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Wang A, Yan X, Feng G, Cao F. Shared and task-specific brain functional differences across multiple tasks in children with developmental dyslexia. Neuropsychologia 2024; 201:108935. [PMID: 38848989 DOI: 10.1016/j.neuropsychologia.2024.108935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/09/2024]
Abstract
Different tasks have been used in examining the neural functional differences associated with developmental dyslexia (DD), and consequently, different findings have been reported. However, very few studies have systematically compared multiple tasks in understanding what specific task differences each brain region is associated with. In this study, we employed an auditory rhyming task, a visual rhyming task, and a visual spelling task, in order to investigate shared and task-specific neural differences in Chinese children with DD. First, we found that children with DD had reduced activation in the opercular part of the left inferior frontal gyrus (IFG) only in the two rhyming tasks, suggesting impaired phonological analysis. Children with DD showed functional differences in the right lingual gyrus/inferior occipital gyrus only in the two visual tasks, suggesting deficiency in their visuo-orthographic processing. Moreover, children with DD showed reduced activation in the left dorsal inferior frontal gyrus and increased activation in the right precentral gyrus across all of the three tasks, suggesting neural signatures of DD in Chinese. In summary, our study successfully separated brain regions associated with differences in orthographic processing, phonological processing, and general lexical processing in DD. It advances our understanding about the neural mechanisms of DD.
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Affiliation(s)
- Anqi Wang
- Department of Psychology, Sun Yat-Sen University, China
| | - Xiaohui Yan
- Department of Psychology, the University of Hong Kong, China; State Key Lab of Brain and Cognitive Sciences, the University of Hong Kong, China
| | - Guoyan Feng
- Department of Psychology, Sun Yat-Sen University, China; School of Management, Guangzhou Xinhua University, China
| | - Fan Cao
- Department of Psychology, the University of Hong Kong, China; State Key Lab of Brain and Cognitive Sciences, the University of Hong Kong, China.
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2
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Ocklenburg S, Mundorf A, Gerrits R, Karlsson EM, Papadatou-Pastou M, Vingerhoets G. Clinical implications of brain asymmetries. Nat Rev Neurol 2024:10.1038/s41582-024-00974-8. [PMID: 38783057 DOI: 10.1038/s41582-024-00974-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
No two human brains are alike, and with the rise of precision medicine in neurology, we are seeing an increased emphasis on understanding the individual variability in brain structure and function that renders every brain unique. Functional and structural brain asymmetries are a fundamental principle of brain organization, and recent research suggests substantial individual variability in these asymmetries that needs to be considered in clinical practice. In this Review, we provide an overview of brain asymmetries, variations in such asymmetries and their relevance in the clinical context. We review recent findings on brain asymmetries in neuropsychiatric and neurodevelopmental disorders, as well as in specific learning disabilities, with an emphasis on large-scale database studies and meta-analyses. We also highlight the relevance of asymmetries for disease symptom onset in neurodegenerative diseases and their implications for lateralized treatments, including brain stimulation. We conclude that alterations in brain asymmetry are not sufficiently specific to act as diagnostic biomarkers but can serve as meaningful symptom or treatment response biomarkers in certain contexts. On the basis of these insights, we provide several recommendations for neurological clinical practice.
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Affiliation(s)
- Sebastian Ocklenburg
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany.
- ICAN Institute for Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany.
- Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Annakarina Mundorf
- ISM Institute for Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
- Division of Cognitive Neuroscience, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robin Gerrits
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Emma M Karlsson
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Marietta Papadatou-Pastou
- National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Guy Vingerhoets
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
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Conte G, Quadrana L, Zotti L, Di Garbo A, Oliveri M. Prismatic adaptation coupled with cognitive training as novel treatment for developmental dyslexia: a randomized controlled trial. Sci Rep 2024; 14:7148. [PMID: 38531968 DOI: 10.1038/s41598-024-57499-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024] Open
Abstract
Despite intense and costly treatments, developmental dyslexia (DD) often persists into adulthood. Several brain skills unrelated to speech sound processing (i.e., phonology), including the spatial distribution of visual attention, are abnormal in DD and may represent possible treatment targets. This study explores the efficacy in DD of rightward prismatic adaptation (rPA), a visuomotor adaptation technique that enables visuo-attentive recalibration through shifts in the visual field induced by prismatic goggles. A digital intervention of rPA plus cognitive training was delivered weekly over 10 weeks to adolescents with DD (aged 13-17) assigned either to treatment (N = 35) or waitlist (N = 35) group. Efficacy was evaluated by repeated measures MANOVA assessing changes in working memory index (WMI), processing speed index (PSI), text reading speed, and words/pseudowords reading accuracy. rPA treatment was significantly more effective than waitlist (p ≤ 0.001; ηp2 = 0.815). WMI, PSI, and reading speed increased in the intervention group only (p ≤ 0.001, ηp2 = 0.67; p ≤ 0.001, ηp2 = 0.58; p ≤ 0.001, ηp2 = 0.29, respectively). Although modest change was detected for words and pseudowords accuracy in the waitlist group only (words: p ≤ 0.001, d = 0.17, pseudowords: p = 0.028; d = 0.27), between-group differences were non-significant. rPA-coupled cognitive training enhances cognitive and reading abilities in adolescents with DD. This innovative approach could have implications for early remedial treatment.
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Affiliation(s)
- Giulia Conte
- Child and Adolescent Neuropsychiatry Division, Department of Human Neuroscience, Sapienza University of Rome, 108 via dei Sabelli, 00185, Rome, Italy.
| | - Lauro Quadrana
- Child and Adolescent Neuropsychiatry Division, Department of Human Neuroscience, Sapienza University of Rome, 108 via dei Sabelli, 00185, Rome, Italy
| | - Lilian Zotti
- Child and Adolescent Neuropsychiatry Division, Department of Human Neuroscience, Sapienza University of Rome, 108 via dei Sabelli, 00185, Rome, Italy
| | - Agnese Di Garbo
- NeuroTeam Life & Science, 112 via della Libertà, 90143, Palermo, Italy
| | - Massimiliano Oliveri
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, 129 via del Vespro, 90127, Palermo, Italy
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Battisti A, Lazzaro G, Varuzza C, Vicari S, Menghini D. Effects of online tDCS and hf-tRNS on reading performance in children and adolescents with developmental dyslexia: a study protocol for a cross sectional, within-subject, randomized, double-blind, and sham-controlled trial. Front Neurol 2024; 15:1338430. [PMID: 38533416 PMCID: PMC10964771 DOI: 10.3389/fneur.2024.1338430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
Background Developmental Dyslexia (DD) is a brain-based developmental disorder causing severe reading difficulties. The extensive data on the neurobiology of DD have increased interest in brain-directed approaches, such as transcranial direct current stimulation (tDCS), which have been proposed for DD. While positive outcomes have been observed, results remain heterogeneous. Various methodological approaches have been employed to address this issue. However, no studies have compared the effects of different transcranial electrical stimulation techniques (e.g., tDCS and transcranial random noise stimulation, tRNS), on reading in children and adolescents with DD. Methods The present within-subject, double-blind, and sham-controlled trial aims to investigate the effects of tDCS and hf-tRNS on reading in children and adolescents with DD. Participants will undergo three conditions with a one-week interval session: (A) single active tDCS session; (B) single active hf-tRNS session; and (C) single sham session (tDCS/hf-tRNS). Left anodal/right cathodal tDCS and bilateral tRNS will be applied over the temporo-parietal regions for 20 min each. Reading measures will be collected before and during each session. Safety and blinding parameters will be recordered. Discussion We hypothesize that tRNS will demonstrate comparable effectiveness to tDCS in improving reading compared to sham conditions. Additionally, we anticipate that hf-tRNS will exhibit a similar safety profile to tDCS. This study will contribute novel insights into the effectiveness of hf-tRNS, expediting the validation of brain-based treatments for DD.
