Integrating MRI brain imaging studies of pre-reading children with current theories of developmental dyslexia: A review and quantitative meta-analysis

Unique longitudinal contributions of sulcal interruptions to reading acquisition in children

A growing body of literature indicates strong associations between indentations of the cerebral cortex (i.e., sulci) and individual differences in cognitive performance. Interruptions, or gaps, of sulci (historically known as pli de passage) are particularly intriguing as previous work suggests that these interruptions have a causal effect on cognitive development. Here, we tested how the presence and morphology of sulcal interruptions in the left posterior occipitotemporal sulcus (pOTS) longitudinally impact the development of a culturally-acquired skill: reading. Forty-three children were successfully followed from age 5 in kindergarten, at the onset of literacy instruction, to ages 7 and 8 with assessments of cognitive, pre-literacy, and literacy skills, as well as MRI anatomical scans at ages 5 and 8. Crucially, we demonstrate that the presence of a left pOTS gap at 5 years is a specific and robust longitudinal predictor of better future reading skills in children, with large observed benefits on reading behavior ranging from letter knowledge to reading comprehension. The effect of left pOTS interruptions on reading acquisition accumulated through time, and was larger than the impact of benchmark cognitive and familial predictors of reading ability and disability. Finally, we show that increased local U-fiber white matter connectivity associated with such sulcal interruptions possibly underlie these behavioral benefits, by providing a computational advantage. To our knowledge, this is the first quantitative evidence supporting a potential integrative gray-white matter mechanism underlying the cognitive benefits of macro-anatomical differences in sulcal morphology related to longitudinal improvements in a culturally-acquired skill.

Neural Signature of Rhyming Ability During Story Listening in Preschool-Age Children

Purpose: Rhyming is a phonological skill that typically emerges in the preschool-age range. Prosody/rhythm processing involves right-lateralized temporal cortex, yet the neural basis of rhyming ability in young children is unclear. The study objective was to use functional magnetic resonance imaging (fMRI) to quantify neural correlates of rhyming abilities in preschool-age children. Method: Healthy pre-kindergarten child-parent dyads were recruited for a study visit including MRI and the Preschool and Primary Inventory of Phonological Awareness (PIPA) rhyme subtest. MRI included an fMRI task where the child listened to a rhymed and unrhymed story without visual stimuli. fMRI data were processed using the CONN functional connectivity (FC) toolbox, with FC computed between 132 regions of interest (ROI) across the brain. Associations between PIPA score and FC during the rhymed versus unrhymed story were compared accounting for age, sex, and maternal education. Results: In total, 45 children completed MRI (age 54 ± 8 months, 37-63; 19M 26F). Median maternal education was college graduate. FC between ROIs in posterior default mode (imagery) and right fronto-parietal (executive function) networks was more strongly positively associated with PIPA score during the rhymed compared with the unrhymed story [F(2,39) = 10.95, p-FDR = 0.043], as was FC between ROIs in right-sided language (prosody) and dorsal attention networks [F(2,39) = 9.85, p-FDR = 0.044]. Conclusions: Preschool-age children with better rhyming abilities had stronger FC between ROIs supporting attention and prosody and also between ROIs supporting executive function and imagery, suggesting rhyme as a catalyst for attention, visualization, and comprehension. These represent novel neural biomarkers of nascent phonological skills.

Exploring brain plasticity in developmental dyslexia through implicit sequence learning

Developmental dyslexia (DD) is defined as difficulties in learning to read even with normal intelligence and adequate educational guidance. Deficits in implicit sequence learning (ISL) abilities have been reported in children with DD. We investigated brain plasticity in a group of 17 children with DD, compared with 18 typically developing (TD) children, after two sessions of training on a serial reaction time (SRT) task with a 24-h interval. Our outcome measures for the task were: a sequence-specific implicit learning measure (ISL), entailing implicit recognition and learning of sequential associations; and a general visuomotor skill learning measure (GSL). Gray matter volume (GMV) increased, and white matter volume (WMV) decreased from day 1 to day 2 in cerebellar areas regardless of group. A moderating effect of group was found on the correlation between WMV underlying the left precentral gyrus at day 2 and the change in ISL performance, suggesting the use of different underlying learning mechanisms in DD and TD children during the ISL task. Moreover, DD had larger WMV in the posterior thalamic radiation compared with TD, supporting previous reports of atypical development of this structure in DD. Further studies with larger sample sizes are warranted to validate these results.

Developmental dyslexia susceptibility genes DNAAF4, DCDC2, and NRSN1 are associated with brain function in fluently reading adolescents and young adults

Reading skills and developmental dyslexia, characterized by difficulties in developing reading skills, have been associated with brain anomalies within the language network. Genetic factors contribute to developmental dyslexia risk, but the mechanisms by which these genes influence reading skills remain unclear. In this preregistered study (https://osf.io/7sehx), we explored if developmental dyslexia susceptibility genes DNAAF4, DCDC2, NRSN1, and KIAA0319 are associated with brain function in fluently reading adolescents and young adults. Functional MRI and task performance data were collected during tasks involving written and spoken sentence processing, and DNA sequence variants of developmental dyslexia susceptibility genes previously associated with brain structure anomalies were genotyped. The results revealed that variation in DNAAF4, DCDC2, and NRSN1 is associated with brain activity in key language regions: the left inferior frontal gyrus, middle temporal gyrus, and intraparietal sulcus. Furthermore, NRSN1 was associated with task performance, but KIAA0319 did not yield any significant associations. Our findings suggest that individuals with a genetic predisposition to developmental dyslexia may partly employ compensatory neural and behavioral mechanisms to maintain typical task performance. Our study highlights the relevance of these developmental dyslexia susceptibility genes in language-related brain function, even in individuals without developmental dyslexia, providing valuable insights into the genetic factors influencing language processing.

Will you read how I will read? Naturalistic fMRI predictors of emergent reading

Despite reading being an essential and almost universal skill in the developed world, reading proficiency varies substantially from person to person. To study why, the fMRI field is beginning to turn from single-word or nonword reading tasks to naturalistic stimuli like connected text and listening to stories. To study reading development in children just beginning to read, listening to stories is an appropriate paradigm because speech perception and phonological processing are important for, and are predictors of, reading proficiency. Our study examined the relationship between behavioral reading-related skills and the neural response to listening to stories in the fMRI environment. Functional MRI were gathered in a 3T TIM-Trio scanner. During the fMRI scan, children aged approximately 7 years listened to professionally narrated common short stories and answered comprehension questions following the narration. Analyses of the data used inter-subject correlation (ISC), and representational similarity analysis (RSA). Our primary finding is that ISC reveals areas of increased synchrony in both high- and low-performing emergent readers previously implicated in reading ability/disability. Of particular interest are that several previously identified brain regions (medial temporal gyrus (MTG), inferior frontal gyrus (IFG), inferior temporal gyrus (ITG)) were found to "synchronize" across higher reading ability participants, while lower reading ability participants had idiosyncratic activation patterns in these regions. Additionally, two regions (superior frontal gyrus (SFG) and another portion of ITG) were recruited by all participants, but their specific timecourse of activation depended on reading performance. These analyses support the idea that different brain regions involved in reading follow different developmental trajectories that correlate with reading proficiency on a spectrum rather than the usual dichotomy of poor readers versus strong readers.

