Anomalous cerebral structure in dyslexia revealed with magnetic resonance imaging

Volumetric analysis of a specific language region – the planum temporale

Planum temporale volumes were determined for 42 control children (ages 4.2-15.7 years) using magnetic resonance imaging. The mean left planum temporale volume was 2729 mm3 (SD = 567) and the mean right planum temporale volume was 2758 mm3 (SD = 546). No significant hemispheric asymmetry was demonstrated. Analysis of co-variance (ANCOVA) showed that the absolute and proportional planum temporale volumes were not significantly associated with age or gender. We also demonstrated a reproducible method for planum temporale volume measurement by acquiring images in the coronal plane and then visualising the sagittal plane to improve accuracy for the posterior border.

Right hemisphere brain morphology, attention-deficit hyperactivity disorder (ADHD) subtype, and social comprehension

Social comprehension involves empathy for others' experiences and appropriate responses to nonverbal cues. Previous research using magnetic resonance imaging (MRI) has suggested a relationship between brain morphology and psychiatric syndromes, such as attention-deficit hyperactivity disorder (ADHD), that typically entail social difficulties. The right hemisphere, specifically, has been associated with social skill deficits, and numerous studies have also associated ADHD with social skill deficits. No studies, however, have examined the association of ADHD subtype with both social comprehension and right-hemisphere morphology. Fifty-nine children (6-12 years old) underwent MRI, from which the right hemisphere was classified into four morphologic subtypes. Children were also grouped by ADHD subtype or clinical control status. From Behavior Assessment System for Children (BASC) items, a social comprehension subscale was constructed. Analyses revealed significant differences in social comprehension based on ADHD subtype. Differences in social comprehension based on ADHD status were especially pronounced in children with atypical right-hemisphere morphology. Thus, the diagnosis of ADHD might be associated with underlying risk in the area of social comprehension, especially for children with atypical right-hemisphere morphology.

Exploiting human anatomical variability as a link between genome and cognome

Although talents and disabilities appear to run in families, direct links between genes and cognitive ability are difficult to establish. Investigators are currently searching for intermediate phenotypes with plausible links to both genome and cognome (the cognitive phenotype). Cortical anatomy could provide one such intermediate phenotype. Variation in cortical size, asymmetry and sulcal pattern is influenced by genetic variation in neurotrophic factors and can predict variation in verbal and mathematical talent. Anecdotal evidence suggests that individuals with a rare morphological variant of Sylvian fissure sometimes have superior visualization ability combined with verbal deficits. Documentation of such 'cognitive cortical syndromes' might prove as genetically informative as the identification of dysmorphic syndromes associated with mental retardation. A necessary prerequisite for the establishment of such syndromes is a reliable technique for the identification of cortical patterns. Recent technical advances in software for automatically labeling and measuring cortical sulci now provide the possibility of establishing standard measures for their shape, size and location. Such measures are a prerequisite for genetic studies of cortical patterns that could illuminate the neurodevelopmental pathways by which genes affect cognitive ability.

Planum temporale volume in children and adolescents with autism

Previous research has revealed a lack of planum temporale (PT) asymmetry in adults with autism. This finding is now extended to children and adolescents with the disorder. MRI scans were obtained from 12 children with autism and 12 gender, handedness and age-matched comparison participants. The volume of gray matter in the PT and Heschl's gyrus (HG) in both hemispheres was measured. PT volume was larger in the left hemisphere than in the right in the comparison, but not the autism group. This specifically reflected reduced volume of the left PT in the autism group. There were noted differences in the overall morphological appearance of the right Sylvian fissure in the autism group, but no volumetric difference in the right PT. No differences in HG volumes were observed between the two groups. Lack of PT asymmetry may suggest an early neurodevelopmental disturbance in autism.

The infant as a prelinguistic model for language learning impairments: predicting from event-related potentials to behavior

Associations between efficient processing of brief, rapidly presented, successive stimuli and language learning impairments (LLI) in older children and adults have been well documented. In this paper we examine the role that impaired rapid auditory processing (RAP) might play during early language acquisition. Using behavioral measures we have demonstrated that RAP abilities in infancy are critically linked to later language abilities for both non-speech and speech stimuli. Variance in infant RAP thresholds reliably predict language outcome at 3 years-of-age for infants at risk for LLI and control infants. We present data here describing patterns of electrocortical (EEG/ERP) activation at 6 month-of-age to the same non-verbal stimuli used in our behavioral studies. Well-defined differences were seen between infants from families with a history of LLI (FH+) and FH- controls in the amplitude of the mismatch response (MMR) as well as the latency of the N250 component in the 70 ms ISI condition only. Smaller mismatch responses and delayed onsets of the N250 component were seen in the FH+ group. The latency differences in the N250 component, but not the MMR amplitude variation, were significantly related to 24-month language outcome. Such converging tasks provide the opportunity to examine early precursors of LLI and allow the opportunity for earlier identification and intervention.

Does brain white matter growth expand the cortex like a balloon? Hypothesis and consequences

Horrobin (2001) has proposed that phospholipid metabolism is linked to human brain growth, and that deviations in the metabolism may be linked to creativity as well as mental disorders. The present literature review leads to a framework or model which states that brain white matter growth causes the overlying cortex to expand tangentially, like a balloon, and that this expansion affects the cortex's capacity to differentiate afferent signals. The neuroanatomical description of this model is based on publications linking human white matter growth and mass to the thickness of the overlying cortex, and of some linking cortical thickness and surface area (inversely). The link between the surface area of a cortical region and its differentiation capacity is based on previous work on hemispheric differences and functional lateralisation in the human auditory cortices. The link between differentiation capacity and inappropriate responses or "loose associations" is based on publications linking perceptual deficits and abnormal cortical structure, especially abnormal laterality. Finally, perceptual deficits have been linked to aspects of schizophrenia or other "disorders".