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Affiliation(s)
- Andrea Battisti
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Human Sciences, LUMSA University, Rome, Italy
| | - Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Cristiana Varuzza
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Cilia ND, De Stefano C, Fontanella F, Siniscalchi SM. How word semantics and phonology affect handwriting of Alzheimer's patients: A machine learning based analysis. Comput Biol Med 2024; 169:107891. [PMID: 38181607 DOI: 10.1016/j.compbiomed.2023.107891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/10/2023] [Accepted: 12/19/2023] [Indexed: 01/07/2024]
Abstract
Using kinematic properties of handwriting to support the diagnosis of neurodegenerative disease is a real challenge: non-invasive detection techniques combined with machine learning approaches promise big steps forward in this research field. In literature, the tasks proposed focused on different cognitive skills to elicitate handwriting movements. In particular, the meaning and phonology of words to copy can compromise writing fluency. In this paper, we investigated how word semantics and phonology affect the handwriting of people affected by Alzheimer's disease. To this aim, we used the data from six handwriting tasks, each requiring copying a word belonging to one of the following categories: regular (have a predictable phoneme-grapheme correspondence, e.g., cat), non-regular (have atypical phoneme-grapheme correspondence, e.g., laugh), and non-word (non-meaningful pronounceable letter strings that conform to phoneme-grapheme conversion rules). We analyzed the data using a machine learning approach by implementing four well-known and widely-used classifiers and feature selection. The experimental results showed that the feature selection allowed us to derive a different set of highly distinctive features for each word type. Furthermore, non-regular words needed, on average, more features but achieved excellent classification performance: the best result was obtained on a non-regular, reaching an accuracy close to 90%.
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Affiliation(s)
- Nicole D Cilia
- Department of Computer Engineering, University of Enna "Kore", Italy; Institute for Computing and Information Sciences, Radboud University Nijmegen, The Netherlands.
| | - Claudio De Stefano
- Department of Electrical and Information Engineering Mathematics, University of Cassino and Southern Lazio, Italy.
| | - Francesco Fontanella
- Department of Electrical and Information Engineering Mathematics, University of Cassino and Southern Lazio, Italy.
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Lasnick OHM, Hoeft F. Sensory temporal sampling in time: an integrated model of the TSF and neural noise hypothesis as an etiological pathway for dyslexia. Front Hum Neurosci 2024; 17:1294941. [PMID: 38234592 PMCID: PMC10792016 DOI: 10.3389/fnhum.2023.1294941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024] Open
Abstract
Much progress has been made in research on the causal mechanisms of developmental dyslexia. In recent years, the "temporal sampling" account of dyslexia has evolved considerably, with contributions from neurogenetics and novel imaging methods resulting in a much more complex etiological view of the disorder. The original temporal sampling framework implicates disrupted neural entrainment to speech as a causal factor for atypical phonological representations. Yet, empirical findings have not provided clear evidence of a low-level etiology for this endophenotype. In contrast, the neural noise hypothesis presents a theoretical view of the manifestation of dyslexia from the level of genes to behavior. However, its relative novelty (published in 2017) means that empirical research focused on specific predictions is sparse. The current paper reviews dyslexia research using a dual framework from the temporal sampling and neural noise hypotheses and discusses the complementary nature of these two views of dyslexia. We present an argument for an integrated model of sensory temporal sampling as an etiological pathway for dyslexia. Finally, we conclude with a brief discussion of outstanding questions.
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Affiliation(s)
- Oliver H. M. Lasnick
- brainLENS Laboratory, Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States
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7
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Cainelli E, Vedovelli L, Carretti B, Bisiacchi P. EEG correlates of developmental dyslexia: a systematic review. ANNALS OF DYSLEXIA 2023; 73:184-213. [PMID: 36417146 DOI: 10.1007/s11881-022-00273-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/25/2022] [Indexed: 06/08/2023]
Abstract
Dyslexia is one of the most studied learning disorders. Despite this, its biological basis and main causes are still not fully understood. Electroencephalography (EEG) could be a powerful tool in identifying the underlying mechanisms, but knowledge of the EEG correlates of developmental dyslexia (DD) remains elusive. We aimed to systematically review the evidence on EEG correlates of DD and establish their quality. In July 2021, we carried out an online search of the PubMed and Scopus databases to identify published articles on EEG correlates in children with dyslexia aged 6 to 12 years without comorbidities. We follow the PRISMA guidelines and assess the quality using the Appraisal Tool questionnaire. Our final analysis included 49 studies (14% high quality, 63% medium, 20% low, and 2% very low). Studies differed greatly in methodology, making a summary of their results challenging. However, some points came to light. Even at rest, children with dyslexia and children in the control group exhibited differences in several EEG measures, particularly in theta and alpha frequencies; these frequencies appear to be associated with learning performance. During reading-related tasks, the differences between dyslexic and control children seem more localized in the left temporoparietal sites. The EEG activity of children with dyslexia and children in the control group differed in many aspects, both at rest and during reading-related tasks. Our data are compatible with neuroimaging studies in the same diagnostic group and expand the literature by offering new insights into functional significance.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy.
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Barbara Carretti
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy
| | - Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy
- Padova Neuroscience Centre, PNC, Padua, Italy
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Kristjánsson Á, Sigurdardottir HM. The Role of Visual Factors in Dyslexia. J Cogn 2023; 6:31. [PMID: 37397349 PMCID: PMC10312247 DOI: 10.5334/joc.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/13/2023] [Indexed: 07/04/2023] Open
Abstract
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.