Dyslexia, the Amsterdam Way

The current aim is to illustrate our research on dyslexia conducted at the Developmental Psychology section of the Department of Psychology, University of Amsterdam, in collaboration with the nationwide IWAL institute for learning disabilities (now RID). The collaborative efforts are institutionalized in the Rudolf Berlin Center. The first series of studies aimed at furthering the understanding of dyslexia using a gamified tool based on an artificial script. Behavioral measures were augmented with diffusion modeling in one study, and indices derived from the electroencephalogram were used in others. Next, we illustrated a series of studies aiming to assess individuals who struggle with reading and spelling using similar research strategies. In one study, we used methodology derived from the machine learning literature. The third series of studies involved intervention targeting the phonics of language. These studies included a network analysis that is now rapidly gaining prominence in the psychopathology literature. Collectively, the studies demonstrate the importance of letter-speech sound mapping and word decoding in the acquisition of reading. It was demonstrated that focusing on these abilities may inform the prediction, classification, and intervention of reading difficulties and their neural underpinnings. A final section examined dyslexia, conceived as a neurobiological disorder. This analysis converged on the conclusion that recent developments in the psychopathology literature inspired by the focus on research domain criteria and network analysis might further the field by staying away from longstanding debates in the dyslexia literature (single vs. a multiple deficit, category vs. dimension, disorder vs. lack of skill).

Inter-subject correlation during long narratives reveals widespread neural correlates of reading ability

Recent work using fMRI inter-subject correlation analysis has provided new information about the brain's response to video and audio narratives, particularly in frontal regions not typically activated by single words. This approach is very well suited to the study of reading, where narrative is central to natural experience. But since past reading paradigms have primarily presented single words or phrases, the influence of narrative on semantic processing in the brain - and how that influence might change with reading ability - remains largely unexplored. In this study, we presented coherent stories to adolescents and young adults with a wide range of reading abilities. The stories were presented in alternating visual and auditory blocks. We used a dimensional inter-subject correlation analysis to identify regions in which better and worse readers had varying levels of consistency with other readers. This analysis identified a widespread set of brain regions in which activity timecourses were more similar among better readers than among worse readers. These differences were not detected with standard block activation analyses. Worse readers had higher correlation with better readers than with other worse readers, suggesting that the worse readers had "idiosyncratic" responses rather than using a single compensatory mechanism. Close inspection confirmed that these differences were not explained by differences in IQ or motion. These results suggest an expansion of the current view of where and how reading ability is reflected in the brain, and in doing so, they establish inter-subject correlation as a sensitive tool for future studies of reading disorders.

The shared genetic architecture and evolution of human language and musical rhythm

Rhythm and language-related traits are phenotypically correlated, but their genetic overlap is largely unknown. Here, we leveraged two large-scale genome-wide association studies performed to shed light on the shared genetics of rhythm (N=606,825) and dyslexia (N=1,138,870). Our results reveal an intricate shared genetic and neurobiological architecture, and lay groundwork for resolving longstanding debates about the potential co-evolution of human language and musical traits.

The Role of Visual Factors in Dyslexia

What are the causes of dyslexia? Decades of research reflect a determined search for a single cause where a common assumption is that dyslexia is a consequence of problems with converting phonological information into lexical codes. But reading is a highly complex activity requiring many well-functioning mechanisms, and several different visual problems have been documented in dyslexic readers. We critically review evidence from various sources for the role of visual factors in dyslexia, from magnocellular dysfunction through accounts based on abnormal eye movements and attentional processing, to recent proposals that problems with high-level vision contribute to dyslexia. We believe that the role of visual problems in dyslexia has been underestimated in the literature, to the detriment of the understanding and treatment of the disorder. We propose that rather than focusing on a single core cause, the role of visual factors in dyslexia fits well with risk and resilience models that assume that several variables interact throughout prenatal and postnatal development to either promote or hinder efficient reading.

Deep Learning Classification of Reading Disability with Regional Brain Volume Features

Developmental reading disability is a prevalent and often enduring problem with varied mechanisms that contributes to its phenotypic heterogeneity. This mechanistic and phenotypic variation, as well as relatively modest sample sizes, may have limited the development of accurate neuroimaging-based classifiers for reading disability, including because of the large feature space of neuroimaging datasets. An unsupervised learning model was used to reduce deformation-based data to a lower-dimensional manifold and then supervised learning models were used to classify these latent representations in a dataset of 96 reading disability cases and 96 controls (mean age: 9.86 ± 1.56). A combined unsupervised autoencoder and supervised convolutional neural network approach provided an effective classification of cases and controls (accuracy: 77%; precision: 0.75; recall: 0.78). Brain regions that contributed to this classification accuracy were identified by adding noise to the voxel-level image data, which showed that reading disability classification accuracy was most influenced by the superior temporal sulcus, dorsal cingulate, and lateral occipital cortex. Regions that were most important for the accurate classification of controls included the supramarginal gyrus, orbitofrontal, and medial occipital cortex. The contribution of these regions reflected individual differences in reading-related abilities, such as non-word decoding or verbal comprehension. Together, the results demonstrate an optimal deep learning solution for classification using neuroimaging data. In contrast with standard mass-univariate test results, results from the deep learning model also provided evidence for regions that may be specifically affected in reading disability cases.

The Role of Neural and Genetic Processes in Learning to Read and Specific Reading Disabilities: Implications for Instruction

To learn to read, the brain must repurpose neural systems for oral language and visual processing to mediate written language. We begin with a description of computational models for how alphabetic written language is processed. Next, we explain the roles of a dorsal sublexical system in the brain that relates print and speech, a ventral lexical system that develops the visual expertise for rapid orthographic processing at the word level, and the role of cognitive control networks that regulate attentional processes as children read. We then use studies of children, adult illiterates learning to read, and studies of poor readers involved in intervention, to demonstrate the plasticity of these neural networks in development and in relation to instruction. We provide a brief overview of the rapid increase in the field's understanding and technology for assessing genetic influence on reading. Family studies of twins have shown that reading skills are heritable, and molecular genetic studies have identified numerous regions of the genome that may harbor candidate genes for the heritability of reading. In selected families, reading impairment has been associated with major genetic effects, despite individual gene contributions across the broader population that appear to be small. Neural and genetic studies do not prescribe how children should be taught to read, but these studies have underscored the critical role of early intervention and ongoing support. These studies also have highlighted how structured instruction that facilitates access to the sublexical components of words is a critical part of training the brain to read.