Gray matter alteration in dyslexia: converging evidence from volumetric and voxel-by-voxel MRI analyses

Affecting up to 4-10% of the population, dyslexia is a highly prevalent, childhood onset developmental disorder adversely influencing multiple domains of adaptive functioning throughout the lifespan. The present brain imaging study was conducted in order to investigate the neuroanatomical correlates of developmental dyslexia. The MRI brain scans of 10 males with dyslexia and 14 matched controls were analyzed with (1) a classical volumetric method measuring gray and white matter lobar volumes and (2) a voxel-by-voxel method. The voxel-by-voxel method identifies changes in tissue density and localizes morphologic alterations without limiting the analyses to predefined regions. Subsequent correlations between gray matter density and neuropsychological performance on specific phonological processing tasks (rhyme judgment) were conducted. Volumetric analyses revealed significantly reduced gray matter volumes in both temporal lobes in dyslexic individuals. The voxel-by-voxel analyses further localized changes to the left temporal lobe, revealing reduced gray matter density in the middle and inferior temporal gyri. Conversely, increased gray matter density was found in the precentral gyri bilaterally. As a combined group, the dyslexic and control subjects demonstrated positive correlations between performance on the rhyme judgment tasks and gray matter density in the middle and inferior frontal gyri, and the middle temporal gyri bilaterally. The current study indicates that dyslexia is associated with a structural gray matter deficit involving a complex fronto-temporal network implicated in phonological processing.

Auditory Evoked Potential Patterns to Voiced and Voiceless Speech Sounds in Adult Developmental Dyslexics with Persistent Deficits

Auditory evoked potentials (AEPs) were recorded from eight developmental dyslexic adults with persistent reading, spelling and phonological deficits, and 10 non-dyslexic controls to voiced (/ba/) and voiceless (/pa/) consonant-vowel syllables. Consistent with previous data, non-dyslexics coded these stimuli differentially according to the temporal cues that form the basis of the voiced/voiceless contrast: AEPs had time-locked components with latencies that were determined by the temporal structure of the stimuli. Dyslexics were characterized by one of two electrophysiological patterns: AEP pattern I dyslexics demonstrated a differential coding of stimuli on the basis of some temporal cues, but with an atypically large number of components and a considerable delay in AEP termination time; AEP pattern II dyslexics demonstrated no clear differential coding of stimuli on the basis of temporal cues. These data reveal the presence of anomalies in cortical auditory processing which could underlie persistent perceptual and linguistic impairments in some developmental dyslexics. Furthermore, scalp AEP distribution maps showing the difference observed between /ba/ and /pa/ activity over time suggest that the regions implicated in the processing of crucial time-related acoustic cues were not systematically lateralized to the left hemisphere like they were for non-dyslexics. These findings may be conducive to a better understanding and treatment of perceptual dysfunctions in developmental language disorders.

Cortical differentiation of speech and nonspeech sounds at 100 ms: implications for dyslexia

Neurophysiological measures indicate cortical sensitivity to speech sounds by 150 ms after stimulus onset. In this time window dyslexic subjects start to show abnormal cortical processing. We investigated whether phonetic analysis is reflected in the robust auditory cortical activation at approximately 100 ms (N100m), and whether dyslexic subjects show abnormal N100m responses to speech or nonspeech sounds. We used magnetoencephalography to record auditory responses of 10 normally reading and 10 dyslexic adults. The speech stimuli were synthetic Finnish speech sounds (/a/, /u/, /pa/, /ka/). The nonspeech stimuli were complex nonspeech sounds and simple sine wave tones, composed of the F1+F2+F3 and F2 formant frequencies of the speech sounds, respectively. All sounds evoked a prominent N100m response in the bilateral auditory cortices. The N100m activation was stronger to speech than nonspeech sounds in the left but not in the right auditory cortex, in both subject groups. The leftward shift of hemispheric balance for speech sounds is likely to reflect analysis at the phonetic level. In dyslexic subjects the overall interhemispheric amplitude balance and timing were altered for all sound types alike. Dyslexic individuals thus seem to have an unusual cortical organization of general auditory processing in the time window of speech-sensitive analysis.

Neuroanatomical markers for dyslexia: a review of dyslexia structural imaging studies

A neuroanatomical description of dyslexia has been elusive, due in part to the complex cognitive nature of dyslexia. People with dyslexia have varying degrees of impairment in reading skills that engage oral and written language (reading) neural networks. Although findings for the inferior parietal lobule, inferior frontal gyrus, and cerebellum have been relatively consistent across studies, these studies also demonstrate that anatomical patterns of results vary according to the reading skills that characterize dyslexia. The number and likelihood of atypical anatomical findings in oral and/or written language systems appears to be related to the pattern of impairments in measures of phonology, orthography, and fluency. A comprehensive neurobiological understanding of dyslexia will depend on studies of dyslexic individuals with homogeneous perceptual, cognitive, and genetic backgrounds.

Stuttering and the basal ganglia circuits: a critical review of possible relations

The possible relation between stuttering and the basal ganglia is discussed. Important clues to the pathophysiology of stuttering are given by conditions known to alleviate dysfluency, like the rhythm effect, chorus speech, and singing. Information regarding pharmacologic trials, lesion studies, brain imaging, genetics, and developmental changes of the nervous system is reviewed. The symptoms of stuttering are compared with basal ganglia motor disorders like Parkinson's disease and dystonia. It is proposed that the basal ganglia-thalamocortical motor circuits through the putamen are likely to play a key role in stuttering. The core dysfunction in stuttering is suggested to be impaired ability of the basal ganglia to produce timing cues for the initiation of the next motor segment in speech. Similarities between stuttering and dystonia are indicated, and possible relations to the dopamine system are discussed, as well as the interaction between the cerebral cortex and the basal ganglia. Behavioral and pharmacologic information suggests the existence of subtypes of stuttering.