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Affiliation(s)
- Árni Kristjánsson
- Icelandic Vision Lab, Department of Psychology, University of Iceland, IS
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Proverbio AM, Tacchini M, Jiang K. What do you have in mind? ERP markers of visual and auditory imagery. Brain Cogn 2023; 166:105954. [PMID: 36657242 DOI: 10.1016/j.bandc.2023.105954] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/19/2023]
Abstract
This study aimed to investigate the psychophysiological markers of imagery processes through EEG/ERP recordings. Visual and auditory stimuli representing 10 different semantic categories were shown to 30 healthy participants. After a given interval and prompted by a light signal, participants were asked to activate a mental image corresponding to the semantic category for recording synchronized electrical potentials. Unprecedented electrophysiological markers of imagination were recorded in the absence of sensory stimulation. The following peaks were identified at specific scalp sites and latencies, during imagination of infants (centroparietal positivity, CPP, and late CPP), human faces (anterior negativity, AN), animals (anterior positivity, AP), music (P300-like), speech (N400-like), affective vocalizations (P2-like) and sensory (visual vs auditory) modality (PN300). Overall, perception and imagery conditions shared some common electro/cortical markers, but during imagery the category-dependent modulation of ERPs was long latency and more anterior, with respect to the perceptual condition. These ERP markers might be precious tools for BCI systems (pattern recognition, classification, or A.I. algorithms) applied to patients affected by consciousness disorders (e.g., in a vegetative or comatose state) or locked-in-patients (e.g., spinal or SLA patients).
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Affiliation(s)
- Alice Mado Proverbio
- Cognitive Electrophysiology lab, Dept. of Psychology, University of Milano-Bicocca, Italy.
| | - Marta Tacchini
- Cognitive Electrophysiology lab, Dept. of Psychology, University of Milano-Bicocca, Italy
| | - Kaijun Jiang
- Cognitive Electrophysiology lab, Dept. of Psychology, University of Milano-Bicocca, Italy; Department of Psychology, University of Jyväskylä, Finland
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Di Pietro SV, Willinger D, Frei N, Lutz C, Coraj S, Schneider C, Stämpfli P, Brem S. Disentangling influences of dyslexia, development, and reading experience on effective brain connectivity in children. Neuroimage 2023; 268:119869. [PMID: 36639004 DOI: 10.1016/j.neuroimage.2023.119869] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
Altered brain connectivity between regions of the reading network has been associated with reading difficulties. However, it remains unclear whether connectivity differences between children with dyslexia (DYS) and those with typical reading skills (TR) are specific to reading impairments or to reading experience. In this functional MRI study, 132 children (M = 10.06 y, SD = 1.46) performed a phonological lexical decision task. We aimed to disentangle (1) disorder-specific from (2) experience-related differences in effective connectivity and to (3) characterize the development of DYS and TR. We applied dynamic causal modeling to age-matched (ndys = 25, nTR = 35) and reading-level-matched (ndys = 25, nTR = 22) groups. Developmental effects were assessed in beginning and advanced readers (TR: nbeg = 48, nadv = 35, DYS: nbeg = 24, nadv = 25). We show that altered feedback connectivity between the inferior parietal lobule and the visual word form area (VWFA) during print processing can be specifically attributed to reading impairments, because these alterations were found in DYS compared to both the age-matched and reading-level-matched TR. In contrast, feedforward connectivity from the VWFA to parietal and frontal regions characterized experience in TR and increased with age and reading skill. These directed connectivity findings pinpoint disorder-specific and experience-dependent alterations in the brain's reading network.
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Affiliation(s)
- Sarah V Di Pietro
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; URPP Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Zurich, Switzerland
| | - David Willinger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Nada Frei
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Christina Lutz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Seline Coraj
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Chiara Schneider
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
| | - Philipp Stämpfli
- MR-Center of the Department of Psychiatry, Psychotherapy and Psychosomatics and the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; URPP Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Zurich, Switzerland; MR-Center of the Department of Psychiatry, Psychotherapy and Psychosomatics and the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
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Is learning a logographic script easier than reading an alphabetic script for German children with dyslexia? PLoS One 2023; 18:e0282200. [PMID: 36827407 PMCID: PMC9956901 DOI: 10.1371/journal.pone.0282200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/30/2023] [Indexed: 02/26/2023] Open
Abstract
PURPOSE Developmental dyslexia in alphabetic languages (DD) is characterized by a phonological deficit. Since logographic scripts rely predominantly on visual and morphological processing, reading performance in DD can be assumed to be less impaired when reading logographic scripts. METHODS 40 German-speaking children (18 with DD, 22 not reading-impaired-group C; 9-11 years) received Chinese lessons. Eye movements (EM) were recorded during naming single alphabetic words, pictures (confrontational) and Chinese characters to be named in German and Chinese. The main outcome variables were: Articulation latency, numbers and durations of fixations. Quality of life (QoL) was assessed by questionnaires. RESULTS While reading alphabetic words, articulation latencies and numbers of fixations were significantly higher for group DD than for group C (AL-DD = 1.13, AL-C = 0.84, p< .001; FN-DD = 3.50; FN-C = 2.00, p< .001). For naming pictures and Chinese characters in German and in Chinese, no significant group differences were found for any of the EM variables. The percentage of correct answers was high for German naming (DD = 86.67%, C = 95.24%; p = .015) and lower for Chinese naming in both groups, but significantly lower in group DD, especially for Chinese naming (DD = 56.67%, C: 83.77%; p = .003). QoL differed between groups from the children's perspective only at posttest. Parents of group DD perceived their children`s QoL to be lower compared with parents of group C at pre- and posttest. CONCLUSIONS Children with dyslexia performed as well as group C during naming Chinese characters in German and in Chinese regarding their EM variables, presumably because they processed Chinese characters by the visuo-spatial pathway with direct access to the semantic system. However, the significantly lower percentage of correct answers especially during Chinese naming showed that group DD had more difficulties naming Chinese characters than group C, which could be attributed to their phonological deficit, among other factors. TRIAL REGISTRATION German clinical trials register (DRKS00015697).
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12
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Proverbio AM, Tacchini M, Jiang K. Event-related brain potential markers of visual and auditory perception: A useful tool for brain computer interface systems. Front Behav Neurosci 2022; 16:1025870. [PMID: 36523756 PMCID: PMC9744781 DOI: 10.3389/fnbeh.2022.1025870] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/03/2022] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE A majority of BCI systems, enabling communication with patients with locked-in syndrome, are based on electroencephalogram (EEG) frequency analysis (e.g., linked to motor imagery) or P300 detection. Only recently, the use of event-related brain potentials (ERPs) has received much attention, especially for face or music recognition, but neuro-engineering research into this new approach has not been carried out yet. The aim of this study was to provide a variety of reliable ERP markers of visual and auditory perception for the development of new and more complex mind-reading systems for reconstructing the mental content from brain activity. METHODS A total of 30 participants were shown 280 color pictures (adult, infant, and animal faces; human bodies; written words; checkerboards; and objects) and 120 auditory files (speech, music, and affective vocalizations). This paradigm did not involve target selection to avoid artifactual waves linked to decision-making and response preparation (e.g., P300 and motor potentials), masking the neural signature of semantic representation. Overall, 12,000 ERP waveforms × 126 electrode channels (1 million 512,000 ERP waveforms) were processed and artifact-rejected. RESULTS Clear and distinct category-dependent markers of perceptual and cognitive processing were identified through statistical analyses, some of which were novel to the literature. Results are discussed from the view of current knowledge of ERP functional properties and with respect to machine learning classification methods previously applied to similar data. CONCLUSION The data showed a high level of accuracy (p ≤ 0.01) in the discriminating the perceptual categories eliciting the various electrical potentials by statistical analyses. Therefore, the ERP markers identified in this study could be significant tools for optimizing BCI systems [pattern recognition or artificial intelligence (AI) algorithms] applied to EEG/ERP signals.
