus, and bilateral Superior frontal gyrus among those in the training group. Correlations were noted between reading abilities and cortical volume in areas such as the left Middle temporal gyrus, pulvinar, and Middle occipital gyrus. White matter integrity also improved, as evidenced by increased fractional anisotropy in tracts such as the superior longitudinal fasciculus, corona radiata, and internal capsule. These findings suggest a link between articulation training and enhanced neuroplasticity in both grey and white matter regions related to language processing.

CONCLUSION

The study demonstrates that a 4-week verbal articulation training intervention period can lead to significant improvements in grey matter volume in the left Supplementary motor area, the left Postcentral gyrus, and the bilateral Superior frontal gyrus, as well as the integrity of white matter tracts associated with language processing among older adults. These results suggest that such training could be a valuable tool in enhancing cognitive functions related to language in older populations.

Adynamic spoken language in corpus callosum dysgenesis

Corpus callosum dysgenesis (CCD) is a congenital brain malformation that occurs when the development of the corpus callosum is disrupted, either partially or completely. The cognitive outcomes in individuals with CCD vary greatly, but generally the neuropsychological profile is characterised by slow processing speed, poor transfer of interhemispheric sensory-motor information, and impaired complex problem solving. Core language skills are often preserved in CCD, but there is some evidence that complex language may be impaired. Thus, the current study sought to examine whether spontaneous speech output was reduced in a cohort of individuals with CCD compared to age-matched controls. We further explored a series of factors that may be contributing to poor spontaneous speech in CCD, such as difficulties generating, selecting, and sequencing ideas for expression, as well as apathy and slowed processing speed. A cohort of 25 individuals with CCD and 39 neurotypical controls were enrolled in this study. Participants completed a picture description task to measure spontaneous speech output, alongside a series of cognitive and language baseline tests. Verbal and nonverbal fluency tasks gauged idea generation and sequencing, and sentence-level selection tasks measured idea selection. We found that, despite having largely intact core language skills, individuals with CCD produced significantly less spontaneous speech on the picture description task than controls. This language profile may be described as "adynamic". Further, we found that poor spontaneous speech output in CCD was related to problems generating ideas for expression, as individuals with CCD performed below controls on the verbal and nonverbal fluency tasks. Exploratory analyses revealed that apathy and slowed processing speed may be contributing factors. Adynamia in CCD is a novel finding that may be an intervention target for improving communication skills in this population.

Microstructural Changes in the Corpus Callosum in Neurodegenerative Diseases

The corpus callosum, the largest white matter structure in the brain, plays a crucial role in interhemispheric communication and cognitive function. This review examines the microstructural changes observed in the corpus callosum across various neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis (ALS). New neuroimaging studies, mainly those that use diffusion tensor imaging (DTI) and advanced tractography methods, were put together to show how changes have happened in the organization of white matter and the connections between them. Some of the most common ways the corpus callosum breaks down are discussed, including less fractional anisotropy, higher mean diffusivity, and atrophy in certain regions. The relationship between these microstructural changes and cognitive decline, motor dysfunction, and disease progression is explored. Additionally, we consider the potential of corpus callosum imaging as a biomarker for early disease detection and monitoring. Studies show that people with these disorders have lower fractional anisotropy and higher mean diffusivity in the corpus callosum, often in ways that are specific to the disease. These changes often happen before gray matter atrophy and are linked to symptoms, which suggests that the corpus callosum could be used as an early sign of neurodegeneration. The review also highlights the implications of these findings for understanding disease mechanisms and developing therapeutic strategies. Future directions, including the application of advanced imaging techniques and longitudinal studies, are discussed to elucidate the role of corpus callosum degeneration in neurodegenerative processes. This review underscores the importance of the corpus callosum in understanding the pathophysiology of neurodegenerative diseases and its potential as a target for therapeutic interventions.

