Responsivity to dyslexia training indexed by the N170 amplitude of the brain potential elicited by word reading

Dyslexia, the Amsterdam Way

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

Elevated levels of mixed-hand preference in dyslexia: Meta-analyses of 68 studies

Since almost a hundred years, psychologists have investigated the link between hand preference and dyslexia. We present a meta-analysis to determine whether there is indeed an increase in atypical hand preference in dyslexia. We included studies used in two previous meta-analyses (Bishop, 1990; Eglinton & Annett, 1994) as well as studies identified through PubMed MEDLINE, PsycInfo, Google Scholar, and Web of Science up to August 2022. K = 68 studies (n = 4660 individuals with dyslexia; n = 40845 controls) were entered into three random effects meta-analyses using the odds ratio as the effect size (non-right-handers; left-handers; mixed-handers vs. total). Evidence of elevated levels of atypical hand preference in dyslexia emerged that were especially pronounced for mixed-hand preference (OR = 1.57), although this category was underdefined. Differences in (direction or degree) of hand skill or degree of hand preference could not be assessed as no pertinent studies were located. Our findings allow for robust conclusions only for a relationship of mixed-hand preference with dyslexia.

Lateralization of orthographic processing in fixed-gaze and natural reading conditions

Lateralized processing of orthographic information is a hallmark of proficient reading. However, how this finding obtained for fixed-gaze processing of orthographic stimuli translates to ecologically valid reading conditions remained to be clarified. To address this shortcoming, here we assessed the lateralization of early orthographic processing in fixed-gaze and natural reading conditions using concurrent eye-tracking and EEG data recorded from young adults without reading difficulties. Sensor-space analyses confirmed the well-known left-lateralized negative-going deflection of fixed-gaze EEG activity throughout the period of early orthographic processing. At the same time, fixation-related EEG activity exhibited left-lateralized followed by right-lateralized processing of text stimuli during natural reading. A strong positive relationship was found between the early leftward lateralization in fixed-gaze and natural reading conditions. Using source-space analyses, early left-lateralized brain activity was obtained in lateraloccipital and posterior ventral occipito-temporal cortices reflecting letter-level processing in both conditions. In addition, in the same time interval, left-lateralized source activity was found also in premotor and parietal brain regions during natural reading. While brain activity remained left-lateralized in later stages representing word-level processing in posterior and middle ventral temporal regions in the fixed-gaze condition, fixation-related source activity became stronger in the right hemisphere in medial and more anterior ventral temporal brain regions indicating higher-level processing of orthographic information. Although our results show a strong positive relationship between the lateralization of letter-level processing in the two reading modes and suggest lateralized brain activity as a general marker for processing of orthographic information, they also clearly indicate the need for reading research in ecologically valid conditions to identify the neural basis of visuospatial attentional, oculomotor and higher-level processes specific to natural reading.

How visual attention span and phonological skills contribute to N170 print tuning: An EEG study in French dyslexic students

Developmental dyslexia is a disorder characterized by a sustainable learning deficit in reading. Based on ERP-driven approaches focusing on the visual word form area, electrophysiological studies have pointed a lack of visual expertise for written word recognition in dyslexic readers by contrasting the left-lateralized N170 amplitudes elicited by alphabetic versus non-alphabetic stimuli. Here, we investigated in 22 dyslexic participants and 22 age-matched control subjects how two behavioural abilities potentially affected in dyslexic readers (phonological and visual attention skills) contributed to the N170 expertise during a word detection task. Consistent with literature, dyslexic participants exhibited poorer performance in these both abilities as compared to healthy subjects. At the brain level, we observed (1) an unexpected preservation of the N170 expertise in the dyslexic group suggesting a possible compensatory mechanism and (2) a modulation of this expertise only by phonological skills, providing evidence for the phonological mapping deficit hypothesis.