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Affiliation(s)
- Alice Mado Proverbio
- Laboratory of Cognitive Electrophysiology, Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marta Tacchini
- Laboratory of Cognitive Electrophysiology, Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Kaijun Jiang
- Laboratory of Cognitive Electrophysiology, Department of Psychology, University of Milano-Bicocca, Milan, Italy
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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13
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Xue H, Deng R, Chen Y, Zheng W. How does bilingual experience influence novel word learning? Evidence from comparing L1-L3 and L2-L3 cognate status. Front Psychol 2022; 13:1003199. [PMID: 36506949 PMCID: PMC9731340 DOI: 10.3389/fpsyg.2022.1003199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/11/2022] [Indexed: 11/25/2022] Open
Abstract
Bilingual experience exerts a complex influence on novel word learning, including the direct effects of transferable prior knowledge and learning skill. However, the facilitation and interference mechanism of such influence has largely been tangled by the similarity of the previously learned word knowledge. The present study compared Chinese-English bilinguals' paired-associate learning of nonwords in logographic and alphabetic writing systems. The logographic nonwords resemble the form and meaning of L1 Chinese words in varying degrees, being cognates, false cognates, or non-cognates of Chinese. The alphabetic nonwords resemble the form and meaning of L2 English words, being cognates, false cognates, or non-cognates of English. The learning sequence of logographic and alphabetic words was cross-balanced. The learning results were measured in production and recognition tasks. As for learning the logographic nonwords, both the recognition and production results showed that cognates were learned significantly faster than the non-cognates, and the false cognates were also learned significantly faster than the non-cognates. This suggests stronger facilitation rather than interference from L1 on novel word learning. As for learning the alphabetic nonwords, both the recognition and production results revealed that cognates were learned significantly faster than the non-cognates, but false cognates showed no advantage over the non-cognates. This indicates that interference from L2 is stronger than that from L1. Taken together, the results provide new evidence for the dissociable facilitation and interference effects of bilingual experience. These results carry potential educational implications in that learning novel words depends on substantial bilingual experience.
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Affiliation(s)
- Heng Xue
- College of Education, Hebei Normal University, Shijiazhuang, China
| | - Renhua Deng
- School of Foreign Languages, South China University of Technology, Guangzhou, China
| | - Yanyan Chen
- School of Foreign Languages, South China University of Technology, Guangzhou, China,*Correspondence: Yanyan Chen,
| | - Wenxin Zheng
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
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14
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Galaburda AM. Animal models of developmental dyslexia. Front Neurosci 2022; 16:981801. [DOI: 10.3389/fnins.2022.981801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/28/2022] [Indexed: 11/15/2022] Open
Abstract
As some critics have stated, the term “developmental dyslexia” refers to a strictly human disorder, relating to a strictly human capacity – reading – so it cannot be modeled in experimental animals, much less so in lowly rodents. However, two endophenotypes associated with developmental dyslexia are eminently suitable for animal modeling: Cerebral Lateralization, as illustrated by the association between dyslexia and non-righthandedness, and Cerebrocortical Dysfunction, as illustrated by the described abnormal structural anatomy and/or physiology and functional imaging of the dyslexic cerebral cortex. This paper will provide a brief review of these two endophenotypes in human beings with developmental dyslexia and will describe the animal work done in my laboratory and that of others to try to shed light on the etiology of and neural mechanisms underlying developmental dyslexia. Some thought will also be given to future directions of the research.
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15
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Gabel LA, Battison A, Truong DT, Lindström ER, Voss K, Yu YC, Roongruengratanakul S, Shyntassov K, Riebesell S, Toumanios N, Nielsen-Pheiffer CM, Paniagua S, Gruen JR. Orthographic Depth May Influence the Degree of Severity of Maze Learning Performance in Children at Risk for Reading Disorder. Dev Neurosci 2022; 44:651-670. [PMID: 36223729 PMCID: PMC9928771 DOI: 10.1159/000527480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/06/2022] [Indexed: 11/19/2022] Open
Abstract
Reading disability (RD), which affects between 5 and 17% of the population worldwide, is the most prevalent form of learning disability, and is associated with underactivation of a universal reading network in children. However, recent research suggests there are differences in learning rates on cognitive predictors of reading performance, as well as differences in activation patterns within the reading neural network, based on orthographic depth (i.e., transparent/shallow vs. deep/opaque orthographies) in children with RD. Recently, we showed that native English-speaking children with RD exhibit impaired performance on a maze learning task that taps into the same neural networks that are activated during reading. In addition, we demonstrated that genetic risk for RD strengthens the relationship between reading impairment and maze learning performance. However, it is unclear whether the results from these studies can be broadly applied to children from other language orthographies. In this study, we examined whether low reading skill was associated with poor maze learning performance in native English-speaking and native German-speaking children, and the influence of genetic risk for RD on cognition and behavior. In addition, we investigated the link between genetic risk and performance on this task in an orthographically diverse sample of children attending an English-speaking international school in Germany. The results from our data suggest that children with low reading skill, or with a genetic risk for reading impairment, exhibit impaired performance on the maze learning task, regardless of orthographic depth. However, these data also suggest that orthographic depth influences the degree of impairment on this task. The maze learning task requires the involvement of various cognitive processes and neural networks that underlie reading, but is not influenced by potential differences in reading experience due to lack of text or oral reporting. As a fully automated tool, it does not require specialized training to administer, and current results suggest it may be a practicable screening tool for early identification of reading impairment across orthographies.
