Altered hemispheric asymmetry during word processing in dyslexic children: an event-related potential study

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.

Laterality and visuospatial strategies among young children: A novel 3D-2D transcription task

Recent findings showed that children, like adults, exhibit directional biases leading to asymmetrical drawings. This appears to be the result of a complex interaction between several biological, motoric, and cultural factors. We created a drawing task designed to investigate the influence of laterality (i.e., hemispherical functional specialization and handedness) and sex on children's graphical asymmetries. This task consists of transcribing a symmetrical three-dimensional landscape model to a two-dimensional representation. Sixty-six French pre-school children, aged between 5 and 6 years, were asked to undertake the 3D-2D transcription task, as well as the classical Alter's directionality task. The novel task exhibited higher sensitivity than the Alter's directionality test when examining the spatial biases resulting from handedness, and sex. Specific drawing patterns related to these variables were identified. These results suggest that, in addition to the influence of biomechanical factors and handedness, sex plays a role in children's early graphomotor development. They also support the influence of laterality as a key factor underlying early directional biases.

Cortical responses to tone and phoneme mismatch as a predictor of dyslexia? A systematic review

Evidence from event-related-potential (ERP) studies has repeatedly shown differences in the perception and processing of auditory stimuli in children with dyslexia compared to control children. The mismatch negativity (MMN) - an ERP component reflecting passive auditory change detection ability - has been found to be reduced, not only in children with a diagnosis of dyslexia, but also in infants and preschool children at risk of developing dyslexia. However, the results are controversial due to the different methods, age of the children and stimuli used. The aim of the present review is to summarize and evaluate the MMN research about at-risk children in order to identify risk factors that discriminate between children with and without dyslexia risk and to analyze if the MMR (the abbreviation refers to positive and negative mismatch responses) correlates with later reading and spelling ability. A literature search yielded 17 studies reporting MMR to speech or non-speech stimuli in children at risk of dyslexia. The results of the studies were inconsistent. Studies measuring speech MMR often found attenuated amplitudes in the at-risk group, but mainly in very young children. The results for older children (6-7years) and for non-speech stimuli are more heterogeneous. A moderate positive correlation of MMR amplitude size with later reading and spelling abilities was consistently found. Overall, the findings of this review indicate that the MMR can be a valuable part of early dyslexia identification, which can enable efficient support and intervention for a child before the first problems appear.

Event Related Potentials Reveal Early Phonological and Orthographic Processing of Single Letters in Letter-Detection and Letter-Rhyme Paradigms

INTRODUCTION

When and where phonological processing occurs in the brain is still under some debate. Most paired-rhyme and phonological priming studies used word stimuli, which involve complex neural networks for word recognition and semantics. This study investigates early (<300 ms) and late (>300 ms) orthographic and phonological processing of letters.

METHODS

Fifteen participants aged 20-35 engaged in three two-forced choice experiments, one letter-detection (LetterID) and two letter-rhyme (Paired-Rhyme and Letter-Rhyme) tasks. From the EEG recordings, event related potential (ERP) differences within and across task stimuli were found. We also calculated the global field power (GFP) for each participant. Accuracies and reaction times were also measured from their button presses for each task.

RESULTS

Behavioral: Reaction times were 18 ms faster to letter than pseudoletter stimuli, and 27 ms faster to rhyme than nonrhyme stimuli.

ERP/GFP

In the LetterID task, grand-mean evoked potentials (EPs) showed typical P1, N1, P2, and P3 waveform morphologies to letter and pseudoletter stimuli, with GFPs to pseudoletters being greater than letters from 160-600 ms. Across both rhyme tasks, there were greater negativities for nonrhyme than for rhyme stimuli at 145 ms and 426 ms. The P2 effect for rhyme stimuli was smaller than letter stimuli when compared across tasks.

CONCLUSION

Differences in early processing of letters vs. pseudoletters between 130-190 ms suggest that letters are processed earlier and perhaps faster in the brain than pseudoletters. The P2 effect between letter and rhyme stimuli likely reflect sublexical phonological processing. Together, findings from our study fill in evidence for the temporal dynamics of orthographic and phonological processing of single letters.