LEARNING OUTCOMES

As a result of this activity, the reader will (1) become familiar with the research regarding the basal ganglia system relating to speech motor control; (2) become familiar with the research on stuttering with indications of basal ganglia involvement; and (3) be able to discuss basal ganglia mechanisms with relevance for theory of stuttering.

The relationship between perisylvian morphology and verbal short-term memory functioning in children with neurodevelopmental disorders

Although children with neurodevelopmental disorders frequently present with reduced short-term memory functioning, the relationship between perisylvian morphology and verbal short-term memory functioning has received limited attention. Thus, examining this relationship in children with neurodevelopmental disorders was the focus of this exploratory study. Results suggested leftward asymmetry in the temporal bank of the planum temporale is related to better coding and storage of semantic material. In contrast, parietal bank morphology is related to coding and storage of phonological material, and presence of an extra gyrus in the parietal region is associated with reduced phonological working memory. Data also supported a relationship between pars triangularis morphology and verbal short-term memory functioning, but this is not material-specific.

Developmental Dyslexia and Specific Language Impairment: Same or Different?

Developmental dyslexia and specific language impairment (SLI) were for many years treated as distinct disorders but are now often regarded as different manifestations of the same underlying problem, differing only in severity or developmental stage. The merging of these categories has been motivated by the reconceptualization of dyslexia as a language disorder in which phonological processing is deficient. The authors argue that this focus underestimates the independent influence of semantic and syntactic deficits, which are widespread in SLI and which affect reading comprehension and impair attainment of fluent reading in adolescence. The authors suggest that 2 dimensions of impairment are needed to conceptualize the relationship between these disorders and to capture phenotypic features that are important for identifying neurobiologically and etiologically coherent subgroups.

Cerebral Asymmetries for Language: Evidence for Structural-Behavioral Correlations

The current investigation tested 20 male right-handers in 5 divided visual field lexical tasks. Asymmetries in Heschl's gyrus, planum temporale, and planum parietale were measured using structural magnetic resonance imaging. Composite task asymmetries were positively correlated with asymmetry of the planum temporale only. There was also an association between the consistency of anatomical and behavioral asymmetries: Individuals who departed the most from the modal pattern of cortical asymmetry across regions also tended to show the greatest variability in asymmetry across tasks. Hence, individual differences in language laterality tasks may be affected by variation in asymmetry of posterior language structures. Additionally, when typical anatomical asymmetries fail to co-occur, there may be a less strictly regulated distribution of function across hemispheres.

Atypical cerebral laterality in adults with persistent developmental stuttering

BACKGROUND

Two of the most consistent anatomic asymmetries found in the human brain are a larger right than left prefrontal and left than right occipital lobe. Reduced or reversed asymmetries of these regions are considered markers of atypical cerebral laterality, and atypical cerebral laterality has been proposed to increase neural risk for developmental stuttering.

OBJECTIVE

S: To learn if atypical prefrontal and occipital lobe asymmetries are more common in adults who stutter vs fluent control subjects and to determine whether lobar size or asymmetry patterns are associated with stuttering severity or language abilities.

METHODS

Adults with persistent developmental stuttering (n = 16) and matched control subjects (n = 16) had language and stuttering assessments. Subjects were also studied with volumetric MRI scans. Total hemisphere, prefrontal, and occipital lobe regions were measured, and volumes were calculated proportionally to hemisphere volume.

RESULTS

Hemisphere and total brain volumes did not differ between the groups. Control subjects had the expected larger right than left prefrontal and larger left than right occipital lobe volume. In contrast, the adults who stutter did not have these asymmetries. Stuttering severity was not associated with specific anatomic configurations, whereas language-processing deficits in adults who stutter were associated with prefrontal and occipital volume reduction.

CONCLUSIONS

Developmental stuttering is associated with atypical prefrontal and occipital lobe asymmetries. In addition, deficits in language processing were associated with some anatomic measures in the adults who stutter.

Broca's region: cytoarchitectonic asymmetry and developmental changes

Functional imaging and clinical studies in children and adults have provided evidence of developmental changes in the hemispheric specialization for language. Whereas cytoarchitectonic asymmetry has been demonstrated in Broca's region of adults, the anatomical correlates of developmental changes in language dominance are largely unknown. In the present postmortem study of 34 human brains (ages ranging from 3.5 months to 85 years), the cytoarchitecture of areas 44 and 45 as the putative anatomical correlates of Broca's region, their developmental changes, and interhemispheric asymmetry were analyzed. Asymmetry as estimated by Euclidean distances between feature vectors of cytoarchitectonic profiles of left and right areas 44 and 45 was already found in 1-year-old infants. Asymmetry tended to increase with age, which was significant in area 45, but not in area 44. An adult-like, left-larger-than-right asymmetry in the volume fraction of cell bodies [gray level index (GLI)] was reached at approximately 5 years in area 45 and 11 years in area 44. These time points indicate a delayed development of the cytoarchitectonic asymmetry in Broca's region in comparison with that of the primary motor cortex. It may be hypothesized that the delayed maturation is the microstructural basis of the development of language abilities and the influence of language practice on cytoarchitecture during childhood. Interhemispheric asymmetry in the cytoarchitecture of areas 44 and 45 continues to change throughout life. We conclude that the cytoarchitectonic asymmetry of areas 44 and 45 is a result of microstructural plasticity that endures throughout almost the whole lifespan.

Magnetic resonance imaging studies on autism and childhood-onset schizophrenia in children and adolescents - a review

OBJECTIVE

To find out whether the neurodevelopmental disorders autism and childhood-onset schizophrenia have a common developmental pathway and whether the abnormalities detected are 'disorder-specific', by reviewing magnetic resonance imaging (MRI) studies.

METHODS

As a result of a Medline search, we were able to access 28 studies on autism and 12 studies on childhood-onset schizophrenia, which focused on children and adolescents.