Language and communication functioning in children and adolescents with agenesis of the corpus callosum

The corpus callosum, the largest white matter inter-hemispheric pathway, is involved in language and communication. In a cohort of 15 children and adolescents (8-15 years) with developmental absence of the corpus callosum (AgCC), this study aimed to describe language and everyday communication functioning, and explored the role of anatomical factors, social risk, and non-verbal IQ in these outcomes. Standardised measures of language and everyday communication functioning, intellectual ability and social risk were used. AgCC classification and anterior commissure volume, a potential alternative pathway, were extracted from T1-weighted images. Participants with AgCC showed reduced receptive and expressive language compared with test norms, and high rates of language and communication impairments. Complete AgCC, higher social risk and lower non-verbal IQ were associated with communication difficulties. Anterior commissure volume was not associated with language and communication. Recognising heterogeneity in language and communication functioning enhances our understanding and suggests specific focuses for potential interventions.

Sex Differences in White Matter Diffusivity in Children with Developmental Dyslexia

Despite the high prevalence of developmental dyslexia in the U.S. population, research remains limited and possibly biased due to the overrepresentation of males in most dyslexic samples. Studying biological sex differences in the context of developmental dyslexia can help provide a more complete understanding of the neurological markers that underly this disorder. The current study aimed to explore sex differences in white matter diffusivity in typical and dyslexic samples in third and fourth graders. Participants were asked to complete behavioral/cognitive assessments at baseline followed by MRI scanning and diffusion-weighted imaging sequences. A series of ANOVAs were conducted for comparing group membership (developmental dyslexia or typically developing), gender status (F/M), and white matter diffusivity in the tracts of interest. The Results indicated significant differences in fractional anisotropy in the left hemisphere components of the inferior and superior (parietal and temporal) longitudinal fasciculi. While males with dyslexia had lower fractional anisotropy in these tracts compared to control males, no such differences were found in females. The results of the current study may suggest that females may use a more bilateral/alternative reading network.

Developmental surface dyslexia and dysgraphia in a child with corpus callosum agenesis: an approach to diagnosis and treatment

We present a case study detailing cognitive performance, functional neuroimaging, and effects of a hypothesis-driven treatment in a 10-year-old girl diagnosed with complete, isolated corpus callosum agenesis. Despite having average overall intellectual abilities, the girl exhibited profound surface dyslexia and dysgraphia. Spelling treatment significantly and persistently improved her spelling of trained irregular words, and this improvement generalized to reading accuracy and speed of trained words. Diffusion weighted imaging revealed strengthened intrahemispheric white matter connectivity of the left temporal cortex after treatment and identified interhemispheric connectivity between the occipital lobes, likely facilitated by a pathway crossing the midline via the posterior commissure. This case underlines the corpus callosum's critical role in lexical reading and writing. It demonstrates that spelling treatment may enhance interhemispheric connectivity in corpus callosum agenesis through alternative pathways, boosting the development of a more efficient functional organization of the visual word form area within the left temporo-occipital cortex.

Beyond 'speech delay': Expanding the phenotype of BRPF1-related disorder

Pathogenic variants in BRPF1 cause intellectual disability, ptosis and facial dysmorphism. Speech and language deficits have been identified as a manifestation of BRPF1-related disorder but have not been systematically characterized. We provide a comprehensive delineation of speech and language abilities in BRPF1-related disorder and expand the phenotype. Speech and language, and health and medical history were assessed in 15 participants (male = 10, median age = 7 years 4 months) with 14 BRPF1 variants. Language disorders were common (11/12), and most had mild to moderate deficits across receptive, expressive, written, and social-pragmatic domains. Speech disorders were frequent (7/9), including phonological delay (6/9) and disorder (3/9), and childhood apraxia of speech (3/9). All those tested for cognitive abilities had a FSIQ ≥70 (4/4). Participants had vision impairment (13/15), fine (8/15) and gross motor delay (10/15) which often resolved in later childhood, infant feeding impairment (8/15), and infant hypotonia (9/15). We have implicated BRPF1-related disorder as causative for speech and language disorder, including childhood apraxia of speech. Adaptive behavior and cognition were strengths when compared to other monogenic neurodevelopmental chromatin-related disorders. The universal involvement of speech and language impairment is noteable, relative to the high degree of phenotypic variability in BRPF1-related disorder.

What happens to the inhibitory control functions of the right inferior frontal cortex when this area is dominant for language?

