Event-related correlations in learning impaired children during A hybrid go/no-go choice reaction visual-motor task

MRI in assessing children with learning disability, focal findings, and reduced automaticity

OBJECTIVES

In children with clinically diagnosed learning disabilities with focal findings on neurologic or neuropsychological evaluations, there is a hypothesized association between disorders in automaticity and focal structural abnormalities observed in brain MRIs.

METHODS

We undertook a retrospective analysis of cases referred to a tertiary-hospital-based learning disabilities program. Individuals were coded as having a focal deficit if either neurologic or neuropsychological evaluation demonstrated focal dysfunction. Those with abnormal MRI findings were categorized based on findings. Children with abnormalities from each of these categories were compared in terms of deficits in automaticity, as measured by the tasks of Rapid Automatized Naming, Rapid Alternating Stimulus Naming, or the timed motor performance battery from the Physical and Neurological Examination for Soft Signs. Data were compared in children with and without disorders of automaticity regarding type of brain structure abnormality.

RESULTS

Of the 1,587 children evaluated, 127 had a focal deficit. Eighty-seven had a brain MRI (52 on 1.5-tesla machines and 35 on 3.0-tesla machines). Forty of these images were found to be abnormal. These children were compared with a clinic sample of 150 patients with learning disabilities and no focal findings on examination, who also had undergone MRI. Only 5 of the latter group had abnormalities on MRI. Reduced verbal automaticity was associated with cerebellar abnormalities, whereas reduced automaticity on motor or motor and verbal tasks was associated with white matter abnormalities.

CONCLUSION

Reduced automaticity of retrieval and slow timed motor performance appear to be highly associated with MRI findings.

Long latency evoked potential database for clinical applications: justification and examples

We summarize our experience with the clinical utility of long latency evoked potential (EP) data in clinical QEEG studies. In contrast to common wisdom, such EP data are consistent across appropriately chosen age groups. In a healthy adult population, EP data correlate consistently with independently collected psychological variables. In our pediatric referral population, EP data are of greatest and most unique value in the learning disabilities but also augment detection of abnormality in epilepsy and behavioral abnormality. Selection of subjects for a clinical database on the basis of examined medical, neurological and behavioral health, forms adequately consistent groupings for clinical utility. The use of the Z-SPM is essential for detection of EP abnormality. A minimum of three replications within a clinical study protects against chance/false positives. Also, the true data dimensionality within EP data sets is far less than the total number of variables typically collected.