Correspondence between cognitive and neural representations for phonology, orthography, and semantics in supramarginal compared to angular gyrus

The angular and supramarginal gyri (AG and SMG) together constitute the inferior parietal lobule (IPL) and have been associated with cognitive functions that support reading. How those functions are distributed across the AG and SMG is a matter of debate, the resolution of which is hampered by inconsistencies across stereotactic atlases provided by the major brain image analysis software packages. Schematic results from automated meta-analyses suggest primarily semantic (word meaning) processing in the left AG, with more spatial overlap among phonological (auditory word form), orthographic (visual word form), and semantic processing in the left SMG. To systematically test for correspondence between patterns of neural activation and phonological, orthographic, and semantic representations, we re-analyze a functional magnetic resonance imaging data set of participants reading aloud 465 words. Using representational similarity analysis, we test the hypothesis that within cytoarchitecture-defined subregions of the IPL, phonological representations are primarily associated with the SMG, while semantic representations are primarily associated with the AG. To the extent that orthographic representations can be de-correlated from phonological representations, they will be associated with cortex peripheral to the IPL, such as the intraparietal sulcus. Results largely confirmed these hypotheses, with some nuanced exceptions, which we discuss in terms of neurally inspired computational cognitive models of reading that learn mappings among distributed representations for orthography, phonology, and semantics. De-correlating constituent representations making up complex cognitive processes, such as reading, by careful selection of stimuli, representational formats, and analysis techniques, are promising approaches for bringing additional clarity to brain structure-function relationships.

Researcher-practitioner partnerships and in-school laboratories facilitate translational research in reading

Educational neuroscience approaches have helped to elucidate the brain basis of Reading Disability (RD) and of reading intervention response; however, there is often limited translation of this knowledge to the broader scientific and educational communities. Moreover, this work is traditionally lab-based, and thus the underlying theories and research questions are siloed from classroom practices. With growing awareness of the neurobiological origins of RD and increasing popularity of putative "brain-based" approaches in clinics and classrooms, it is imperative that we create more direct and bidirectional communication between scientists and practitioners. Such direct collaborations can help dispel neuromyths, and lead to increased understanding of the promises and pitfalls of neuroscience approaches. Moreover, direct partnerships between researchers and practitioners can lead to greater ecological validity in study designs to improve upon the translational potential of findings. To this end, we have forged collaborative partnerships, and built cognitive neuroscience laboratories within independent reading disabilities schools. This approach affords frequent and ecologically valid neurobiological assessment as children's reading improves in response to intervention. It also permits the creation of dynamic models of leading and lagging relationships of students' learning, and identification of individual-level predictors of intervention response. The partnerships also provide in-depth knowledge of student characteristics and classroom practices, which, when combined with the data we acquire, may facilitate optimization of instructional approaches. In this commentary, we discuss the creation of our partnerships, the scientific problem we are addressing (variable response to reading intervention), and the epistemological significance of researcher-practitioner bi-directional learning.

Structural white matter characteristics for working memory and switching/inhibition in children with reading difficulties: The role of the left superior longitudinal fasciculus

Reading difficulties (RDs) are characterized by slow and inaccurate reading as well as additional challenges in cognitive control (i.e., executive functions, especially in working memory, inhibition, and visual attention). Despite evidence demonstrating differences in these readers' language and visual processing abilities, white matter differences associated with executive functions (EFs) difficulties in children with RDs are scarce. Structural correlates for reading and EFs in 8- to 12-year-old children with RDs versus typical readers (TRs) were examined using diffusion tensor imaging (DTI) data. Results suggest that children with RDs showed significantly lower reading and EF abilities versus TRs. Lower fractional anisotropy (FA) in left temporo-parietal tracts was found in children with RDs, who also showed positive correlations between reading and working memory and switching/inhibition scores and FA in the left superior longitudinal fasciculus (SLF). FA in the left SLF predicted working memory performance mediated by reading ability in children with RDs but not TRs. Our findings support alterations in white matter tracts related to working memory, switching/inhibition, and overall EF challenges in children with RDs and the linkage between working memory difficulties and FA alterations in the left SLF in children with RDs via reading.

Reading and phonological awareness improvement accomplished by transcranial direct current stimulation combined with phonological awareness training: A randomized controlled trial

Phonological awareness (PA) training is a core intervention in dyslexia. Recently, transcranial direct current stimulation (tDCS) has been probed as a complementary intervention for increasing reading ability in dyslexia, but not for enhancing the efficacy of PA. The aim of the current study was thus to examine whether tDCS combined with a PA intervention improves reading, but also PA abilities as a proxy in children with dyslexia. A randomized, double-blind, sham-controlled clinical trial was performed to assess the effects of tDCS (applied bilaterally over the temporo-parietal junction with the anode placed over the left, and the cathode placed over the right hemisphere) combined with PA training on reading and PA abilities in dyslexic patients. Twenty-eight participants were randomly assigned to active (PA + anodal tDCS) or sham (PA + sham tDCS) groups. Each subject participated in 15 treatment sessions. PA and real/non-word reading were evaluated at baseline before the intervention, at the end of the fifth, tenth, and final intervention sessions, and then 6 weeks after intervention. In the active tDCS group, the mean scores of non-word reading and PA tests were significantly improved during, immediately, and 6 weeks after the treatment, as compared to the sham tDCS group. tDCS is thus a promising complementary intervention if combined with PA training to enhance PA and reading abilities in dyslexia for an extended period after treatment.

The use of noninvasive brain stimulation techniques to improve reading difficulties in dyslexia: A systematic review

Noninvasive brain stimulation (NIBS) allows to actively and noninvasively modulate brain function. Aside from inhibiting specific processes, NIBS may also enhance cognitive functions, which might be used for the prevention and intervention of learning disabilities such as dyslexia. However, despite the growing interest in modulating learning abilities, a comprehensive, up-to-date review synthesizing NIBS studies with dyslexics is missing. Here, we fill this gap and elucidate the potential of NIBS as treatment option in dyslexia. The findings of the 15 included studies suggest that repeated sessions of reading training combined with different NIBS protocols may induce long-lasting improvements of reading performance in child and adult dyslexics, opening promising avenues for future research. In particular, the "classical" reading areas seem to be most successfully modulated through NIBS, and facilitatory protocols can improve various reading-related subprocesses. Moreover, we emphasize the need to further explore the potential to modulate auditory cortex function as a preintervention and intervention approach for affected children, for example, to avoid the development of auditory and phonological difficulties at the core of dyslexia. Finally, we outline how future studies may increase our understanding of the neurobiological basis of NIBS-induced improvements in dyslexia.

Visual attention and reading: A test of their relation across paradigms

Relations of visual attention to reading have long been hypothesized; however, findings in this literature are quite mixed. These relations have been investigated using several different visual attention paradigms and with variable controls for other competing reading-related processes. We extended current knowledge by evaluating four of the key visual attention paradigms used in this research-visual attention span, attention blink, visual search, and visuospatial attention-in a single study. We tested the relations of these to reading in 90 middle schoolers at high risk for reading difficulties while considering their effect in the context of known language predictors. Performance on visual-spatial, visual search, and attentional blink paradigms showed weak nonsignificant relations to reading. Visual attention span tasks showed robust relations to reading even when controlling for language, but only when stimuli were alphanumeric. Although further exploration of visual attention in relation to reading may be warranted, the robustness of this relationship appears to be questionable, particularly beyond methodological factors associated with the measurement of visual attention. Findings extend and refine our understanding of the contribution of attention to reading skill and raise questions about the mechanism by which visual attention is purported to affect reading.