RESULTS

Larger lateral ventricles were found to be a common abnormality in both disorders. 'Disorder-specific' abnormalities in patients with autism were larger brains, a larger thalamic area, and a smaller right cingulate gyrus. Subjects with childhood-onset schizophrenia were found to have smaller brains, a smaller amygdalum and thalamus, and a larger nucleus caudatus. In subjects with childhood-onset schizophrenia, abnormalities appeared to progress over a limited period of time.

CONCLUSIONS

Because the study designs varied so much, the results should be interpreted cautiously. Before abnormalities found in the disorders can be designated as equal or 'disorder-specific', it will be essential to perform large longitudinal and cross-sectional follow-up studies.

Significant relation between MR measures of planum temporale area and dichotic processing of syllables in dyslexic children

In the present study, we investigated differences between dyslexic and normal reading children in asymmetry of the planum temporale area in the upper posterior part of the temporal lobe and dichotic listening performance to consonant-vowel syllables. The current study was an extension of previous studies in our laboratory on the same participants, now including also girls and left-handers. There were 20 boys and 3 girls in the dyslexic group and 19 boys and 4 girls in the normal reading group. The age of the participants was 10-12 years for both groups. The participants were screened from a population of 950 students in the fourth school grade in the greater Bergen district. The planum temporale area was measured in sagittal magnetic resonance (MR) images. Mean left and right area and asymmetry index were compared between the groups. Dichotic presentations of consonant-vowel syllables made it possible to separately probe left and right hemisphere phonological function, and to correlate this with planum temporale area. The results showed a significantly larger left than right planum temporale area for both groups. However, while the right planum temporale area was similar for the dyslexic and control groups, the left planum temporale was significantly (one-tailed t-test) smaller in the dyslexic group. Both groups also showed a significant right ear advantage to the consonant-vowel syllables in the dichotic listening test. The relation between planum temporale and dichotic listening asymmetry showed a significant correlation for the dyslexic group only, indicating a positive relation between brain structure and function in dyslexic children. The results are discussed in terms of important subject characteristics with regard to brain markers of dyslexia.

Cortical morphology associated with language function in neurofibromatosis, type I

Neurofibromatosis, type I (NF-I) is associated with verbal and nonverbal neuropsychological deficits and neuroanatomical anomalies. Few relationships between CNS abnormalities and cognitive function in this population, however, have been found. Reading disabilities and developmental language impairments in the general population have been associated with particular morphologic features in inferior frontal gyrus (IFG) and Heschl's gyrus (HG). We compared the morphology of these regions in children with NF-I and controls. Verbal skills in NF-I were related to IFG morphology, such that individuals with NF-I who showed "typical" gyral patterns in the right hemisphere performed worse across language measures than those showing an extra "atypical" gyrus. A doubling of HG in the left and right hemispheres was also significantly associated with performance on several neuropsychological measures. This is the first study to link regional gyral morphology with language function in NF-I. A possible molecular basis for the observed relationships is discussed.

Variability in the anatomy of the planum temporale and posterior ascending ramus: do right- and left handers differ?

The anatomy of the planum temporale (PT) and posterior ascending ramus (PAR) was studied in vivo in 67 healthy right- and left-handed adults using MRI-based morphometry. The left PT was significantly larger than the right, and there was a weakly significant effect of the right PAR larger than the left. A leftward PT asymmetry was found in 72%, and a rightward PAR asymmetry was found in 64% of the sample. The "typical" configuration of a larger left PT and larger right PAR co-occurred in 56% of the subjects studied, which was only slightly more often than predicted by chance. Eight of 67 subjects had "reversed" PT and PAR asymmetries, with consistent left and mixed handers over-represented in this group. Right PAR size was the only variable that predicted writing hand, and left PT size was the only measure that differed by sex. The left PT was expanded relative to the left PAR in 93% of the sample, suggesting that this configuration may be developmentally regulated and may be a critical substrate for the development of language. These findings demonstrate that important relationships exist between hand preference, and the anatomy of posterior cortical language areas.

Abnormal asymmetry in language association cortex in autism

Autism is a neurodevelopmental disorder affecting cognitive, language, and social functioning. Although language and social communication abnormalities are characteristic, prior structural imaging studies have not examined language-related cortex in autistic and control subjects. Subjects included 16 boys with autism (aged 7-11 years), with nonverbal IQ greater than 80, and 15 age- and handedness-matched controls. Magnetic resonance brain images were segmented into gray and white matter; cerebral cortex was parcellated into 48 gyral-based divisions per hemisphere. Asymmetry was assessed a priori in language-related inferior lateral frontal and posterior superior temporal regions and assessed post hoc in all regions to determine specificity of asymmetry abnormalities. Boys with autism had significant asymmetry reversal in frontal language-related cortex: 27% larger on the right in autism and 17% larger on the left in controls. Only one additional region had significant asymmetry differences on post hoc analysis: posterior temporal fusiform gyrus (more left-sided in autism), whereas adjacent fusiform gyrus and temporooccipital inferior temporal gyrus both approached significance (more right-sided in autism). These inferior temporal regions are involved in visual face processing. In boys with autism, language and social/face processing-related regions displayed abnormal asymmetry. These structural abnormalities may relate to language and social disturbances observed in autism.