Brain Source Correlates of Speech Perception and Reading Processes in Children With and Without Reading Difficulties

Neural correlates in reading and speech processing have been addressed extensively in the literature. While reading skills and speech perception have been shown to be associated with each other, their relationship remains debatable. In this study, we investigated reading skills, speech perception, reading, and their correlates with brain source activity in auditory and visual modalities. We used high-density event-related potentials (ERPs), fixation-related potentials (FRPs), and the source reconstruction method. The analysis was conducted on 12–13-year-old schoolchildren who had different reading levels. Brain ERP source indices were computed from frequently repeated Finnish speech stimuli presented in an auditory oddball paradigm. Brain FRP source indices were also computed for words within sentences presented in a reading task. The results showed significant correlations between speech ERP sources and reading scores at the P100 (P1) time range in the left hemisphere and the N250 time range in both hemispheres, and a weaker correlation for visual word processing N170 FRP source(s) in the posterior occipital areas, in the vicinity of the visual word form areas (VWFA). Furthermore, significant brain-to-brain correlations were found between the two modalities, where the speech brain sources of the P1 and N250 responses correlated with the reading N170 response. The results suggest that speech processes are linked to reading fluency and that brain activations to speech are linked to visual brain processes of reading. These results indicate that a relationship between language and reading systems is present even after several years of exposure to print.

Typical and Atypical Development of Visual Expertise for Print as Indexed by the Visual Word N1 (N170w): A Systematic Review

The visual word N1 (N170w) is an early brain ERP component that has been found to be a neurophysiological marker for print expertise, which is a prelexical requirement associated with reading development. To date, no other review has assimilated existing research on reading difficulties and atypical development of processes reflected in the N170w response. Hence, this systematic review synthesized results and evaluated neurophysiological and experimental procedures across different studies about visual print expertise in reading development. Literature databases were examined for relevant studies from 1995 to 2020 investigating the N170w response in individuals with or without reading disorders. To capture the development of the N170w related to reading, results were compared between three different age groups: pre-literate children, school-aged children, and young adults. The majority of available N170w studies (N = 69) investigated adults (n = 31) followed by children (school-aged: n = 21; pre-literate: n = 4) and adolescents (n = 1) while some studies investigated a combination of these age groups (n = 12). Most studies were conducted with German-speaking populations (n = 17), followed by English (n = 15) and Chinese (n = 14) speaking participants. The N170w was primarily investigated using a combination of words, pseudowords, and symbols (n = 20) and mostly used repetition-detection (n = 16) or lexical-decision tasks (n = 16). Different studies posed huge variability in selecting electrode sites for analysis; however, most focused on P7, P8, and O1 sites of the international 10–20 system. Most of the studies in adults have found a more negative N170w in controls than poor readers, whereas in children, the results have been mixed. In typical readers, N170w ranged from having a bilateral distribution to a left-hemispheric dominance throughout development, whereas in young, poor readers, the response was mainly right-lateralized and then remained in a bilateral distribution. Moreover, the N170w latency has varied according to age group, with adults having an earlier onset yet with shorter latency than school-aged and pre-literate children. This systematic review provides a comprehensive picture of the development of print expertise as indexed by the N170w across age groups and reading abilities and discusses theoretical and methodological differences and challenges in the field, aiming to guide future research.

Lateralization of early orthographic processing during natural reading is impaired in developmental dyslexia

Skilled reading requires specialized visual cortical processing of orthographic information and its impairment has been proposed as a potential correlate of compromised reading in dyslexia. However, which stage of orthographic information processing during natural reading is disturbed in dyslexics remains unexplored. Here we addressed this question by simultaneously measuring the eye movements and EEG of dyslexic and control young adults during natural reading. Isolated meaningful sentences were presented at five inter-letter spacing levels spanning the range from minimal to extra-large spacing, and participants were instructed to read the text silently at their own pace. Control participants read faster, performed larger saccades and shorter fixations compared to dyslexics. While reading speed peaked around the default letter spacing, saccade amplitude increased and fixation duration decreased with the increase of letter spacing in both groups. Lateralization of occipito-temporal fixation-related EEG activity (FREA) was found in three consecutive time intervals corresponding to early orthographic processing in control readers. Importantly, the lateralization in the time range of the first negative left occipito-temporal FREA peak was specific for first fixations and exhibited an interaction effect between reading ability and letter spacing. The interaction originated in the significant decrease of FREA lateralization at extra-large compared to default letter spacing in control readers and the lack of lateralization in both letter spacing conditions in the case of dyslexics. These findings suggest that expertise-driven hemispheric functional specialization for early orthographic processing thought to be responsible for letter identity extraction during natural reading is compromised in dyslexia.