The value of structural brain imaging in explaining individual differences in children's arithmetic fluency

How do different measures of brain structure correlate with individual differences in arithmetic fluency? This paper builds on two previously published studies in which individual differences in children's arithmetic fluency were correlated with measures of white (Polspoel et al., 2019) and grey matter (Polspoel et al., 2020) in one sample of children. We combined the brain imaging data of these two studies with measures of cognitive abilities that have been shown to be predictive of arithmetic fluency, i.e., numerical magnitude processing, working memory and rapid automatized naming (RAN). This allowed us to investigate to which extend the observed structural brain imaging measures uniquely correlated with children's arithmetic fluency, on top of each other as well as on top of the abovementioned cognitive variables. Participants were 43 typically developing 9-10-year-olds. All measures were added to a hierarchical multiple regression model. This regression model showed that the white matter integrity of the right inferior longitudinal fasciculus and the cortical complexity of the left postcentral gyrus remained unique predictors of individual differences in arithmetic when the abovementioned cognitive variables were taken into account. This indicates that structural neuroimaging measures can explain individual differences in arithmetic performance that are not merely accounted for by relevant cognitive predictors.

Whole-object effects in visual word processing: Parallels with and differences from face recognition

Visual words and faces differ in their structural properties, but both are objects of high expertise. Holistic processing is said to characterize expert face recognition, but the extent to which whole-word processes contribute to word recognition is unclear, particularly as word recognition is thought to proceed by a component-based process. We review the evidence for experimental effects in word recognition that parallel those used to support holistic face processing, namely inversion effects, the part-whole task, and composite effects, as well as the status of whole-word processing in pure alexia and developmental dyslexia, contrasts between familiar and unfamiliar languages, and the differences between handwriting and typeset font. The observations support some parallels in whole-object influences between face and visual word recognition, but do not necessarily imply similar expert mechanisms. It remains to be determined whether and how the relative balance between part-based and whole-object processing differs for visual words and faces.

Distinct neural sources underlying visual word form processing as revealed by steady state visual evoked potentials (SSVEP)

EEG has been central to investigations of the time course of various neural functions underpinning visual word recognition. Recently the steady-state visual evoked potential (SSVEP) paradigm has been increasingly adopted for word recognition studies due to its high signal-to-noise ratio. Such studies, however, have been typically framed around a single source in the left ventral occipitotemporal cortex (vOT). Here, we combine SSVEP recorded from 16 adult native English speakers with a data-driven spatial filtering approach—Reliable Components Analysis (RCA)—to elucidate distinct functional sources with overlapping yet separable time courses and topographies that emerge when contrasting words with pseudofont visual controls. The first component topography was maximal over left vOT regions with a shorter latency (approximately 180 ms). A second component was maximal over more dorsal parietal regions with a longer latency (approximately 260 ms). Both components consistently emerged across a range of parameter manipulations including changes in the spatial overlap between successive stimuli, and changes in both base and deviation frequency. We then contrasted word-in-nonword and word-in-pseudoword to test the hierarchical processing mechanisms underlying visual word recognition. Results suggest that these hierarchical contrasts fail to evoke a unitary component that might be reasonably associated with lexical access.

Functional and morphological correlates of developmental dyslexia: A multimodal investigation of the ventral occipitotemporal cortex

BACKGROUND AND PURPOSE

The ventral occipitotemporal cortex (vOT) is a region crucial for reading acquisition through selective tuning to printed words. Developmental dyslexia is a disorder of reading with underlying neurobiological bases often associated with atypical neural responses to printed words. Previous studies have discovered anomalous structural development and function of the vOT in individuals with dyslexia. However, it remains unclear if or how structural abnormalities relate to functional alterations.

METHODS

In this study, we acquired structural, functional (words and faces processing), and diffusion MRI data from 26 children with dyslexia (average age = 10.4 ± 2.0 years) and 14 age-matched typically developing readers (average age = 10.4 ± 1.6 years). Morphological indices of local gyrification, neurite density (i.e., dendritic arborization structure), and orientation dispersion (i.e., dendritic arborization orientation) were analyzed within the vOT region that showed preferential activation in typically developing readers for words (as compared to face stimuli).

RESULTS

The two cohorts diverged significantly in both functional and structural measures. Compared to typically developing controls, children with dyslexia did not show selectivity for words in the left vOT (contrast: words > false fonts). This lack of tuning to printed words was associated with greater neurite dispersion heterogeneity in the dyslexia cohort, but similar neurite density. These group differences were not present in the homologous contralateral area, the right vOT.

CONCLUSIONS

Our findings provide new insight into the neurobiology of the lack of vOT word tuning in dyslexia by linking behavior, alterations in functional activation, and neurite organization.

Developmental brain dynamics of numerical and arithmetic abilities

The development of numerical and arithmetic abilities constitutes a crucial cornerstone in our modern and educated societies. Difficulties to acquire these central skills can lead to severe consequences for an individual's well-being and nation's economy. In the present review, we describe our current broad understanding of the functional and structural brain organization that supports the development of numbers and arithmetic. The existing evidence points towards a complex interaction among multiple domain-specific (e.g., representation of quantities and number symbols) and domain-general (e.g., working memory, visual-spatial abilities) cognitive processes, as well as a dynamic integration of several brain regions into functional networks that support these processes. These networks are mainly, but not exclusively, located in regions of the frontal and parietal cortex, and the functional and structural dynamics of these networks differ as a function of age and performance level. Distinctive brain activation patterns have also been shown for children with dyscalculia, a specific learning disability in the domain of mathematics. Although our knowledge about the developmental brain dynamics of number and arithmetic has greatly improved over the past years, many questions about the interaction and the causal involvement of the abovementioned functional brain networks remain. This review provides a broad and critical overview of the known developmental processes and what is yet to be discovered.

Altered gray matter development in pre-reading children with a family history of reading disorder

Reading disorders are common in children and can impact academic success, mental health, and career prospects. Reading is supported by network of interconnected left hemisphere brain regions, including temporo-parietal, occipito-temporal, and inferior-frontal circuits. Poor readers often show hypoactivation and reduced gray matter volumes in this reading network, with hyperactivation and increased volumes in the posterior right hemisphere. We assessed gray matter development longitudinally in pre-reading children aged 2-5 years using magnetic resonance imaging (MRI) (N = 32, 110 MRI scans; mean age: 4.40 ± 0.77 years), half of whom had a family history of reading disorder. The family history group showed slower proportional growth (relative to total brain volume) in the left supramarginal and inferior frontal gyri, and faster proportional growth in the right angular, right fusiform, and bilateral lingual gyri. This suggests delayed development of left hemisphere reading areas in children with a family history of dyslexia, along with faster growth in right homologues. This alternate development pattern may predispose the brain to later reading difficulties and may later manifest as the commonly noted compensatory mechanisms. The results of this study further shows our understanding of structural brain alterations that may form the neurological basis of reading difficulties.