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Affiliation(s)
- Lisa A. Gabel
- Department of Psychology, Lafayette College, Easton, PA
- Program in Neuroscience, Lafayette College, Easton, PA
| | | | | | - Esther R. Lindström
- Department of Education and Human Services, Lehigh University, Bethlehem, PA
| | - Kelsey Voss
- Program in Neuroscience, Lafayette College, Easton, PA
| | - Yih-Choung Yu
- Department of Electrical & Computer Engineering, Lafayette College, Easton, PA
| | | | | | | | | | | | - Steven Paniagua
- Department of Genetics, Yale School of Medicine, New Haven, CT
| | - Jeffrey R. Gruen
- Department of Genetics, Yale School of Medicine, New Haven, CT
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
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16
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Battisti A, Lazzaro G, Costanzo F, Varuzza C, Rossi S, Vicari S, Menghini D. Effects of a short and intensive transcranial direct current stimulation treatment in children and adolescents with developmental dyslexia: A crossover clinical trial. Front Psychol 2022; 13:986242. [PMID: 36160506 PMCID: PMC9500580 DOI: 10.3389/fpsyg.2022.986242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Developmental Dyslexia (DD) significantly interferes with children’s academic, personal, social, and emotional functioning. Nevertheless, therapeutic options need to be further validated and tested in randomized controlled clinical trials. The use of transcranial direct current stimulation (tDCS) has been gaining ground in recent years as a new intervention option for DD. However, there are still open questions regarding the most suitable tDCS protocol for young people with DD. The current crossover study tested the effectiveness of a short and intensive tDCS protocol, including the long-term effects, as well as the influence of age and neuropsychological processes at baseline on reading improvements. Twenty-four children and adolescents with DD were randomly assigned to receive active tDCS during the first slot and sham tDCS during the second slot or vice versa. Five consecutive daily sessions of left anodal/right cathodal tDCS set at 1 mA for 20 min were administered over the parieto-occipital regions. Reading measures (text, high frequency word, low frequency word, and non-word lists) and neuropsychological measures (visual-spatial and verbal working memory, phoneme blending, and rapid automatized naming tasks) were collected before, immediately after, 1 week and 1 month later the treatment. Our results showed that only the active tDCS condition improved non-word reading speed immediately after and 1 month later the end of the treatment compared with baseline. In addition, the improvement in non-word reading speed was significantly correlated with age and with neuropsychological measures (verbal working memory and phoneme blending) at baseline but only in the active tDCS condition. The current crossover study contributed to enforce previous effects of tDCS, including long-term effects, on non-word reading speed and to understand the effect of age and neuropsychological processes on reading outcomes. Our findings showed that tDCS could be a low-cost and easy-to-implement treatment option with long-term effects for children and adolescents with DD.
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Affiliation(s)
- Andrea Battisti
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Human Science, LUMSA University, Rome, Italy
| | - Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Cristiana Varuzza
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Serena Rossi
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- *Correspondence: Deny Menghini,
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17
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No effects of prefrontal multichannel tACS at individual alpha frequency on phonological decisions. Clin Neurophysiol 2022; 142:96-108. [DOI: 10.1016/j.clinph.2022.07.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/23/2022] [Accepted: 07/17/2022] [Indexed: 11/23/2022]
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18
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Braid J, Richlan F. The Functional Neuroanatomy of Reading Intervention. Front Neurosci 2022; 16:921931. [PMID: 35784836 PMCID: PMC9243375 DOI: 10.3389/fnins.2022.921931] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022] Open
Abstract
The present article reviews the literature on the brain mechanisms underlying reading improvements following behavioral intervention for reading disability. This includes evidence of neuroplasticity concerning functional brain activation, brain structure, and brain connectivity related to reading intervention. Consequently, the functional neuroanatomy of reading intervention is compared to the existing literature on neurocognitive models and brain abnormalities associated with reading disability. A particular focus is on the left hemisphere reading network including left occipito-temporal, temporo-parietal, and inferior frontal language regions. In addition, potential normalization/compensation mechanisms involving right hemisphere cortical regions, as well as bilateral sub-cortical and cerebellar regions are taken into account. The comparison of the brain systems associated with reading intervention and the brain systems associated with reading disability enhances our understanding of the neurobiological basis of typical and atypical reading development. All in all, however, there is a lack of sufficient evidence regarding rehabilitative brain mechanisms in reading disability, which we discuss in this review.
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19
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Provazza S, Carretti B, Giofrè D, Adams AM, Montesano L, Roberts D. Shallow or deep? The impact of orthographic depth on visual processing impairments in developmental dyslexia. ANNALS OF DYSLEXIA 2022; 72:171-196. [PMID: 35286579 PMCID: PMC8942915 DOI: 10.1007/s11881-021-00249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
The extent to which impaired visual and phonological mechanisms may contribute to the manifestation of developmental dyslexia across orthographies of varying depth has yet to be fully established. By adopting a cross-linguistic approach, the current study aimed to explore the nature of visual and phonological processing in developmental dyslexic readers of shallow (Italian) and deep (English) orthographies, and specifically the characterisation of visual processing deficits in relation to orthographic depth. To achieve this aim, we administered a battery of non-reading visual and phonological tasks. Developmental dyslexics performed worse than typically developing readers on all visual and phonological tasks. Critically, readers of the shallow orthography were disproportionately impaired on visual processing tasks. Our results suggest that the impaired reading and associated deficits observed in developmental dyslexia are anchored by dual impairments to visual and phonological mechanisms that underpin reading, with the magnitude of the visual deficit varying according to orthographic depth.
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Affiliation(s)
- Serena Provazza
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Barbara Carretti
- Department of General Psychology, University of Padova, Padua, Italy
| | - David Giofrè
- School of Psychology, Liverpool John Moores University, Liverpool, UK
- Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Anne-Marie Adams
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | | | - Daniel Roberts
- Centre for Cognitive Neuroscience, Division of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
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20
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Zhang M, Riecke L, Fraga-González G, Bonte M. Altered brain network topology during speech tracking in developmental dyslexia. Neuroimage 2022; 254:119142. [PMID: 35342007 DOI: 10.1016/j.neuroimage.2022.119142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/15/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022] Open
Abstract
Developmental dyslexia is often accompanied by altered phonological processing of speech. Underlying neural changes have typically been characterized in terms of stimulus- and/or task-related responses within individual brain regions or their functional connectivity. Less is known about potential changes in the more global functional organization of brain networks. Here we recorded electroencephalography (EEG) in typical and dyslexic readers while they listened to (a) a random sequence of syllables and (b) a series of tri-syllabic real words. The network topology of the phase synchronization of evoked cortical oscillations was investigated in four frequency bands (delta, theta, alpha and beta) using minimum spanning tree graphs. We found that, compared to syllable tracking, word tracking triggered a shift toward a more integrated network topology in the theta band in both groups. Importantly, this change was significantly stronger in the dyslexic readers, who also showed increased reliance on a right frontal cluster of electrodes for word tracking. The current findings point towards an altered effect of word-level processing on the functional brain network organization that may be associated with less efficient phonological and reading skills in dyslexia.