Brain plasticity in aphasic patients: intra- and inter-hemispheric reorganisation of the whole linguistic network probed by N150 and N350 components

The present study examined linguistic plastic reorganization of language through Evoked Potentials in a group of 17 non-fluent aphasic patients who had suffered left perisylvian focal lesions, and showed a good linguistic recovery. Language reorganisation was probed with three linguistic tasks (Phonological, Semantic, Orthographic), the early word recognition potential (N150) and the later phonological-related component (N350). Results showed the typical left-lateralised posterior N150 in healthy controls (source: left Fusiform Gyrus), that was bilateral (Semantic) or right sided (Phonological task) in patients (sources: right Inferior/Middle Temporal and Fusiform Gyri). As regards N350, controls revealed different intra- and inter-hemispheric linguistic activation across linguistic tasks, whereas patients exhibited greater activity in left intact sites, anterior and posterior to the damaged area, in all tasks (sources: Superior Frontal Gyri). A comprehensive neurofunctional model is presented, describing how complete intra- and inter-hemispheric reorganisation of the linguistic networks occurs after aphasic damage in the strategically dominant left perisylvian linguistic centres.

What does the brain of children with developmental dyslexia tell us about reading improvement? ERP evidence from an intervention study

Intervention is key to managing developmental dyslexia (DD), but not all children with DD benefit from treatment. Some children improve (improvers, IMP), whereas others do not improve (non-improvers, NIMP). Neurobiological differences between IMP and NIMP have been suggested, but studies comparing IMP and NIMP in childhood are missing. The present study examined whether ERP patterns change with treatment and differ between IMP and NIMP. We investigated the ERPs of 28 children with DD and 25 control children (CON) while performing a phonological lexical decision (PLD) task before and after a 6-month intervention. After intervention children with DD were divided into IMP (n = 11) and NIMP (n = 17). In the PLD–task children were visually presented with words, pseudohomophones, pseudowords, and false fonts and had to decide whether the presented stimulus sounded like an existing German word or not. Prior to intervention IMP showed higher N300 amplitudes over fronto-temporal electrodes compared to NIMP and CON and N400 amplitudes were attenuated in both IMP and NIMP compared to CON. After intervention N300 amplitudes of IMP were comparable to those of CON and NIMP. This suggests that the N300, which has been related to phonological access of orthographic stimuli and integration of orthographic and phonological representations, might index a compensatory mechanism or precursor that facilitates reading improvement. The N400, which is thought to reflect grapheme-phoneme conversion or the access to the orthographic lexicon increased in IMP from pre to post and was comparable to CON after intervention. Correlations between N300 amplitudes pre, growth in reading ability and N400 amplitudes post indicated that higher N300 amplitudes might be important for reading improvement and increase in N400 amplitudes. The results suggest that children with DD, showing the same cognitive profile might differ regarding their neuronal profile which could further influence reading improvement.

Space representation in children with dyslexia and children without dyslexia: contribution of line bisection and circle centering tasks

Line bisection tasks (different space locations and different line lengths) and circle centering tasks (visuo-proprioceptive and proprioceptive explorations, with left or right starting positions) were used to investigate space representation in children with dyslexia and children without dyslexia. In line bisection, children with dyslexia showed a significant rightward bias for central and right-sided locations and a leftward bias for left-sided location. Furthermore, the spatial context processing was asymmetrically more efficient in the left space. In children without dyslexia, no significant bias was observed in central lines but the spatial context processing was symmetrical in both spaces. When the line length varied, no main effect was shown. These results strengthen the 'inverse pseudoneglect' hypothesis in dyslexia. In the lateral dimension of the circle centering tasks, children showed a response bias in the direction of the starting hand location for proprioceptive condition. For radial dimension, the children showed a forward bias in visuo-proprioceptive condition and more backward error in proprioceptive condition. Children with dyslexia showed a forward bias in clockwise exploration and more accurate performance in counterclockwise exploration for left starting position which may be in accordance with leftward asymmetrical spatial context processing in line bisection. These results underline the necessity to use the line bisection task with different locations as an appropriate experimental paradigm to study lateral representational bias in dyslexia. The contribution of the present results in the understanding of space representation in children with dyslexia and children without dyslexia is discussed in terms of attentional processes and neuroanatomical substrate.

Beta EEG band: a measure of functional brain damage and language reorganization in aphasic patients after recovery

Functional reorganization of language was investigated in a group of eleven non-fluent aphasic patients after linguistic recovery and in a group of matched healthy adults. The ElectroEncephaloGram (EEG) was recorded from 38 scalp electrodes and high-beta band (21-28 Hz), an index of cognitive cortical arousal, was computed as normalized percentage across 0-100 Hz spectral range in six electrode clusters during three linguistic tasks: Phonological, Semantic and Orthographic/visuo-perceptual. During the Phonological task, controls showed greater beta activation on left versus right central cluster, whereas aphasic patients exhibited an inverted pattern of lateralization. In addition, patients' left central cluster, located over the core lesion, showed reduced beta activity with respect to controls. A similar inhibited activation was found in aphasics' left posterior cluster located over undamaged areas. At left anterior locations, aphasics, unlike controls, exhibited larger left versus right beta activity during both Phonological and Orthographic/visuo-perceptual tasks. Results point to substantial reorganization of language in recovered non-fluent aphasics at left prefrontal sites located anterior to the damaged Broca's area and inhibited language-related activation in left posterior undamaged, but disconnected, regions.