Anatomical risk factors that distinguish dyslexia from SLI predict reading skill in normal children

These studies investigated whether anatomical measures could separate phonologically-based reading disability (PD) from nonphonologically-based learning disabilities such as specific language impairment (SLI). In a previous study. four brain measures (cerebral asymmetry. summed planum temporale and parietale asymmetry, anterior cerebellar asymmetry, and a duplicated left Heschl's gyrus) distinguished a group of PD adults from reading disabled adults without specific phonological deficits (URD). Study 1 found that these measures did not distinguish 14 reading disabled children from 21 children with SLI. Instead, differences were found in cerebral volume, planum temporale asymmetry, and the size of a single left Heschl's gyrus. Study 2 demonstrated that including all seven measures in a discriminant analysis separated the adults and children into two groups: one with 100% of the PD adults and 75% of the reading disabled children and the other with 72% of the SLI children and 75% of the URD adults. Study 3 demonstrated that an anatomical risk factor index (ARF7) generated from the discriminant function with seven brain measures predicted reading in normal children. Children with ARF7 near 0 (normal anatomy) had superior verbal ability and phonological decoding scores that improved with age. Normal children with negative ARF7 the relatively s mall symmetrical structures that characterize SLI)had deficits in verbal ability. Children with positive ARF7 (the asymmetrical structures that characterize PD) had phonological decoding scores that decreased with age. These results suggest that PD and SLI are qualitatively different disorders associated with anatomical deviations in opposite directions from the population mean.

LEARNING OUTCOMES

As a result of this activity, the participant will be able to: (1) distinguish the neuroanatomical features that characterize PD and SLI; (2) recognize that PD is associated with large asymmetrical brain structures while SLI is associated with smaller symmetrical brain structures; (3) understand that children with moderate sized brains and whose anatomy is intermediate between symmetry and extreme asymmetry have an enhanced probability of developing good verbal ability; (4) understand that reading disabilities depend on the interaction of neurodevelopment and the environment.

Infant discrimination of rapid auditory cues predicts later language impairment

The etiology and mechanisms of specific language impairment (SLI) in children are unknown. Differences in basic auditory processing abilities have been suggested to underlie their language deficits. Studies suggest that the neuropathology, such as atypical patterns of cerebral lateralization and cortical cellular anomalies, implicated in such impairments likely occur early in life. Such anomalies may play a part in the rapid processing deficits seen in this disorder. However, prospective, longitudinal studies in infant populations that are critical to examining these hypotheses have not been done. In the study described, performance on brief, rapidly-presented, successive auditory processing and perceptual-cognitive tasks were assessed in two groups of infants: normal control infants with no family history of language disorders and infants from families with a positive family history for language impairment. Initial assessments were obtained when infants were 6-9 months of age (M=7.5 months) and the sample was then followed through age 36 months. At the first visit, infants' processing of rapid auditory cues as well as global processing speed and memory were assessed. Significant differences in mean thresholds were seen in infants born into families with a history of SLI as compared with controls. Examination of relations between infant processing abilities and emerging language through 24 months-of-age revealed that threshold for rapid auditory processing at 7.5 months was the single best predictor of language outcome. At age 3, rapid auditory processing threshold and being male, together predicted 39-41% of the variance in language outcome. Thus, early deficits in rapid auditory processing abilities both precede and predict subsequent language delays. These findings support an essential role for basic nonlinguistic, central auditory processes, particularly rapid spectrotemporal processing, in early language development. Further, these findings provide a temporal diagnostic window during which future language impairments may be addressed.

Cerebellar morphology in developmental dyslexia

Recent evidence has suggested cerebellar anomalies in developmental dyslexia. Therefore, we investigated cerebellar morphology in subjects with documented reading disabilities. We obtained T1-weighted magnetic resonance images in the coronal and sagittal planes from 11 males with prior histories of developmental dyslexia, and nine similarly-aged male controls. Proton magnetic resonance spectra (TE=136ms, TR=2.4s) were obtained bilaterally in the cerebellum. Phonological decoding skill was measured using non-word reading. Handedness was assessed using both the Annett questionnaire of hand preference and Annett's peg moving task. Cerebellar symmetry was observed in the dyslexics but there was significant asymmetry (right grey matter>left grey matter) in controls. The interpretation of these results depended whether a motor- or questionnaire-based method was used to determine handedness. The degree of cerebellar symmetry was correlated with the severity of dyslexics' phonological decoding deficit. Those with more symmetric cerebella made more errors on a nonsense word reading measure of phonological decoding ability. Left cerebellar metabolite ratios were shown to correlate significantly with the degree of cerebellar asymmetry (P<0.05) in controls. This relationship was absent in developmental dyslexics. Cerebellar morphology reflects the higher degree of symmetry found previously in the temporal and parietal cortex of dyslexics. The relationship of cerebellar asymmetry to phonological decoding ability and handedness, together with our previous finding of altered metabolite ratios in the cerebellum of dyslexics, lead us to suggest that there are alterations in the neurological organisation of the cerebellum which relate to phonological decoding skills, in addition to motor skills and handedness.

Structural brain abnormalities in adult males with clefts of the lip and/or palate

PURPOSE

To evaluate brain morphology of adult males with nonsyndromic clefts of the lip and/or palate (NSCLP) in comparison to a matched healthy control group.

METHODS

Brain structure was measured using quantitative analysis of magnetic resonance images.

RESULTS

Subjects with NSCLP had significant abnormalities in brain morphology consisting of abnormally enlarged anterior regions of the cerebrum, and decreased volumes of the posterior cerebrum and cerebellum. Overall, the most severely affected region was the left temporal lobe. Furthermore, these structural abnormalities were directly related to cognitive dysfunction.

CONCLUSIONS

These findings highlight the important relationship and interplay between face and brain development.

Absolute pitch and planum temporale

An increased leftward asymmetry of the planum temporale (PT) in absolute-pitch (AP) musicians has been previously reported, with speculation that early exposure to music influences the degree of PT asymmetry. To test this hypothesis and to determine whether a larger left PT or a smaller right PT actually accounts for the increased overall PT asymmetry in AP musicians, anatomical magnetic resonance images were taken from a right-handed group of 27 AP musicians, 27 nonmusicians, and 22 non-AP musicians. A significantly greater leftward PT asymmetry and a significantly smaller right absolute PT size for the AP musicians compared to the two control groups was found, while the left PT was only marginally larger in the AP group. The absolute size of the right PT and not the left PT was a better predictor of music group membership, possibly indicating "pruning" of the right PT rather than expansion of the left underlying the increased PT asymmetry in AP musicians. Although early exposure to music may be a prerequisite for acquiring AP, the increased PT asymmetry in AP musicians may be determined in utero, implicating possible genetic influences on PT asymmetry. This may explain why the increased PT asymmetry of AP musicians was not seen in the group of early beginning non-AP musicians.