Development of an Eco-Biodevelopmental Model of Emergent Literacy Before Kindergarten: A Review

IMPORTANCE

Literacy has been described as an important social determinant of health. Its components emerge in infancy and are dependent on genetic, medical, and environmental factors. The American Academy of Pediatrics advocates a substantial role for pediatricians in literacy promotion, developmental surveillance, and school readiness to promote cognitive, relational, and brain development. Many children, especially those from minority and underserved households, enter kindergarten unprepared to learn to read and subsequently have difficulty in school.

OBSERVATIONS

Emergent literacy is a developmental process beginning in infancy. Component skills are supported by brain regions that must be adequately stimulated and integrated to form a functional reading network. Trajectories are associated with genetic, medical, and environmental factors, notably the home literacy environment, which is defined as resources, motivation, and stimulation that encourage the literacy development process. Eco-biodevelopmental models are advocated by the American Academy of Pediatrics, and these models offer insights into the neurobiological processes associated with environmental factors and the ways in which these processes may be addressed to improve outcomes. Emergent literacy is well suited for such a model, particularly because the mechanisms underlying component skills are elucidated. In addition to cognitive-behavioral benefits, the association of home literacy environment with the developing brain before kindergarten has recently been described via neuroimaging. Rather than a passive approach, which may subject the child to stress and engender negative attitudes, early literacy screening and interventions that are administered by pediatric practitioners can help identify potential reading difficulties, address risk factors during a period when neural plasticity is high, and improve outcomes.

CONCLUSIONS AND RELEVANCE

Neuroimaging and behavioral evidence inform an eco-biodevelopmental model of emergent literacy that is associated with genetic, medical, and home literacy environmental factors before kindergarten, a time of rapid brain development. This framework is consistent with recommendations from the American Academy of Pediatrics and provides insights to help identify risk factors and signs of potential reading difficulties, tailor guidance, and provide direction for future research.

Neural processing of vision and language in kindergarten is associated with prereading skills and predicts future literacy

The main objective of this longitudinal study was to investigate the neural predictors of reading acquisition. For this purpose, we followed a sample of 54 children from the end of kindergarten to the end of second grade. Preliterate children were tested for visual symbol (checkerboards, houses, faces, written words) and auditory language processing (spoken words) using a passive functional magnetic resonance imaging paradigm. To examine brain-behavior relationships, we also tested cognitive-linguistic prereading skills at kindergarten age and reading performance of 48 of the same children 2 years later. Face-selective response in the bilateral fusiform gyrus was positively associated with rapid automatized naming (RAN). Response to both spoken and written words at preliterate age was negatively associated with RAN in the dorsal temporo-parietal language system. Longitudinally, neural response to faces in the ventral stream predicted future reading fluency. Here, stronger neural activity in inferior and middle temporal gyri at kindergarten age was associated with higher reading performance. Our results suggest that interindividual differences in the neural system of language and reading affect literacy acquisition and thus might serve as a marker for successful reading acquisition in preliterate children.

White matter but not grey matter predicts change in reading skills after intervention

This study examined changes in white matter microstructure and grey matter volume, cortical thickness, and cortical surface area before and after reading intervention. Participants included 22 average readers and 13 dyslexic readers (8-9 years old in third grade); the dyslexic readers were enrolled in reading intervention programs at their elementary school. Participants completed scans of diffusion tensor imaging and T1-weighted MRI before and after 3 months of instruction. An a priori region of interest (ROI) analysis was used. Dyslexic readers, compared to average readers, showed higher mean diffusivity in white matter ROIs including bilateral inferior frontal, bilateral insula, left superior temporal, and right supramarginal gyri across time points. Dyslexic readers also had thicker cortex in left fusiform and bilateral supramarginal gyri; whereas, average readers had greater surface area in right fusiform across time. There were no significant changes in white or grey matter following intervention; however, mean diffusivity in the right hemisphere was associated with reading gains over time. White matter organization in the right hemisphere predicts reading changes, and dyslexic readers may have persistent differences in white and grey matter due to ongoing reading deficits.

Beyond Reading Modulation: Temporo-Parietal tDCS Alters Visuo-Spatial Attention and Motion Perception in Dyslexia

Dyslexia is a neurodevelopmental disorder with an atypical activation of posterior left-hemisphere brain reading networks (i.e., temporo-occipital and temporo-parietal regions) and multiple neuropsychological deficits. Transcranial direct current stimulation (tDCS) is a tool for manipulating neural activity and, in turn, neurocognitive processes. While studies have demonstrated the significant effects of tDCS on reading, neurocognitive changes beyond reading modulation have been poorly investigated. The present study aimed at examining whether tDCS on temporo-parietal regions affected not only reading, but also phonological skills, visuo-spatial working memory, visuo-spatial attention, and motion perception in a polarity-dependent way. In a within-subjects design, ten children and adolescents with dyslexia performed reading and neuropsychological tasks after 20 min of exposure to Left Anodal/Right Cathodal (LA/RC) and Right Anodal/Left Cathodal (RA/LC) tDCS. LA/RC tDCS compared to RA/LC tDCS improved text accuracy, word recognition speed, motion perception, and modified attentional focusing in our group of children and adolescents with dyslexia. Changes in text reading accuracy and word recognition speed—after LA/RC tDCS compared to RA/LC—were related to changes in motion perception and in visuo-spatial working memory, respectively. Our findings demonstrated that reading and domain-general neurocognitive functions in a group of children and adolescents with dyslexia change following tDCS and that they are polarity-dependent.

Brain dynamics of (a)typical reading development-a review of longitudinal studies

Literacy development is a process rather than a single event and thus should be studied at multiple time points. A longitudinal design employing neuroimaging methods offers the possibility to identify neural changes associated with reading development, and to reveal early markers of dyslexia. The core of this review is a summary of findings from longitudinal neuroimaging studies on typical and atypical reading development. Studies focused on the prediction of reading gains with a single neuroimaging time point complement this review. Evidence from structural studies suggests that reading development results in increased structural integrity and functional specialization of left-hemispheric language areas. Compromised integrity of some of these tracts in children at risk for dyslexia might be compensated by higher anatomical connectivity in the homologous right hemisphere tracts. Regarding function, activation in phonological and audiovisual integration areas and growing sensitivity to print in the ventral occipito-temporal cortex (vOT) seem to be relevant neurodevelopmental markers of successful reading acquisition. Atypical vOT responses at the beginning of reading training and infant auditory brain potentials have been proposed as neuroimaging predictors of dyslexia that can complement behavioral measures. Besides these insights, longitudinal neuroimaging studies on reading and dyslexia are still relatively scarce and small sample sizes raise legitimate concerns about the reliability of the results. This review discusses the challenges of these studies and provides recommendations to improve this research area. Future longitudinal research with larger sample sizes are needed to improve our knowledge of typical and atypical reading neurodevelopment.