Early adversity and neural correlates of executive function: implications for academic adjustment

Early adversity can negatively impact the development of cognitive functions, although little is known about whether such effects can be remediated later in life. The current study examined one facet of executive functioning - inhibitory control - among children who experienced institutional care and explored the impact of a foster care intervention within the context of the Bucharest Early Intervention Project (BEIP). Specifically, a go/nogo task was administered when children were eight years old and behavioral and event-related potential (ERP) measures were collected. Results revealed that children assigned to care as usual (i.e. institutional care) were less accurate and exhibited slower neural responses compared to children assigned to the foster care intervention and children who had never been institutionalized. However, children in both the care as usual and foster care groups exhibited diminished attention processing of nogo cues as assessed via P300 amplitude. Foster care children also showed differential reactivity between correct and error responses via the error-related negativity (ERN) as compared to children in the care as usual group. Combined, the results highlight perturbations in neural sources of behavioral and attention problems among children experiencing early adversity. Potential implications for academic adjustment in at risk children are discussed.

Language comprehension vs. language production: age effects on fMRI activation

Normal language acquisition is a process that unfolds with amazing speed primarily in the first years of life. However, the refinement of linguistic proficiency is an ongoing process, extending well into childhood and adolescence. An increase in lateralization and a more focussed productive language network have been suggested to be the neural correlates of this process. However, the processes underlying the refinement of language comprehension are less clear. Using a language comprehension (Beep Stories) and a language production (Vowel Identification) task in fMRI, we studied language representation and lateralization in 36 children, adolescents, and young adults (age 6-24 years). For the language comprehension network, we found a more focal activation with age in the bilateral superior temporal gyri. No significant increase of lateralization with age could be observed, so the neural basis of language comprehension as assessed with the Beep Stories task seems to be established in a bilateral network by late childhood. For the productive network, however, we could confirm an increase with age both in focus and lateralization. Only in the language comprehension task did verbal IQ correlate with lateralization, with higher verbal IQ being associated with more right-hemispheric involvement. In some subjects (24%), language comprehension and language production were lateralized to opposite hemispheres.

Cortical reorganization in dyslexic children after phonological training: evidence from early evoked potentials

Brain plasticity was investigated in 14 Italian children affected by developmental dyslexia after 6 months of phonological training. The means used to measure language reorganization was the recognition potential, an early wave, also called N150, elicited by automatic word recognition. This component peaks over the left temporo-occipital cortex and its amplitude depends on linguistic expertise. N150 elicited by written words was measured both in dyslexic children before and after training and in a sample of matched normal readers during phonological, semantic and orthographic tasks. After training, dyslexic children increased their reading speed. Normal readers showed a typical left posterior N150, whereas in dyslexic children it was equally distributed across hemispheres before and shifted to left posterior sites after training. In addition, dyslexics' left posterior N150 asymmetry on the phonological task after training was significantly correlated with reading speed improvement, that is, those children who showed the greatest left shift in phonological N150 also had the greatest reading speed improvement. Source localization of the N150 component was made with both the Standard Low Resolution Electromagnetic Tomography software and the classical dipole analysis method termed Brain Electrical Source Analysis. The N150 generator lies in the left occipito-temporal cortex (Brodmann areas 39, 37 and 19) in good readers, but in right homologous areas in dyslexic children before training. After the treatment, the dyslexics' main N150 generator shifted to the left occipito-inferotemporal cortex (namely Brodmann areas 37 and 19) with small differences between tasks. The two source location methods provided consistent, converging solutions. Results add to the current literature on the phonological hypothesis of dyslexia by showing hemispheric reorganization of linguistic networks at the level of early word recognition potential. Furthermore, the present work is the first to investigate brain reorganization in a regular/transparent language like Italian.