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Affiliation(s)
- Manli Zhang
- Maastricht Brain Imaging Center, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
| | - Lars Riecke
- Maastricht Brain Imaging Center, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Gorka Fraga-González
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University of Zurich, Switzerland
| | - Milene Bonte
- Maastricht Brain Imaging Center, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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21
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Evidence of Altered Functional Connectivity at Rest in the Writing Network of Children with Dyslexia. Brain Sci 2022; 12:brainsci12020243. [PMID: 35204006 PMCID: PMC8869855 DOI: 10.3390/brainsci12020243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 02/04/2023] Open
Abstract
Aim. Handwriting abilities in children with dyslexia (DYS) are not well documented in the current literature, and the presence of graphomotor impairment in addition to spelling impairment in dyslexia is controversial. Using resting-state functional connectivity (RSFC), the present study aims to answer the following question: are there markers of graphomotor impairment at rest in DYS children? Method. The participants were children with DYS and typically developing (TD) children (n = 32) from French-speaking primary schools (Mage = 9.3 years). The behavioural evaluation consisted of spelling and handwriting measures. Participants underwent a resting-state fMRI scan. Results. Analyses of RSFC focused on a brain region responsible for graphomotor processes—the graphemic/motor frontal area (GMFA). The RSFC between the GMFA and all other voxels of the brain was measured. Whole-brain ANOVAs were run to compare RSFC in DYS and TD children. The results demonstrated reduced RSFC in DYS compared to TD between the GMFA and brain areas involved in both spelling processes and motor-related processes. Conclusions. For the first time, this study highlighted a disruption of the writing network in DYS. By identifying functional markers of both spelling and handwriting deficits at rest in young DYS participants, this study supports the presence of graphomotor impairment in dyslexia.
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22
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Xia Z, Yang T, Cui X, Hoeft F, Liu H, Zhang X, Liu X, Shu H. Atypical Relationships Between Neurofunctional Features of Print-Sound Integration and Reading Abilities in Chinese Children With Dyslexia. Front Psychol 2022; 12:748644. [PMID: 35145448 PMCID: PMC8822058 DOI: 10.3389/fpsyg.2021.748644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/27/2021] [Indexed: 11/24/2022] Open
Abstract
Conquering print-sound mappings (e.g., grapheme-phoneme correspondence rules) is vital for developing fluent reading skills. In neuroimaging research, this ability can be indexed by activation differences between audiovisual congruent against incongruent conditions in brain areas such as the left superior temporal cortex. In line with it, individuals with dyslexia have difficulty in tasks requiring print-sound processing, accompanied by a reduced neural integration. However, existing evidence is almost restricted to alphabetic languages. Whether and how multisensory processing of print and sound is impaired in Chinese dyslexia remains underexplored. In this study, we applied a passive audiovisual integration paradigm with functional magnetic resonance imaging to investigate the possible dysfunctions in processing character-sound (opaque; semantics can be automatically accessed) and pinyin-sound associations (transparent; no particular meaning can be confirmed) in Chinese dyslexic children. Unexpectedly, the dyslexic group did not show reduced neural integration compared with typically developing readers in either character or pinyin experiment. However, the results revealed atypical correlations between neural integration and different reading abilities in dyslexia. Specifically, while the neural integration in the left inferior frontal cortex in processing character-sound pairs correlated with silent reading comprehension in both children with and without dyslexia, it was associated with morphological awareness (semantic-related) in controls but with rapid naming (phonological-related) in dyslexics. This result indicates Chinese dyslexic children may not use the same grapho-semantic processing strategy as their typical peers do. As for pinyin-sound processing, while a stronger neural integration in the direction of “congruent > incongruent” in the left occipito-temporal cortex and bilateral superior temporal cortices was associated with better oral reading fluency in the control group, an opposite pattern was found in dyslexia. This finding may reflect dyslexia's dysfunctional recruitment of the regions in grapho-phonological processing, which further impedes character learning.
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Affiliation(s)
- Zhichao Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- School of Systems Science, Beijing Normal University, Beijing, China
- *Correspondence: Zhichao Xia
| | - Ting Yang
- Faculty of Psychology, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xin Cui
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- College of Education for the Future, Beijing Normal University at Zhuhai, Zhuhai, China
- Haskins Laboratories, New Haven, CT, United States
| | - Fumiko Hoeft
- Haskins Laboratories, New Haven, CT, United States
- Department of Psychological Sciences, Brain Imaging Research Center, University of Connecticut, Storrs, CT, United States
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hong Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
- Department of Psychological Sciences, Brain Imaging Research Center, University of Connecticut, Storrs, CT, United States
| | - Xianglin Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
- Xiangping Liu
| | - Hua Shu
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- Hua Shu
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23
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Is human face recognition lateralized to the right hemisphere due to neural competition with left-lateralized visual word recognition? A critical review. Brain Struct Funct 2021; 227:599-629. [PMID: 34731327 DOI: 10.1007/s00429-021-02370-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/23/2021] [Indexed: 02/07/2023]
Abstract
The right hemispheric lateralization of face recognition, which is well documented and appears to be specific to the human species, remains a scientific mystery. According to a long-standing view, the evolution of language, which is typically substantiated in the left hemisphere, competes with the cortical space in that hemisphere available for visuospatial processes, including face recognition. Over the last decade, a specific hypothesis derived from this view according to which neural competition in the left ventral occipito-temporal cortex with selective representations of letter strings causes right hemispheric lateralization of face recognition, has generated considerable interest and research in the scientific community. Here, a systematic review of studies performed in various populations (infants, children, literate and illiterate adults, left-handed adults) and methodologies (behavior, lesion studies, (intra)electroencephalography, neuroimaging) offers little if any support for this reading lateralized neural competition hypothesis. Specifically, right-lateralized face-selective neural activity already emerges at a few months of age, well before reading acquisition. Moreover, consistent evidence of face recognition performance and its right hemispheric lateralization being modulated by literacy level during development or at adulthood is lacking. Given the absence of solid alternative hypotheses and the key role of neural competition in the sensory-motor cortices for selectivity of representations, learning, and plasticity, a revised language-related neural competition hypothesis for the right hemispheric lateralization of face recognition should be further explored in future research, albeit with substantial conceptual clarification and advances in methodological rigor.
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24
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Animal models of developmental dyslexia: Where we are and what we are missing. Neurosci Biobehav Rev 2021; 131:1180-1197. [PMID: 34699847 DOI: 10.1016/j.neubiorev.2021.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/21/2022]
Abstract
Developmental dyslexia (DD) is a complex neurodevelopmental disorder and the most common learning disability among both school-aged children and across languages. Recently, sensory and cognitive mechanisms have been reported to be potential endophenotypes (EPs) for DD, and nine DD-candidate genes have been identified. Animal models have been used to investigate the etiopathological pathways that underlie the development of complex traits, as they enable the effects of genetic and/or environmental manipulations to be evaluated. Animal research designs have also been linked to cutting-edge clinical research questions by capitalizing on the use of EPs. For the present scoping review, we reviewed previous studies of murine models investigating the effects of DD-candidate genes. Moreover, we highlighted the use of animal models as an innovative way to unravel new insights behind the pathophysiology of reading (dis)ability and to assess cutting-edge preclinical models.