Action Video Games Enhance Attentional Control and Phonological Decoding in Children with Developmental Dyslexia

Reading acquisition is extremely difficult for about 5% of children because they are affected by a heritable neurobiological disorder called developmental dyslexia (DD). Intervention studies can be used to investigate the causal role of neurocognitive deficits in DD. Recently, it has been proposed that action video games (AVGs)-enhancing attentional control-could improve perception and working memory as well as reading skills. In a partial crossover intervention study, we investigated the effect of AVG and non-AVG training on attentional control using a conjunction visual search task in children with DD. We also measured the non-alphanumeric rapid automatized naming (RAN), phonological decoding and word reading before and after AVG and non-AVG training. After both video game training sessions no effect was found in non-alphanumeric RAN and in word reading performance. However, after only 12 h of AVG training the attentional control was improved (i.e., the set-size slopes were flatter in visual search) and phonological decoding speed was accelerated. Crucially, attentional control and phonological decoding speed were increased only in DD children whose video game score was highly efficient after the AVG training. We demonstrated that only an efficient AVG training induces a plasticity of the fronto-parietal attentional control linked to a selective phonological decoding improvement in children with DD.

An Evolutionary Perspective of Dyslexia, Stress, and Brain Network Homeostasis

Evolution fuels interindividual variability in neuroplasticity, reflected in brain anatomy and functional connectivity of the expanding neocortical regions subserving reading ability. Such variability is orchestrated by an evolutionarily conserved, competitive balance between epigenetic, stress-induced, and cognitive-growth gene expression programs. An evolutionary developmental model of dyslexia, suggests that prenatal and childhood subclinical stress becomes a risk factor for dyslexia when physiological adaptations to stress promoting adaptive fitness, may attenuate neuroplasticity in the brain regions recruited for reading. Stress has the potential to blunt the cognitive-growth functions of the predominantly right hemisphere Ventral and Dorsal attention networks, which are primed with high entropic levels of synaptic plasticity, and are critical for acquiring beginning reading skills. The attentional networks, in collaboration with the stress-responsive Default Mode network, modulate the entrainment and processing of the low frequency auditory oscillations (1-8 Hz) and visuospatial orienting linked etiologically to dyslexia. Thus, dyslexia may result from positive, but costly adaptations to stress system dysregulation: protective measures that reset the stress/growth balance of processing to favor the Default Mode network, compromising development of the attentional networks. Such a normal-variability conceptualization of dyslexia is at odds with the frequent assumption that dyslexia results from a neurological abnormality. To put the normal-variability model in the broader perspective of the state of the field, a traditional evolutionary account of dyslexia is presented to stimulate discussion of the scientific merits of the two approaches.

Electroencephalography decoding of Chinese characters in primary school children and its prediction for word reading performance and development

Research on what neural mechanisms facilitate word reading development in non-alphabetic scripts is relatively rare. The present study was among the first to adopt a multivariate pattern classification analysis to decode electroencephalographic signals recorded for primary school children (N = 236) while performing a Chinese character decision task. Chinese is an ideal script for studying the relationship between neural discriminability (i.e., decodability) of the orthography and behavioral word reading skills since the mapping from orthography to phonology is relatively arbitrary in Chinese. This was also among the first empirical attempts to examine the extent to which decoding performance can predict current and subsequent word reading skills using a longitudinal design. Results showed that neural activation patterns of real characters can be distinguished from activation patterns for pseudo-characters, non-characters, and random stroke combinations in both younger and older children. Topography of the transformed classifier weights revealed two distinct cognitive sub-processes underlying single character recognition, but temporal generalization analysis suggested common neural mechanisms between the distinct cognitive sub-processes. Suggestive evidence from correlational and hierarchical regression analyses showed that decoding performance, assessed on average 2 months before the year 2 behavioral testing, predicted both year 1 word reading performance and the development of word reading fluency over the year. Results demonstrate that decoding performance, one indicator of how the neural system is functionally organized in processing characters and character-like stimuli, can serve as a useful neural marker in predicting current word reading skills and the capacity to learn to read.

Myelin Water Imaging Demonstrates Lower Brain Myelination in Children and Adolescents With Poor Reading Ability

Magnetic resonance imaging (MRI) provides a means to non-invasively investigate the neurological links with dyslexia, a learning disability that affects one’s ability to read. Most previous brain MRI studies of dyslexia and reading skill have used structural or diffusion imaging to reveal regional brain abnormalities. However, volumetric and diffusion MRI lack specificity in their interpretation at the microstructural level. Myelin is a critical neural component for brain function and plasticity, and as such, deficits in myelin may impact reading ability. MRI can estimate myelin using myelin water fraction (MWF) imaging, which is based on evaluation of the proportion of short T2 myelin-associated water from multi-exponential T2 relaxation analysis, but has not yet been applied to the study of reading or dyslexia. In this study, MWF MRI, intelligence, and reading assessments were acquired in 20 participants aged 10–18 years with a wide range of reading ability to investigate the relationship between reading ability and myelination. Group comparisons showed markedly lower MWF by 16–69% in poor readers relative to good readers in the left and right thalamus, as well as the left posterior limb of the internal capsule, left/right anterior limb of the internal capsule, left/right centrum semiovale, and splenium of the corpus callosum. MWF over the entire group also correlated positively with three different reading scores in the bilateral thalamus as well as white matter, including the splenium of the corpus callosum, left posterior limb of the internal capsule, left anterior limb of the internal capsule, and left centrum semiovale. MWF imaging from T2 relaxation suggests that myelination, particularly in the bilateral thalamus, splenium, and left hemisphere white matter, plays a role in reading abilities. Myelin water imaging thus provides a potentially valuable in vivo imaging tool for the study of dyslexia and its remediation.

Development of Print-Speech Integration in the Brain of Beginning Readers With Varying Reading Skills

Learning print-speech sound correspondences is a crucial step at the beginning of reading acquisition and often impaired in children with developmental dyslexia. Despite increasing insight into audiovisual language processing, it remains largely unclear how integration of print and speech develops at the neural level during initial learning in the first years of schooling. To investigate this development, 32 healthy, German-speaking children at varying risk for developmental dyslexia (17 typical readers and 15 poor readers) participated in a longitudinal study including behavioral and fMRI measurements in first (T1) and second (T2) grade. We used an implicit audiovisual (AV) non-word target detection task aimed at characterizing differential activation to congruent (AVc) and incongruent (AVi) audiovisual non-word pairs. While children’s brain activation did not differ between AVc and AVi pairs in first grade, an incongruency effect (AVi > AVc) emerged in bilateral inferior temporal and superior frontal gyri in second grade. Of note, pseudoword reading performance improvements with time were associated with the development of the congruency effect (AVc > AVi) in the left posterior superior temporal gyrus (STG) from first to second grade. Finally, functional connectivity analyses indicated divergent development and reading expertise dependent coupling from the left occipito-temporal and superior temporal cortex to regions of the default mode (precuneus) and fronto-temporal language networks. Our results suggest that audiovisual integration areas as well as their functional coupling to other language areas and areas of the default mode network show a different development in poor vs. typical readers at varying familial risk for dyslexia.