Cognitive levels of performance account for hemispheric lateralisation effects in dyslexic and normally reading children

Recent theories of developmental dyslexia explain reading deficits in terms of deficient phonological awareness, attention, visual and auditory processing, or automaticity. Since dyslexia has a neurobiological basis, the question arises how the reader's proficiency in these cognitive variables affects the brain regions involved in visual word recognition. This question was addressed in two fMRI experiments with 19 normally reading children (Experiment 1) and 19 children with dyslexia (Experiment 2). First, reading-specific brain activation was assessed by contrasting the BOLD signal for reading aloud words vs. overtly naming pictures of real objects. Next, ANCOVAs with brain activation during reading the individuals' scores for all five cognitive variables assessed outside the scanner as covariates were performed. Whereas the normal readers' brain activation during reading showed co-variation effects predominantly in the right hemisphere, the reverse pattern was observed for the dyslexics. In particular, middle frontal gyrus, inferior parietal cortex, and precuneus showed contralateral effects for controls as compared to dyslexics. In line with earlier findings in the literature, these data hint at a global change in hemispheric asymmetry during cognitive processing in dyslexic readers, which, in turn, might affect reading proficiency.

Predicting Reading Growth with Event-Related Potentials: Thinking Differently about Indexing "Responsiveness"

The purpose of this study was to determine if event-related potential (ERP) data collected during three reading-related tasks (Letter Sound Matching, Nonword Rhyming, and Nonword Reading) could be used to predict short-term reading growth on a curriculum-based measure of word identification fluency over 19 weeks in a sample of 29 first-grade children. Results indicate that ERP responses to the Letter Sound Matching task were predictive of reading change and remained so after controlling for two previously validated behavioral predictors of reading, Rapid Letter Naming and Segmenting. ERP data for the other tasks were not correlated with reading change. The potential for cognitive neuroscience to enhance current methods of indexing responsiveness in a response-to-intervention (RTI) model is discussed.

Brain plasticity in developmental dyslexia after phonological treatment: a beta EEG band study

Linguistic EEG hemispheric reorganization was investigated in 14 dyslexic children after a 6-month phonological training (10 min/day through PC software). Error rates from three linguistic tasks significantly decreased and reading speed improved after the training. A significant positive correlation (r(12)=0.536) was found at posterior sites for the phonological task only, showing that those children who had the greatest reading speed enhancement showed the largest left posterior EEG beta power increase.

Cerebral reorganization as a function of linguistic recovery in children: An fMRI study

Characterizing and mapping the relationship between neuronal reorganization and functional recovery are essential to the understanding of cerebral plasticity and the dynamic processes which occur following brain damage. The neuronal mechanisms underlying linguistic recovery following left hemisphere (LH) lesions are still unknown. Using functional magnetic resonance imaging (fMRI), we investigated whether the extent of brain lateralization of linguistic functioning in specific regions of interest (ROIs) is correlated with the level of linguistic performance following recovery from acquired childhood aphasia. The study focused on a rare group of children in whom lesions occurred after normal language acquisition, but prior to complete maturation of the brain. During fMRI scanning, rhyming, comprehension and verb generation activation tasks were monitored. The imaging data were evaluated with reference to linguistic performance measured behaviorally during imaging, as well as outside the scanner. Compared with normal controls, we found greater right hemisphere (RH) lateralization in patients. However, correlations with linguistic performance showed that increased proficiency in linguistic tasks was associated with greater lateralization to the LH. These results were replicated in a longitudinal case study of a patient scanned twice, 3 years apart. Additional improvement in linguistic performance of the patient was accompanied by increasing lateralization to the LH in the anterior language region. This, however, was the result of a decreased involvement of the RH. These findings suggest that recovery is a dynamic, ongoing process, which may last for years after onset. The role of each hemisphere in the recovery process may continuously change within the chronic stage.

Schizophrenia as failure of left hemispheric dominance for the phonological component of language

Background

T. J. Crow suggested that the genetic variance associated with the evolution in Homo sapiens of hemispheric dominance for language carries with it the hazard of the symptoms of schizophrenia. Individuals lacking the typical left hemisphere advantage for language, in particular for phonological components, would be at increased risk of the typical symptoms such as auditory hallucinations and delusions.

Methodology/Principal Findings

Twelve schizophrenic patients treated with low levels of neuroleptics and twelve matched healthy controls participated in an event-related potential experiment. Subjects matched word-pairs in three tasks: rhyming/phonological, semantic judgment and word recognition. Slow evoked potentials were recorded from 26 scalp electrodes, and a laterality index was computed for anterior and posterior regions during the inter stimulus interval. During phonological processing individuals with schizophrenia failed to achieve the left hemispheric dominance consistently observed in healthy controls. The effect involved anterior (fronto-temporal) brain regions and was specific for the Phonological task; group differences were small or absent when subjects processed the same stimulus material in a Semantic task or during Word Recognition, i.e. during tasks that typically activate more widespread areas in both hemispheres.