Brain imaging in neurobehavioral disorders

Neuroimaging studies of neurobehavioral disorders are using new imaging modalities. In dyslexia, anatomic imaging studies demonstrate an abnormal symmetry of the planum temporale. Functional imaging supports the hypothesis that developmental dyslexia is frequently the result of deficits in phonologic processing and that normal reading requires a patent network organization of a number of anterior and posterior brain areas. In autism, anatomic imaging studies are conflicting. Functional imaging demonstrates temporal lobe abnormalities and abnormal interaction between frontal and parietal brain areas. In attention-deficit-hyperactivity disorder, imaging studies suggest an abnormality in the prefrontal and striatal regions. Neuroimaging studies are often contradictory, but trends, especially with functional imaging analysis, are evolving. Because neurobehavioral disorders seem to be a result of a dysfunction in brain circuits, no one region will be abnormal in all patients studied. Further studies with well-defined patient populations and appropriate activation paradigms will better elucidate the pathophysiology of these conditions.

Right hemisphere contribution to developmental language disorder: Neuroanatomical and behavioral evidence

Developmental language disorder (DLD) is identified by virtue of the verbal deficits that define it. However, numerous studies have also documented nonverbal deficits in this population. This study attempts to explain the co-occurrence of both verbal and nonverbal deficits in this population from a brain-based perspective. Two samples of adults selected for DLD were compared with subjects without such a history on verbal and nonverbal skills in exploratory and confirmatory studies. Subjects also received MRI scans, which were used to determine the relation between left- and right-hemisphere regions hypothesized to relate to the behavioral skills tested. Results revealed replicable differences between groups on both verbal and nonverbal tasks. In addition, a significant association between performance on tests sensitive to facial affect and spatial rotation with the gray matter volume within the right supramarginal gyrus was found in both samples. These results support the hypothesis of a right hemisphere contribution to the profile of DLD.

LEARNING OUTCOMES

As a result of this activity, the participant will be able to describe evidence in support of a role for the right hemisphere in DLD.

Probabilistic mapping and volume measurement of human primary auditory cortex

Despite their potential utility in clinical and research settings, the range of intra- and interindividual variations in size and location of cytoarchitectonically defined human primary auditory cortex (PAC) is largely unknown. This study demonstrates that gyral patterns and the size and location of PAC vary independently to a considerable degree. Thus, the cytoarchitectonic borders of PAC cannot be reliably inferred from macroscopic-MR visible-anatomy. Given the remarkable topographical variability of architectonic areal borders, standard brain mapping which is made solely on the basis of macroanatomic landmarks may lead to structural-functional mismatch. Consequently, interpretations of individual auditory activity patterns might often be inaccurate. In view of the anatomic discrepancies, we generated probability maps of PAC in which the degree of intersubject overlap in each stereotaxic position was quantified. These maps show that the location of PAC in Talairach space differs considerably between hemispheres and individuals. In contrast to earlier cytoarchitectonic work which is based in most cases on studies of single brains, our systematic approach provides extensive microanatomic data as a reference system for studies of human auditory function.

Individual differences in neurobehavioral measures of laterality and interhemispheric function as measured by dichotic listening

This article presents analysis of dichotic listening performance in 57 healthy men and women aged 20 to 72 years. The data are presented as a means to cover 2 theoretical issues relevant to the biobehavioral study of laterality and interhemispheric relations. First, the sensitivity of dichotic listening performance to factors such as sex, age, and their interactions was examined. Dichotic listening asymmetry scores were found to vary as a function of sex, age, handedness, and family history of developmental language disorders. The effects of sex and age were then explored in relation to a comparison of nonforced and unilaterally focused test conditions. The results suggest that even within a healthy, normative sample of human participants, individuals vary not only in their underlying perceptual asymmetries for auditory input, but also in the manner in which such asymmetries interact with other higher order cognitive functions.

Planum temporale, planum parietale and dichotic listening in dyslexia

A reduction or reversal of the normal leftward asymmetry of the planum temporale (PT) has been claimed to be typical of dyslexia, although some recent studies have challenged this view. In a population-based study of 20 right-handed dyslexic boys and 20 matched controls, we have measured the PT and the adjacent planum parietale (PP) region in sagittal magnetic resonance images. For the PT, mean left and right areas and asymmetry coefficients were compared. Since a PP area often could not be identified in one or both hemispheres, a qualitative comparison was used for this region. The total planar area (sum of PT and PP) was also compared between the two groups. A dichotic listening (DL) test with consonant-vowel syllables was administered to assess functional asymmetry of language. The results showed a mean leftward PT asymmetry in both the dyslexic and the control group, with no significant difference for the degree of PT asymmetry. Planned comparisons revealed however, a trend towards smaller left PT in the dyslexic group. In control children, but not in the dyslexic children, a significant correlation between PT asymmetry and reading was observed. A mean leftward asymmetry was also found for the total planar area, with no difference between the groups for the degree of asymmetry. Significantly fewer dyslexic children than control children showed a rightward asymmetry for the PP region. Both groups showed a normal right ear advantage on the DL task, with no significant difference for DL asymmetry. No significant correlation was observed between PT asymmetry and DL asymmetry. The present population-based study adds to recent reports of normal PT asymmetry in dyslexia, but indicates that subtle morphological abnormalities in the left planar area may be present in this condition.