Association Between Resting-State Functional Connectivity and Reading in Two Writing Systems in Japanese Children With and Without Developmental Dyslexia

Introduction: Japanese is unique, as it features two distinct writing systems that share the same sound and meaning: syllabic Hiragana and logographic Kanji scripts. Acquired reading difficulties in Hiragana and Kanji have been examined in older patients with brain lesions. However, the precise mechanisms underlying deficits in developmental dyslexia (DD) remain unclear.

Materials and Methods: The neural signatures of Japanese children with DD were examined by using resting-state functional magnetic resonance imaging. We examined 22 dyslexic and 46 typically developing (TD) children, aged 7–14 years.

Results: Reading performance in each writing system was correlated with neural connectivity in TD children. In contrast, in children with DD, weak associations between neural connectivity and reading performance were observed. In TD children, Hiragana-reading fluency was positively correlated with the left fusiform gyrus network. No significant correlations between Hiragana fluency and neural connectivity were observed in children with DD. Correspondingly, there were fewer correlations between Kanji accuracy and strength of reading-related connectivity in children with DD, whereas positive correlations with the bilateral fronto-parietal network and negative correlations with the left fusiform network were found in TD children.

Discussion: These data suggest that positive and negative coupling with neural connectivity is associated with developing Japanese reading skills. Further, different neural connectivity correlations between Hiragana fluency and Kanji accuracy were detected in TD children but less in children with DD.

Conclusion: The two writing systems may exert differential effects and deficits on reading in healthy children and in children with DD, respectively.

Gray Matter Structure Is Associated with Reading Skill in Typically Developing Young Readers

Research using functional and structural magnetic resonance imaging has identified areas of reduced brain activation and gray matter volume in children and adults with reading disability, but associations between cortical structure and individual differences in reading in typically developing children remain underexplored. Furthermore, the majority of research linking gray matter structure to reading ability quantifies gray matter in terms of volume, and cannot specify unique contributions of cortical surface area and thickness to these relationships. Here, we applied a continuous analytic approach to investigate associations between distinct surface-based properties of cortical structure and individual differences in reading-related skills in a sample of typically developing young children. Correlations between cortical structure and reading-related skills were conducted using a surface-based vertex-wise approach. Cortical thickness in the left superior temporal cortex was positively correlated with word and pseudoword reading performance. The observed positive correlation between cortical thickness in the left superior temporal cortex and reading may have implications for the patterns of brain activation that support reading.

Understanding, educating, and supporting children with specific learning disabilities: 50 years of science and practice

Specific learning disabilities (SLDs) are highly relevant to the science and practice of psychology, both historically and currently, exemplifying the integration of interdisciplinary approaches to human conditions. They can be manifested as primary conditions-as difficulties in acquiring specific academic skills-or as secondary conditions, comorbid to other developmental disorders such as attention-deficit hyperactivity disorder. In this synthesis of historical and contemporary trends in research and practice, we mark the 50th anniversary of the recognition of SLDs as a disability in the United States. Specifically, we address the manifestations, occurrence, identification, comorbidity, etiology, and treatment of SLDs, emphasizing the integration of information from the interdisciplinary fields of psychology, education, psychiatry, genetics, and cognitive neuroscience. SLDs, exemplified here by specific word reading, reading comprehension, mathematics, and written expression disabilities, represent spectrum disorders, each occurring in approximately 5% to 15% of the school-aged population. In addition to risk for academic deficiencies and related functional social, emotional, and behavioral difficulties, those with SLDs often have poorer long-term social and vocational outcomes. Given the high rate of occurrence of SLDs and their lifelong negative impact on functioning if not treated, it is important to establish and maintain effective prevention, surveillance, and treatment systems involving professionals from various disciplines trained to minimize the risk and maximize the protective factors for SLDs. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Atypical gray matter in children with dyslexia before the onset of reading instruction

Many studies have focused on neuroanatomical anomalies in dyslexia, yet primarily in school-aged children and adults. In the present study, we investigated gray matter surface area and cortical thickness at the pre-reading stage in a cohort of 54 children, 31 with a family risk for dyslexia and 23 without a family risk for dyslexia, of whom 16 children developed dyslexia. Surface-based analyses in the core regions of the reading network in the left hemisphere and in the corresponding right hemispheric regions were performed in FreeSurfer. Results revealed that pre-readers who develop dyslexia show reduced surface area in bilateral fusiform gyri. In addition, anomalies related to a family risk for dyslexia, irrespectively of later reading ability, were observed in the area of the bilateral inferior and middle temporal gyri. Differences were apparent in surface area, as opposed to cortical thickness. Results indicate that the neuroanatomical anomalies, since they are observed in the pre-reading phase, are not the consequence of impoverished reading experience.

Simultaneous EEG and fMRI reveals stronger sensitivity to orthographic strings in the left occipito-temporal cortex of typical versus poor beginning readers

The level of reading skills in children and adults is reflected in the strength of preferential neural activation to print. Such preferential activation appears in the N1 event-related potential (ERP) over the occipitotemporal scalp after around 150–250 ms and the corresponding blood oxygen level dependent (BOLD) signal in the ventral occipitotemporal (vOT) cortex. Here, orthography-sensitive (print vs. false font) processing was examined using simultaneous EEG-fMRI in 38 first grade children with poor and typical reading skills, and at varying familial risk for developmental dyslexia. Coarse orthographic sensitivity was observed as an increased activation to print in the N1 ERP and in the BOLD signal of individually varying vOT regions in 57% of beginning readers. Finer differentiation in processing orthographic strings (words vs. nonwords) further occurred in specific vOT clusters. Neither method alone showed robust differences in orthography-sensitive processing between typical and poor reading children. Importantly, using single-trial N1 ERP-informed fMRI analysis, we found differential modulation of the orthography-sensitive BOLD response in the left vOT for typical readers only. This result, thus, confirms subtle functional alterations in a brain structure known to be critical for fluent reading at the very beginning of reading instruction.

Linking Early Life Hypothalamic-Pituitary-Adrenal Axis Functioning, Brain Asymmetries, and Personality Traits in Dyslexia: An Informative Case Study

Developmental dyslexia (DD) is a multi-system disorder, combining influences of susceptibility genes and environmental factors. The causative interaction between specific genetic factors, brain regions, and personality/mental disorders, as well as specific learning disabilities, has been thoroughly investigated with regard to the approach of developing a multifaceted diagnostic procedure with an intervention strategy potential. In an attempt to add new translational evidence to the interconnection of the above factors in the occurrence of DD, we performed a combinatorial analysis of brain asymmetries, personality traits, cognitive and learning skills, and expression profiles of selected genes in an adult, early diagnosed with DD, and in his son of typical development. We focused on the expression of genes, based on the assumption that the regulation of transcription may be affected by genetic and epigenetic factors. The results highlighted a potential chain link between neuroplasticity-related as well as stress-related genes, such as BDNF, Sox4, mineralocorticoid receptor (MR), and GILZ, leftward asymmetries in the amygdala and selective cerebellum lobules, and tendencies for personality disorders and dyslexia. This correlation may reflect the presence of a specific neuro-epigenetic component of DD, ensuing from the continuous, multifaceted difficulties in the acquisition of cognitive and learning skills, which in turn may act as a fostering mechanism for the onset of long-term disorders. This is in line with recent findings demonstrating a dysfunction in processes supported by rapid neural adaptation in children and adults with dyslexia. Accordingly, the co-evaluation of all the above parameters may indicate a stress-related dyslexia endophenotype that should be carefully considered for a more integrated diagnosis and effective intervention.