A low number of individuals show an atypical brain control of language functions that differs from the typical lateralization in the left cerebral hemisphere. In these cases, the neural distribution of other cognitive functions is not fully understood. Although there is a bias towards a mirrored brain organization consistent with the Causal hypothesis, some individuals are found to be exceptions to this rule. However, no study has focused on what happens to the homologous language areas in the right frontal inferior cortex. Using an fMRI-adapted stop-signal task in a healthy non right-handed sample (50 typically lateralized and 36 atypically lateralized for language production), our results show that atypical lateralization is associated with a mirrored brain organization of the inhibitory control network in the left hemisphere: inferior frontal cortex, presupplementary motor area, and subthalamic nucleus. However, the individual analyses revealed a large number of cases with a noteworthy overlap in the inferior frontal gyrus, which shared both inhibitory and language functions. Further analyses showed that atypical lateralization was associated with stronger functional interhemispheric connectivity and larger corpus callosum. Importantly, we did not find task performance differences as a function of lateralization, but there was an association between atypical dominance in the inferior frontal cortex and higher scores on schizotypy and autistic spectrum traits, as well as worse performance on a reading accuracy test. Together, these results partially support the Causal hypothesis of hemispheric specialization and provide further evidence of the link between atypical hemispheric lateralization and increased interhemispheric transfer through the corpus callosum.

Assessment of the corpus callosum size in male individuals with high intelligence quotient (members of Mensa International)

OBJECTIVES

The aim of this study was to assess the size of the corpus callosum in members of Mensa International, which is the world's largest and oldest high-intelligence quotient (IQ) society.

METHODS

We performed T2-weighted magnetic resonance imaging (Repetition Time, TR = 3200 ms, Time of Echo, TE = 409 ms) to examine the brain of members of Mensa International (Polish national group) in order to assess the size of the corpus callosum. Results from 113 male MENSA members and 96 controls in the age range of 21-40 years were analyzed.

RESULTS

The comparative analysis showed that the mean length of the corpus callosum and the thickness of the isthmus were significantly greater in the Mensa members compared to the control groups. A statistically significant difference was also identified in the largest linear dimension of the brain from the frontal lobe to the occipital lobe. The mean corpus callosum cross-sectional area and its ratio to the brain area were significantly greater in the Mensa members.

CONCLUSIONS

The results show that the dimensions (linear measures and midsagittal cross-sectional surface area) of the corpus callosum were significantly greater in the group of Mensa members than in the controls.

Interhemispheric functional brain connectivity predicts new language learning success in adults

Investigating interhemispheric interactions between homologous cortical regions during language processing is of interest. Despite prevalent left hemisphere lateralization of language, the right hemisphere also plays an important role and interhemispheric connectivity is influenced by language experience and is implicated in second language (L2) acquisition. Regions involved in language processing have differential connectivity to other cortical regions and to each other, and play specific roles in language. We examined the interhemispheric interactions of subregions of the inferior frontal gyrus (areas 44 and 45), the adjacent area 9/46v in the middle frontal gyrus, the superior temporal gyrus (STG), and the posterior inferior parietal lobule (pIPL) in relation to distinct and specific aspects of L2 learning success. The results indicated that the connectivity between left and right areas 44 and 9/46v predicted improvement in sentence repetition, connectivity between left and right area 45 and mid-STG predicted improvement in auditory comprehension, and connectivity between left and right pIPL predicted improvement in reading speed. We show interhemispheric interactions in the specific context of facilitating performance in adult L2 acquisition that follow an anterior to posterior gradient in the brain, and are consistent with the respective roles of these regions in language processing.

Neuropsychological profiles of children with agenesis of the corpus callosum: A scoping review

AIM

To understand the wide variety of clinical outcomes in children with agenesis of the corpus callosum (AgCC) and examine evidence for the proposed neuropsychological syndrome reported in adults with primary AgCC.

METHOD

PsycINFO, PsycArticles, Medline, Embase, and Web of Science (January 2007-November 2021) were searched to identify studies reporting on cognitive or neuropsychological outcome in children with AgCC aged up to 18 years. Twenty-three articles investigating the cognitive profile were found; their methodology was evaluated against quality criteria.