Atypical organisation of the auditory cortex in dyslexia as revealed by MEG

Neuroanatomical and -radiological studies have converged to suggest an atypical organisation in the temporal bank of the left-hemispheric Sylvian fissure for dyslexia. Against the background of this finding, we applied high temporal resolution magnetoencephalography (MEG) to investigate functional aspects of the left-hemispheric auditory cortex in 11 right-handed dyslexic children (aged 8-13 years) and nine matched normal subjects (aged 8-14 years). Event-related field components during a passive oddball paradigm with pure tones and consonant-vowel syllables were evaluated. The first major peak of the auditory evoked response, the M80, showed identical topographical distributions in both groups. In contrast, the generating brain structures of the later M210 component were located more anterior to the earlier response in children with dyslexia only. Control children exhibited the expected activation of more posterior source locations of the component that appeared later in the processing stream. Since the group difference in the relative location of the M210 source seemed to be independent of stimulus category, it is concluded that dyslexics and normally literate children differ as to the organisation of their left-hemispheric auditory cortex.

Electrophysiological dissociation between verbal and nonverbal semantic processing in learning disabled adults

Event-related potentials (ERPs) were recorded as 16 adults with learning disabilities (LD) and 16 controls were presented with two sets of stimuli. The first set comprised pairs of line drawings and environmental sounds (nonverbal condition); the second consisted of printed and spoken words (verbal condition). In the controls, semantically related items elicited smaller N400s than unrelated items in both conditions, with opposing hemispheric asymmetries for spoken words and environmental sounds. The LD group did not show a significant difference between related and unrelated words, despite a robust context effect for nonspeech sounds. The results suggest anomalous processing limited to the verbal domain in a simple semantic association task in the LD group. Semantic deficits in this group may reflect a relatively specific deficit in forming verbal associations rather than a more general difficulty that spans both verbal and nonverbal domains.

Egocentric mental rotation in Hungarian dyslexic children

A mental rotation task was given to 27 dyslexic children (mean age 9 years, 2 months) and to 28 non-dyslexic children (mean age 8 years, 8 months). Pictures of right and left hands were shown at angles of 0, 50, 90 and 180 degrees, and the subjects were required to indicate whether what was shown was a right hand or a left hand. It was found that, in this task, the dyslexics did not show the normal pattern of response times at different angles, and also, that they made more errors than the controls. It is argued that this result is compatible with hypothesis that, in typical cases of dyslexia, there is a malfunctioning in the posterior parietal area.

Structural imaging in dyslexia: the planum temporale

The search for a neurobiological substrate for dyslexia has focused on anomalous planum symmetry. The results of imaging studies of the planum have been inconsistent, perhaps due to diagnostic uncertainty, technical differences in measurement criteria, and inadequate control of handedness, sex, and cognitive ability. Although structural imaging studies have not clarified the neurobiology of reading disability, converging evidence suggests that variation in asymmetry of the planum temporale does have functional significance. Studies in a variety of populations have shown a significant association between planar asymmetry, the strength of hand preference, and general verbal skills such as vocabulary and comprehension. Future structural imaging studies of dyslexia should match participants on hand preference and general verbal ability in order to determine the relationship between brain structure and written and oral language.

Sulcal/gyral pattern morphology of the perisylvian language region in developmental dyslexia

Two systems for classification of morphology of the perisylvian cortical area have been suggested, that of Steinmetz et al. (1990) and that of Witelson and Kigar (1992). This study examines whether the variations in placement of these convolutions in the language cortex are related to diagnosis of dyslexia in a clinic-referred sample of 55 children ages 8 to 12 years. Additionally, the systems are compared to determine their relationship to neurolinguistic performance. In this study, the Steinmetz et al. (1990) system captured morphological distinctions which were relevant to performance on neurolinguistic measures, while Witelson and Kigar's (1992) system did not. Under neither system was morphology associated with diagnosis of dyslexia.

Measurement of the planum temporale (PT) on magnetic resonance imaging scans: temporal PT alone and with parietal extension

The planum temporale (PT) has been of interest because of (1) its consistent left greater than right asymmetry among right-handed and most left-handed normal individuals; and (2) its relation to language, another variable shown to be highly left-lateralized in normal subjects. Individuals with neurodevelopmental disorders have been reported to show abnormal PT asymmetry (either reversed or absent asymmetry). Several studies have been conducted measuring the PT on MRI scans, although the results do not always concur. We review some of these studies and discuss methodological differences between them. Additionally, we propose a method that has proved to be highly reliable for the measurement of both temporal PT and its parietal extension (PT+).

Reading and spelling disorders: clinical features and causes

Developmental dyslexia (specific reading and specific spelling disorder) is thought to stem from specific features in cognitive processing strongly related to biological maturation of the central nervous system which interact with non-biological learning conditions. The specific learning disorder should not be accounted for by mental age, gross neurological deficits, emotional disturbances or inadequate schooling. As a clinical guideline, the child's level in reading and spelling must be significantly below that expected for the population of children of the same mental age. The persistence rate is high and dyslexia is often associated with psychiatric problems. The etiology is not known. From the biological point of view, dyslexia is supposed to have a neurological basis. Neuroanatomical, neurophysiological, and neuropsychological correlates have been studied by means of autopsy, brain imaging, neurophysiological and neuropsychological methods. There is good evidence that dyslexia is determined by heritable cognitive components of reading and spelling processing. Experimental research focuses on characteristics of brain structure and cognitive skills related to the central nervous systems of auditory-phonological and visual information processing.

The neural basis of developmental dyslexia

Until recently, many thought developmental dyslexia was a behavioral disorder that primarily affected reading. In fact, it is a partly heritable condition, the clinical manifestations of which are extremely complex including deficits in reading, working memory, sensorimotor coordination, and early sensory processing. Even though extensive research has characterized these behavioral abnormalities carefully, the biological mechanisms of the clinical manifestations still are poorly understood. Recent research into both the nature of the structural and functional abnormalities in developmental dyslexia and the functional neuroanatomy of reading have rapidly advanced our understanding of the localization of the processes responsible for the signs and symptoms of dyslexia. This paper reviews recent evidence supporting a biological basis for developmental dyslexia.