Neurobiological Sex Differences in Developmental Dyslexia

Understanding sex differences at the neurobiological level has become increasingly crucial in both basic and applied research. In the study of developmental dyslexia, early neuroimaging investigations were dominated by male-only or male-dominated samples, due at least in part to males being diagnosed more frequently. While recent studies more consistently balance the inclusion of both sexes, there has been little movement toward directly characterizing potential sex differences of the disorder. However, a string of recent work suggests that the brain basis of dyslexia may indeed be different in males and females. This potential sex difference has implications for existing models of dyslexia, and would inform approaches to the remediation of reading difficulties. This article reviews recent evidence for sex differences in dyslexia, discusses the impact these studies have on the understanding of the brain basis of dyslexia, and provides a framework for how these differential neuroanatomical profiles may develop.

Effects of Delayed Cord Clamping on 4-Month Ferritin Levels, Brain Myelin Content, and Neurodevelopment: A Randomized Controlled Trial

OBJECTIVE

To evaluate whether placental transfusion influences brain myelination at 4 months of age.

STUDY DESIGN

A partially blinded, randomized controlled trial was conducted at a level III maternity hospital in the US. Seventy-three healthy term pregnant women and their singleton fetuses were randomized to either delayed umbilical cord clamping (DCC, >5 minutes) or immediate clamping (ICC, <20 seconds). At 4 months of age, blood was drawn for ferritin levels. Neurodevelopmental testing (Mullen Scales of Early Learning) was administered, and brain myelin content was measured with magnetic resonance imaging. Correlations between myelin content and ferritin levels and group-wise DCC vs ICC brain myelin content were completed.

RESULTS

In the DCC and ICC groups, clamping time was 172 ± 188 seconds vs 28 ± 76 seconds (P < .002), respectively; the 48-hour hematocrit was 57.6% vs 53.1% (P < .01). At 4 months, infants with DCC had significantly greater ferritin levels (96.4 vs 65.3 ng/dL, P = .03). There was a positive relationship between ferritin and myelin content. Infants randomized to the DCC group had greater myelin content in the internal capsule and other early maturing brain regions associated with motor, visual, and sensory processing/function. No differences were seen between groups in the Mullen testing.

CONCLUSION

At 4 months, infants born at term receiving DCC had greater ferritin levels and increased brain myelin in areas important for early life functional development. Endowment of iron-rich red blood cells obtained through DCC may offer a longitudinal advantage for early white matter development.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01620008.

Processing of structural neuroimaging data in young children: Bridging the gap between current practice and state-of-the-art methods

The structure of the brain is subject to very rapid developmental changes during early childhood. Pediatric studies based on Magnetic Resonance Imaging (MRI) over this age range have recently become more frequent, with the advantage of providing in vivo and non-invasive high-resolution images of the developing brain, toward understanding typical and atypical trajectories. However, it has also been demonstrated that application of currently standard MRI processing methods that have been developed with datasets from adults may not be appropriate for use with pediatric datasets. In this review, we examine the approaches currently used in MRI studies involving young children, including an overview of the rationale for new MRI processing methods that have been designed specifically for pediatric investigations. These methods are mainly related to the use of age-specific or 4D brain atlases, improved methods for quantifying and optimizing image quality, and provision for registration of developmental data obtained with longitudinal designs. The overall goal is to raise awareness of the existence of these methods and the possibilities for implementing them in developmental neuroimaging studies.

Brain Responses to Letters and Speech Sounds and Their Correlations With Cognitive Skills Related to Reading in Children

Letter-speech sound (LSS) integration is crucial for initial stages of reading acquisition. However, the relationship between cortical organization for supporting LSS integration, including unimodal and multimodal processes, and reading skills in early readers remains unclear. In the present study, we measured brain responses to Finnish letters and speech sounds from 29 typically developing Finnish children in a child-friendly audiovisual integration experiment using magnetoencephalography. Brain source activations in response to auditory, visual and audiovisual stimuli as well as audiovisual integration response were correlated with reading skills and cognitive skills predictive of reading development after controlling for the effect of age. Regression analysis showed that from the brain measures, the auditory late response around 400 ms showed the largest association with phonological processing and rapid automatized naming abilities. In addition, audiovisual integration effect was most pronounced in the left and right temporoparietal regions and the activities in several of these temporoparietal regions correlated with reading and writing skills. Our findings indicated the important role of temporoparietal regions in the early phase of learning to read and their unique contribution to reading skills.

Atypical White Matter Connectivity in Dyslexic Readers of a Fairly Transparent Orthography

Atypical structural properties of the brain's white matter bundles have been associated with failing reading acquisition in developmental dyslexia. Because these white matter properties may show dynamic changes with age and orthographic depth, we examined fractional anisotropy (FA) along 16 white matter tracts in 8- to 11-year-old dyslexic (DR) and typically reading (TR) children learning to read in a fairly transparent orthography (Dutch). Our results showed higher FA values in the bilateral anterior thalamic radiations of DRs and FA values of the left thalamic radiation scaled with behavioral reading-related scores. Furthermore, DRs tended to have atypical FA values in the bilateral arcuate fasciculi. Children's age additionally predicted FA values along the tracts. Together, our findings suggest differential contributions of cortical and thalamo-cortical pathways to the developing reading network in dyslexic and typical readers, possibly indicating prolonged letter-by-letter reading or increased attentional and/or working memory demands in dyslexic children during reading.

Simulating reading acquisition: The link between reading outcome and multimodal brain signatures of letter-speech sound learning in prereaders

During reading acquisition, neural reorganization of the human brain facilitates the integration of letters and speech sounds, which enables successful reading. Neuroimaging and behavioural studies have established that impaired audiovisual integration of letters and speech sounds is a core deficit in individuals with developmental dyslexia. This longitudinal study aimed to identify neural and behavioural markers of audiovisual integration that are related to future reading fluency. We simulated the first step of reading acquisition by performing artificial-letter training with prereading children at risk for dyslexia. Multiple logistic regressions revealed that our training provides new precursors of reading fluency at the beginning of reading acquisition. In addition, an event-related potential around 400 ms and functional magnetic resonance imaging activation patterns in the left planum temporale to audiovisual correspondences improved cross-validated prediction of future poor readers. Finally, an exploratory analysis combining simultaneously acquired electroencephalography and hemodynamic data suggested that modulation of temporoparietal brain regions depended on future reading skills. The multimodal approach demonstrates neural adaptations to audiovisual integration in the developing brain that are related to reading outcome. Despite potential limitations arising from the restricted sample size, our results may have promising implications both for identifying poor-reading children and for monitoring early interventions.