RESULTS

While there was a high degree of heterogeneity across studies, including the methodological quality, there was evidence for some features of the neuropsychological syndrome in children with AgCC. Vulnerabilities in executive function and social cognition were found, with particular difficulties on complex and novel tasks.

INTERPRETATION

Data on the neuropsychological outcomes in children with AgCC are limited. Broad assessments are necessary to determine the extent to which core features of the neuropsychological syndrome may characterize children with AgCC and how additional neuroanatomical features contribute to outcome.

Greater volumes of a callosal sub-region terminating in posterior language-related areas predict a stronger degree of language lateralization: A tractography study

Language lateralization is the most intriguing trait of functional asymmetry for cognitive functions. Nowadays, ontogenetic determinants of this trait are largely unknown, but there are efforts to find its anatomical correlates. In particular, a white matter interhemispheric connection-the corpus callosum-has been proposed as such. In the present study, we aimed to find the association between the degree of language lateralization and metrics of the callosal sub-regions. We applied a sentence completion fMRI task to measure the degree of language lateralization in a group of healthy participants balanced for handedness. We obtained the volumes and microstructural properties of callosal sub-regions with two tractography techniques, diffusion tensor imaging (DTI) and constrained spherical deconvolution (CSD). The analysis of DTI-based metrics did not reveal any significant associations with language lateralization. In contrast, CSD-based analysis revealed that the volumes of a callosal sub-region terminating in the core posterior language-related areas predict a stronger degree of language lateralization. This finding supports the specific inhibitory model implemented through the callosal fibers projecting into the core posterior language-related areas in the degree of language lateralization, with no relevant contribution of other callosal sub-regions.

Fetal Neurology: From Prenatal Counseling to Postnatal Follow-Up

Brain abnormalities detected in fetal life are being increasingly recognized. Child neurologists are often involved in fetal consultations, and specific fetal neurology training has been implemented in many countries. Pediatric neurologists are asked to examine the data available and to contribute to the definition of the long-term outcomes. Ventriculomegaly, posterior fossa malformations, and agenesis/dysgenesis of corpus callosum are among the most common reasons for antenatal neurological consultations. Fetuses with central nervous system and extra-CNS anomalies should ideally be managed in secondary/tertiary hospitals where obstetricians who are experts in fetal medicine and pediatric specialists are available. Obstetricians play a critical role in screening, performing detailed neurosonography, and referring to other specialists for additional investigations. Clinical geneticists are frequently asked to propose diagnostic tests and counsel complex fetal malformations whose phenotypes may differ from those during postnatal life. Advances in fetal MRI and genetic investigations can support the specialists involved in counseling. Nevertheless, data interpretation can be challenging, and it requires a high level of expertise in a multidisciplinary setting. Postnatally, child neurologists should be part of an integrated multidisciplinary follow-up, together with neonatologists and pediatricians. The neurodevelopmental outcomes should be assessed at least up to school age. Children should be evaluated with formal tests of their gross motor, cognitive, language, fine motor/visuo-perceptual skills, and their behavior. In this perspective, fetal neurology can be regarded as the beginning of a long journey which continues with a prolonged, structured follow-up, support to the families, and transition to adult life. A review of the most common conditions is presented, along with the long-term outcomes and a proposal of the neurodevelopmental follow-up of children with CNS malformation which are diagnosed in uterus.

Interhemispheric Brain Communication and the Evolution of Turn-Taking in Mammals

In the last 20 years, research on turn-taking and duetting has flourished in at least three, historically separate disciplines: animal behavior, language sciences, and music cognition. While different in scope and methods, all three ultimately share one goal—namely the understanding of timed interactions among conspecifics. In this perspective, we aim at connecting turn-taking and duetting across species from a neural perspective. While we are still far from a defined neuroethology of turn-taking, we argue that the human neuroscience of turn-taking and duetting can inform animal bioacoustics. For this, we focus on a particular concept, interhemispheric connectivity, and its main white-matter substrate, the corpus callosum. We provide an overview of the role of corpus callosum in human neuroscience and interactive music and speech. We hypothesize its mechanistic connection to turn-taking and duetting in our species, and a potential translational link to mammalian research. We conclude by illustrating empirical venues for neuroethological research of turn-taking and duetting in mammals.