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25
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Thomas T, Khalaf S, Grigorenko EL. A systematic review and meta-analysis of imaging genetics studies of specific reading disorder. Cogn Neuropsychol 2021; 38:179-204. [PMID: 34529546 DOI: 10.1080/02643294.2021.1969900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The imaging genetics of specific reading disabilities (SRD) is an emerging field that aims to characterize the disabilities' neurobiological causes, including atypical brain structure and function and distinct genetic architecture. The present review aimed to summarize current imaging genetics studies of SRD, characterize the effect sizes of reported results by calculating Cohen's d, complete a Fisher's Combined Probability Test for genes featured in multiple studies, and determine areas for future research. Results demonstrate associations between SRD risk genes and reading network brain phenotypes. The Fisher's test revealed promising results for the genes DCDC2, KIAA0319, FOXP2, SLC2A3, and ROBO1. Future research should focus on exploratory approaches to identify previously undiscovered genes. Using comprehensive neuroimaging (e.g., functional and effective connectivity) and genetic (e.g., sequencing and epigenetic) techniques, and using larger samples, diverse stages of development, and longitudinal investigations, would help researchers understand the neurobiological correlates of SRD to improve early identification.
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Affiliation(s)
- Tina Thomas
- Department of Psychology, University of Houston, Houston, TX, USA.,Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | - Shiva Khalaf
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | - Elena L Grigorenko
- Department of Psychology, University of Houston, Houston, TX, USA.,Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA.,Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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26
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Mao J, Liu L, Perkins K, Cao F. Poor reading is characterized by a more connected network with wrong hubs. BRAIN AND LANGUAGE 2021; 220:104983. [PMID: 34174464 DOI: 10.1016/j.bandl.2021.104983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 06/01/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Using graph theory, we examined topological organization of the language network in Chinese children with poor reading during an auditory rhyming task and a visual spelling task, compared to reading-matched controls and age-matched controls. First, poor readers (PR) showed reduced clustering coefficient in the left inferior frontal gyrus (IFG) and higher nodal efficiency in the bilateral superior temporal gyri (STG) during the visual task, indicating a less functionally specialized cluster around the left IFG and stronger functional links between bilateral STGs and other regions. Furthermore, PR adopted additional right-hemispheric hubs in both tasks, which may explain increased global efficiency across both tasks and lower normalized characteristic shortest path length in the visual task for the PR. These results underscore deficits in the left IFG during visual word processing and conform previous findings about compensation in the right hemisphere in children with poor reading.
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Affiliation(s)
- Jiaqi Mao
- Department of Psychology, Sun Yat-Sen University, China
| | - Lanfang Liu
- Department of Psychology, Sun Yat-Sen University, China
| | - Kyle Perkins
- Department of Teaching and Learning, College of Arts, Sciences and Education, Florida International University, United States
| | - Fan Cao
- Department of Psychology, Sun Yat-Sen University, China.
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The Neurological Basis of Developmental Dyslexia and Related Disorders: A Reappraisal of the Temporal Hypothesis, Twenty Years on. Brain Sci 2021; 11:brainsci11060708. [PMID: 34071786 PMCID: PMC8229928 DOI: 10.3390/brainsci11060708] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 01/10/2023] Open
Abstract
In a now-classic article published a couple of decades ago (Brain, 2000; 123: 2373-2399), I proposed an "extended temporal processing deficit hypothesis of dyslexia", suggesting that a deficit in temporal processing could explain not only language-related peculiarities usually noticed in dyslexic children, but also a wider range of symptoms related to impaired processing of time in general. In the present review paper, I will revisit this "historical" hypothesis both in the light of a new clinical perspective, including the central yet poorly explained notion of comorbidity, and also taking a new look at the most recent experimental work, mainly focusing on brain imaging data. First, consistent with daily clinical practice, I propose to distinguish three groups of children who fail to learn to read, of fairly equal occurrence, who share the same initial presentation (difficulty in mastering the rules of grapheme-phoneme correspondence) but with differing associated signs and/or comorbid conditions (language disorders in the first group, attentional deficits in the second one, and motor coordination problems in the last one), thus suggesting, at least in part, potentially different triggering mechanisms. It is then suggested, in the light of brain imaging information available to date, that the three main clinical presentations/associations of cognitive impairments that compromise reading skills acquisition correspond to three distinct patterns of miswiring or "disconnectivity" in specific brain networks which have in common their involvement in the process of learning and their heavy reliance on temporal features of information processing. With reference to the classic temporal processing deficit of dyslexia and to recent evidence of an inability of the dyslexic brain to achieve adequate coupling of oscillatory brain activity to the temporal features of external events, a general model is proposed according to which a common mechanism of temporal uncoupling between various disconnected-and/or mis-wired-processors may account for distinct forms of specific learning disorders, with reading impairment being a more or less constant feature. Finally, the potential therapeutic implications of such a view are considered, with special emphasis on methods seeking to enhance cross-modal connectivity between separate brain systems, including those using rhythmic and musical training in dyslexic patients.
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Thomas T, Perdue MV, Khalaf S, Landi N, Hoeft F, Pugh K, Grigorenko EL. Neuroimaging genetic associations between SEMA6D, brain structure, and reading skills. J Clin Exp Neuropsychol 2021; 43:276-289. [PMID: 33960276 PMCID: PMC8225580 DOI: 10.1080/13803395.2021.1912300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/30/2021] [Indexed: 01/15/2023]
Abstract
Specific reading disability (SRD) is defined by genetic and neural risk factors that are not fully understood. The current study used imaging genetics methodology to investigate relationships between SEMA6D, brain structure, and reading. SEMA6D, located on SRD risk locus DYX1, is involved in axon guidance, synapse formation, and dendrite development. SEMA6D's associations with brain structure in reading-related regions of interest (ROIs) were investigated in a sample of children with a range of reading performance, from sites in Connecticut, CT (n = 67, 6-13 years, mean age = 9.07) and San Francisco, SF (n = 28, 5-8 years, mean age = 6.5). Multiple regression analyses revealed significant associations between SEMA6D's rs16959669 and cortical thickness in the fusiform gyrus and rs4270119 and gyrification in the supramarginal gyrus in the CT sample, but this was not replicated in the SF sample. Significant clusters were not associated with reading. For white matter volume, combined analyses across both samples revealed associations between reading and the left transverse temporal gyrus, left pars triangularis, left cerebellum, and right cerebellum. White matter volume in the left transverse temporal gyrus was nominally related to rs1817178, rs12050859, and rs1898110 in SEMA6D, and rs1817178 was significantly related to reading. Haplotype analyses revealed significant associations between the whole gene and brain phenotypes. Results suggest SEMA6D likely has an impact on multiple reading-related neural structures, but only white matter volume in the transverse temporal gyrus was significantly related to reading in the current sample. As the sample was young, the transverse temporal gyrus, involved in auditory perception, may be more strongly involved in reading because phonological processing is still being learned. The relationship between SEMA6D and reading may change as different brain regions are involved during reading development. Future research should examine mediating effects, use additional brain measures, and use an older sample to better understand effects.