Conclusions/Significance

We show for the first time how the deficit of lateralization in the schizophrenic brain is specific for the phonological component of language. This loss of hemispheric dominance would explain typical symptoms, e.g. when an individual's own thoughts are perceived as an external intruding voice. The change can be interpreted as a consequence of “hemispheric indecision”, a failure to segregate phonological engrams in one hemisphere.

The case of letter rhyming: an ERP study

Previous visual event-related potential (ERP) studies using prime-target pairs of word and pseudoword stimuli have reported a robust rhyming effect such that nonrhyming targets elicit a larger N450 than rhyming targets. However, results of similar studies using simpler linguistic stimuli-single letters-are equivocal. We used lowercase and uppercase letter pairs in a simple ERP prime-target rhyming paradigm to further investigate whether single letters could elicit the typical rhyming effect and, if so, whether the rhyming effect was sensitive to physical orthography (which differed between the case conditions). The typical N450 rhyming effect was observed in both the lowercase and uppercase letter pair conditions, with similar amplitude and latency between conditions. This pattern of results suggests that the N450 rhyming effect is not sensitive to physical (case) orthography and likely primarily indexes phonological processing related to the rhyme task.

Delta EEG activity as a marker of dysfunctional linguistic processing in developmental dyslexia

The present study used delta EEG band to test the hypothesis of a cerebral maturational delay and a functional altered cerebral asymmetry for phonological processing in dyslexic children. A group of 14 children with dyslexia and 28 matched controls participated in a linguistic paradigm in which the same words were processed in three tasks: phonological, semantic, and orthographic. Delta amplitude was computed as an index of cortical inhibition in four different phases of word processing. In anterior sites, controls showed left activation (reduced delta) during the phonological task and bilateral activation in the other two tasks. Conversely, children with dyslexia showed greater overall delta amplitude, indexing a cerebral maturation delay and an altered language laterality pattern. In the phonological task they had larger left anterior delta (inhibition of left frontal linguistic locations) and smaller left posterior delta amplitude (activation of left posterior sites silent in controls). Results support the phonological deficit hypothesis of developmental dyslexia and the validity of EEG delta band as functional and clinical measure of language laterality.

[The effects of functional electrical stimulation on cortical interhemispheric asymmetry]

The aim of the present study was to assess the effects of functional electrical stimulation (FES) on cortical interhemispheric asymmetry. Electrostimulation was performed on the right forearm to stimulate the extension of the index finger. EEG activity was recorded simultaneously. The sample included 45 subjects randomly divided into 3 groups of 15 subjects each: control group (submitted to 24 blocks of stimulation at a null intensity current), group 1 (24 blocks) and group 2 (36 blocks). Interhemispheric asymmetry between F3-F4, C3-C4 and P3-P4 was analyzed through an Anova. Results pointed out to a group x electrode interaction and a general tendency of asymmetry decrease after stimulation.

Language lateralization in phonological, semantic and orthographic tasks: A slow evoked potential study

Most of literature on language has shown how different word-classes activate distinct neural networks within linguistic cortical areas. The present investigation aimed to demonstrate that, by means of slow evoked potentials and using the same set of words in different tasks, it is possible to activate cortical networks that are spatially and temporally distinguished. Twenty healthy subjects had to evaluate, in a word pair matching session, whether two words rhymed (phonological task), were semantically related (semantic task) or were written in the same letter case (orthographic task). Slow wave amplitude was computed in three relevant time windows: the last 0.5 s of first word presentation (W1), the initial contingent negative variation (iCNV) and the terminal CNV (tCNV). During W1 and iCNV intervals, both the orthographic and the phonological tasks were left lateralized. Furthermore, the phonological task was more lateralized than the orthographic because of a greater inhibition of the right hemisphere, whereas the orthographic task was characterized by a greater bilateral posterior activation. During the tCNV, only the phonological task remained left lateralized while orthographic and semantic were bilaterally distributed. Although the use of the same set of words tends to activate widely overlapped networks, in the present research task manipulation was effective in demonstrating task dependent differences in brain lateralization. Thus, the present paradigm and the adopted tasks are especially suited for studying deficit and recovery of language in patients affected by linguistic disorders such as developmental dyslexia and aphasia.