Morphometry and functional connectivity of auditory cortex in school-age children with profound language disabilities: Five comparative case studies

Many neurodevelopmental conditions imply absent or severely reduced language capacities at school age. Evidence from functional magnetic resonance imaging is highly limited. We selected a series of five cases scanned with the same fMRI paradigm and the aim of relating individual language profiles onto underlying patterns of functional connectivity (FC) across auditory language cortex: three with neurogenetic syndromes (Coffin-Siris, Landau-Kleffner, and Fragile-X), one with idiopathic intellectual disability, one with autism spectrum disorder (ASD). Compared to both a group with typical development (TD) and a verbal ASD group (total N = 110), they all showed interhemispheric FC below two standard deviations of the TD mean. Children with higher language scores showed higher intrahemispheric FC between Heschl's gyrus and other auditory language regions, as well as an increase of FC during language stimulation compared to rest. An increase of FC in forward vs. reversed speech in the posterior and middle temporal gyri was seen across all cases. The Coffin-Siris case, the most severe, also had the most anomalous FC patterns and showed reduced myelin content, while the Landau-Kleffner case showed reduced cortical thickness. These results suggest potential for neural markers and mechanisms of severe language processing deficits under highly heterogeneous etiological conditions.

White matter alterations and cognitive outcomes in children born very low birth weight

BACKGROUND

Very low birth weight (VLBW) infants are at risk for disrupted white matter maturation, yet little is known about the contributing factors, particularly at preschool-age when cognitive difficulties begin to emerge. We examined white matter microstructure in five-year-old VLBW and full-term (FT) children, and its association with cognitive outcomes and birth weight.

METHODS

Multi-shell diffusion and MR images were obtained for 41 VLBW (mean birth weight: 1028.6 ± 256.8 g) and 26 FT (3295.4 ± 493.9 g) children. Fractional anisotropy (FA), radial diffusivity (RD), neurite orientation dispersion index (ODI) and density index (NDI) were estimated using diffusion tensor and neurite orientation dispersion and density imaging models. Between-group analyses used a general linear model with group and sex as explanatory variables. Within-group associations between white matter microstructure, cognitive outcomes and birth weight were also investigated.

RESULTS

VLBW compared to FT children showed lower FA and NDI across widespread white matter regions. Smaller clusters of atypical ODI were also found in VLBW children. Within-group analyses in FT children revealed that lower RD and higher NDI were associated with vocabulary acquisition and working memory. In VLBW children, higher FA and NDI, and lower RD and ODI, were associated with improved processing speed. In both groups, FA was positively associated with birth weight.

CONCLUSIONS

Our findings demonstrate white matter alterations in young VLBW children, including widespread reductions in axon density that may reflect sustained myelination disruptions. The associations with cognitive outcomes may also highlight which of the VLBW children are at higher risk for later cognitive difficulties.

Corpus callosum dysgenesis causes novel patterns of structural and functional brain connectivity

Developmental malformations (dysgenesis) of the corpus callosum lead to neurological conditions with a broad range of clinical presentations. Investigating the altered brain connectivity patterns is crucial to understanding both adaptive and maladaptive neuroplasticity in corpus callosum dysgenesis patients. Here, we acquired structural diffusion-weighted and resting-state functional MRI data from a cohort of 11 corpus callosum dysgenesis patients (five with agenesis and six with hypoplasia) and compared their structural and functional connectivity patterns to healthy subjects selected from the Human Connectome Project. We found that these patients have fewer structural inter- and intra-hemispheric brain connections relative to healthy controls. Interestingly, the patients with callosal agenesis have a scant number of inter-hemispheric connections but manage to maintain the full integrity of functional connectivity between the same cortical regions as the healthy subjects. On the other hand, the hypoplasic group presented abnormal structural and functional connectivity patterns relative to healthy controls while maintaining the same total amount of functional connections. These results demonstrate that acallosal patients can compensate for having fewer structural brain connections and present functional adaptation. However, hypoplasics present atypical structural connections to different brain regions, leading to entirely new and abnormal functional brain connectivity patterns.