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Affiliation(s)
- Tina Thomas
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Meaghan V. Perdue
- University of Connecticut Dept. of Psychological Sciences, Storrs, CT, USA
- Haskins Laboratories, University of Connecticut, New Haven, CT, USA
| | - Shiva Khalaf
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | - Nicole Landi
- University of Connecticut Dept. of Psychological Sciences, Storrs, CT, USA
- Haskins Laboratories, University of Connecticut, New Haven, CT, USA
| | - Fumiko Hoeft
- University of Connecticut Dept. of Psychological Sciences, Storrs, CT, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Kenneth Pugh
- University of Connecticut Dept. of Psychological Sciences, Storrs, CT, USA
- Haskins Laboratories, University of Connecticut, New Haven, CT, USA
| | - Elena L. Grigorenko
- Department of Psychology, University of Houston, Houston, TX, USA
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
- Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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Lazzaro G, Costanzo F, Varuzza C, Rossi S, Vicari S, Menghini D. Effects of a short, intensive, multi-session tDCS treatment in developmental dyslexia: Preliminary results of a sham-controlled randomized clinical trial. PROGRESS IN BRAIN RESEARCH 2021; 264:191-210. [PMID: 34167656 DOI: 10.1016/bs.pbr.2021.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Developmental Dyslexia (DD) significantly interferes with academic, personal, social and emotional functioning. Nevertheless, established therapeutic options are still scarce. Research has begun to emerge studying the potential action of transcranial direct current stimulation (tDCS) for ameliorating reading. However, there are still open questions regarding the most suitable tDCS protocol in young with DD. The current study tested the effectiveness of a short, intensive and multi-session tDCS protocol and presented preliminary data from a randomized sham-controlled crossover trial. Twenty-seven children and adolescents with DD were randomly assigned to active tDCS or sham tDCS. Active tDCS group received five daily-consecutive sessions of left anodal/right cathodal set at 1mA for 20min over parieto-occipital regions. Reading measures, including text, high frequency word, low frequency word and non-word lists, were recorded before, immediately after the treatment and 1-week later. We found that only the active tDCS group ameliorated non-word reading speed immediately after and 1-week later the end of the treatment compared to the baseline. Some suggestions for the development of future tDCS protocols in children and adolescents with DD are given.
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Affiliation(s)
- Giulia Lazzaro
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, I.R.C.C.S, Rome, Italy; Department of Human Science, LUMSA University of Rome, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, I.R.C.C.S, Rome, Italy
| | - Cristiana Varuzza
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, I.R.C.C.S, Rome, Italy
| | - Serena Rossi
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, I.R.C.C.S, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, I.R.C.C.S, Rome, Italy; Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, I.R.C.C.S, Rome, Italy.
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Grant JG, Siegel LS, D'Angiulli A. From Schools to Scans: A Neuroeducational Approach to Comorbid Math and Reading Disabilities. Front Public Health 2020; 8:469. [PMID: 33194932 PMCID: PMC7642246 DOI: 10.3389/fpubh.2020.00469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 07/24/2020] [Indexed: 11/13/2022] Open
Abstract
We bridge two analogous concepts of comorbidity, dyslexia-dyscalculia and reading-mathematical disabilities, in neuroscience and education, respectively. We assessed the cognitive profiles of 360 individuals (mean age 25.79 ± 13.65) with disability in reading alone (RD group), mathematics alone (MD group) and both (comorbidity: MDRD group), with tests widely used in both psychoeducational and neuropsychological batteries. As expected, the MDRD group exhibited reading deficits like those shown by the RD group. The former group also exhibited deficits in quantitative reasoning like those shown by the MD group. However, other deficits related to verbal working memory and semantic memory were exclusive to the MDRD group. These findings were independent of gender, age, or socioeconomic and demographic factors. Through a systematic exhaustive review of clinical neuroimaging literature, we mapped the resulting cognitive profiles to correspondingly plausible neuroanatomical substrates of dyslexia and dyscalculia. In our resulting "probing" model, the complex set of domain-specific and domain-general impairments shown in the comorbidity of reading and mathematical disabilities are hypothesized as being related to atypical development of the left angular gyrus. The present neuroeducational approach bridges a long-standing transdisciplinary divide and contributes a step further toward improved early prediction, teaching and interventions for children and adults with combined reading and math disabilities.
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Affiliation(s)
- Jeremy G Grant
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Linda S Siegel
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
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Liebig J, Friederici AD, Neef NE. Auditory brainstem measures and genotyping boost the prediction of literacy: A longitudinal study on early markers of dyslexia. Dev Cogn Neurosci 2020; 46:100869. [PMID: 33091833 PMCID: PMC7576516 DOI: 10.1016/j.dcn.2020.100869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/07/2020] [Accepted: 09/20/2020] [Indexed: 02/05/2023] Open
Abstract
Multi-domain profiles advance retrospective prediction of emergent literacy. DCDC2 and KIAA0319 risk variants influence emergent spelling skills. Combined DYX2 and auditory brainstem measures enhance predictive model fits. Additional benefit of preliterate phonological awareness on predictive power.
Literacy acquisition is impaired in children with developmental dyslexia resulting in lifelong struggle to read and spell. Proper diagnosis is usually late and commonly achieved after structured schooling started, which causes delayed interventions. Legascreen set out to develop a preclinical screening to identify children at risk of developmental dyslexia. To this end we examined 93 preliterate German children, half of them with a family history of dyslexia and half of them without a family history. We assessed standard demographic and behavioral precursors of literacy, acquired saliva samples for genotyping, and recorded speech-evoked brainstem responses to add an objective physiological measure. Reading and spelling was assessed after two years of structured literacy instruction. Multifactorial regression analyses considering demographic information, genotypes, and auditory brainstem encoding, predicted children’s literacy skills to varying degrees. These predictions were improved by adding the standard psychometrics with a slightly higher impact on spelling compared to reading comprehension. Our findings suggest that gene-brain-behavior profiling has the potential to determine the risk of developmental dyslexia. At the same time our results imply the need for a more sophisticated assessment to fully account for the disparate cognitive profiles and the multifactorial basis of developmental dyslexia.
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Affiliation(s)
- Johanna Liebig
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, 04103 Leipzig, Germany.
| | - Angela D Friederici
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, 04103 Leipzig, Germany.
| | - Nicole E Neef
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, 04103 Leipzig, Germany; Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany; Department of Diagnostic and Interventional Neuroradiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
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Zoccolotti P. Putting the Identification of Dyslexia into a Multi-Level Perspective. Brain Sci 2020; 10:brainsci10100661. [PMID: 32977377 PMCID: PMC7597950 DOI: 10.3390/brainsci10100661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Pierluigi Zoccolotti
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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