Developmental dyslexia: atypical cortical asymmetries and functional significance

Using brain magnetic resonance imaging, we measured in 16 young developmental dyslexic adults and 14 age-matched controls cortical asymmetries of posterior language-related areas, including Planum temporale and parietal operculum cortical ribbon, and of the inferior frontal region related in the left hemisphere to speech processing. In addition, we assessed the sulcal morphology of the inferior frontal gyrus in both groups according to a qualitative method. The dyslexic subjects also performed specific tasks exploring different aspects of phonological and lexical-semantic processes. Results showed that: (1) contrary to most results reported in the literature, there is a lack of any morphological difference relative to Planum temporale asymmetry between the two groups; (2) there are significant differences between dyslexic and control subjects relative to frontal areas; (3) concerning the parietal region, there is a more asymmetrical pattern towards the left side in dyslexic subjects than in controls; and (4) relations in dyslexic subjects between parietal asymmetry coefficient and the level of performance in a phonological task have a particular reliance on verbal short-term memory, frontal asymmetry and performance in a non-word reading task. Considering these results it is suggested that phonological segmentation skills may relate to frontal lobe morphology, while phonological memory-based impairment in people with dyslexia may rather relate to parietal lobe morphology.

The evolutionary genetic underpinnings of schizophrenia: the developmental instability model

The importance of genes in the etiology of schizophrenia is well known, but the manner in which the relevant genomic factors influence neural development and the nature of selection forces operating on these factors are poorly understood. In several prominent papers, Crow has provided a unique and comprehensive theory that attempts to deal with these issues. A central aspect of his theory is that a single gene leads to reduced cerebral lateralization, increased ventricular size, and risk for developing schizophrenia. He relies greatly on Annett's right shift theory of individual variation in handedness. An alternative approach, based on the construct of developmental instability, provides a different way to conceptualize genetic influences, selection forces, and atypical lateralization in schizophrenia. We suggest that the developmental instability model has stronger empirical support and is better grounded in contemporary evolutionary genetics.

Neuronal asymmetries in primary visual cortex of dyslexic and nondyslexic brains

Dyslexic brains exhibit histologic changes in the magnocellular (magno) cells of the lateral geniculate nucleus, and consistent with these changes, dyslexics demonstrate abnormal visually evoked potentials and brain activation to magno-specific stimuli. The current study was aimed at determining whether these findings were associated with changes in the primary visual cortex with the prediction that magno components of this cortex would be affected. We measured cross-sectional neuronal areas in primary visual cortex (area 17) in dyslexic and nondyslexic autopsy specimens. There was a significant interaction between hemispheres and diagnostic category; ie, nondyslexic brains had larger neurons in the left hemisphere, whereas dyslexic brains had no asymmetry. On the other hand, cell layers associated with magno input from the lateral geniculate nucleus did not show consistent changes in dyslexic brains. Thus, there is a neuronal size asymmetry in favor of the left primary visual cortex in nondyslexics that is absent in dyslexic brains. This is yet another example of anomalous expression of cerebral asymmetry in dyslexia similar to that of the planum temporale, which in our view reflects abnormality in circuits involved in reading.

Dyslexia, gender, and brain imaging

Future brain imaging studies of dyslexia should have a sufficient number of males and females to detect possible gender differences in the neurological underpinning of this disorder. Detailed knowledge about such differences may clarify our understanding of the structural and functional impairments which lead to the phonological deficits that characterize dyslexia. Functional brain imaging studies have shown that males and females exhibit different patterns of brain activation during phonological processing. Further differences between the brains of males and females have been suggested by studies of normal brain development, morphology, and functional activation during reading. Animal studies have shown that lesions, similar to those seen in postmortem studies of dyslexia, affect rapid auditory processing in males, but not in females. The large body of research on gender differences in brain development, functional organization, and activation during reading tasks urges separation of males and females in dyslexia research in order to minimize variance and to detect subtle, but functionally-relevant, differences. Well-controlled studies, with large numbers of male and female dyslexics, may produce more sensitive and accurate identification of the neurological substrates of dyslexia.

Specific temporoparietal gyral atrophy reflects the pattern of language dissolution in Alzheimer's disease

The aim of this study was to determine the topography and degree of atrophy in speech and language-associated cortical gyri in Alzheimer's disease. The post-mortem brains of 10 patients with pathologically confirmed Alzheimer's disease and 21 neurological and neuropathological controls were sectioned in serial 3 mm coronal slices and grey and white matter volumes were determined for specific cortical gyri. All Alzheimer's disease patients had prospectively documented impairments in verbal and semantic memory with concomitant global decline. The cortical regions of interest included the planum temporale, Heschl's gyri, the anterior superior temporal gyri, the middle and inferior temporal gyri, area 37 at the inferior temporoparietal junction, areas 40 and 39 (supramarginal and angular gyri) and Broca's frontal regions. Although most patients had end-stage disease, the language-associated cortical regions were affected to different degrees, with some regions free of atrophy. These included Broca's regions in the frontal lobe and Heschl's gyri on the superior surface of the temporal lobe. In contrast, the inferior temporal and temporoparietal gyri (area 37) were severely reduced in volume. The phonological processing regions in the superior temporal gyri (the planum temporale) were also atrophic in all Alzheimer's disease patients while the anterior superior temporal gyri were only atrophic in female patients. Such atrophy may underlie the more severe language impairments previously described in females with Alzheimer's disease. The present study is the first to analyse the volumes of language-associated gyri in post-mortem patients with confirmed Alzheimer's disease. The results show that atrophy is not global but site-specific. Atrophied gyri appear to reflect a specific network of language and semantic memory dissolution seen in the clinical features of patients with Alzheimer's disease. Females showed greater atrophy than males in the anterior superior temporal gyri.