How Learning to Read Changes the Listening Brain

Reading acquisition reorganizes existing brain networks for speech and visual processing to form novel audio-visual language representations. This requires substantial cortical plasticity that is reflected in changes in brain activation and functional as well as structural connectivity between brain areas. The extent to which a child's brain can accommodate these changes may underlie the high variability in reading outcome in both typical and dyslexic readers. In this review, we focus on reading-induced functional changes of the dorsal speech network in particular and discuss how its reciprocal interactions with the ventral reading network contributes to reading outcome. We discuss how the dynamic and intertwined development of both reading networks may be best captured by approaching reading from a skill learning perspective, using audio-visual learning paradigms and longitudinal designs to follow neuro-behavioral changes while children's reading skills unfold.

Predicting Reading From Behavioral and Neural Measures - A Longitudinal Event-Related Potential Study

Fluent reading is characterized by fast and effortless decoding of visual and phonological information. Here we used event-related potentials (ERPs) and neuropsychological testing to probe the neurocognitive basis of reading in a sample of children with a wide range of reading skills. We report data of 51 children who were measured at two time points, i.e., at the end of first grade (mean age 7.6 years) and at the end of fourth grade (mean age 10.5 years). The aim of this study was to clarify whether next to behavioral measures also basic unimodal and bimodal neural measures help explaining the variance in the later reading outcome. Specifically, we addressed the question of whether next to the so far investigated unimodal measures of N1 print tuning and mismatch negativity (MMN), a bimodal measure of audiovisual integration (AV) contributes and possibly enhances prediction of the later reading outcome. We found that the largest variance in reading was explained by the behavioral measures of rapid automatized naming (RAN), block design and vocabulary (46%). Furthermore, we demonstrated that both unimodal measures of N1 print tuning (16%) and filtered MMN (7%) predicted reading, suggesting that N1 print tuning at the early stage of reading acquisition is a particularly good predictor of the later reading outcome. Beyond the behavioral measures, the two unimodal neural measures explained 7.2% additional variance in reading, indicating that basic neural measures can improve prediction of the later reading outcome over behavioral measures alone. In this study, the AV congruency effect did not significantly predict reading. It is therefore possible that audiovisual congruency effects reflect higher levels of multisensory integration that may be less important for reading acquisition in the first year of learning to read, and that they may potentially gain on relevance later on.

The rise and fall of rapid occipito-temporal sensitivity to letters: Transient specialization through elementary school

Letters, foundational units of alphabetic writing systems, are quintessential to human culture. The ability to read, indispensable to perform in today’s society, necessitates a reorganization of visual cortex for fast letter recognition, but the developmental course of this process has not yet been characterized. Here, we show the emergence of visual sensitivity to letters across five electroencephalography measurements from kindergarten and throughout elementary school and relate this development to emerging reading skills. We examined the visual N1, the electrophysiological correlate of ventral occipito-temporal cortex activation in 65 children at varying familial risk for dyslexia. N1 letter sensitivity emerged in first grade, when letter sound knowledge gains were most pronounced and decayed shortly after when letter knowledge is consolidated, showing an inverted U-shaped development. This trajectory can be interpreted within an interactive framework that underscores the influence of top-down predictions. While the N1 amplitudes to letters correlated with letter sound knowledge at the beginning of learning, no association between the early N1 letter response and later reading skills was found. In summary, the current findings provide an important reference point for our neuroscientific understanding of learning trajectories and the process of visual specialization during skill learning.

Frontal Cortical Modulation of Temporal Visual Cross-Modal Re-organization in Adults with Hearing Loss

Recent research has demonstrated frontal cortical involvement to co-occur with visual re-organization, suggestive of top-down modulation of cross-modal mechanisms. However, it is unclear whether top-down modulation of visual re-organization takes place in mild hearing loss, or is dependent upon greater degrees of hearing loss severity. Thus, the purpose of this study was to determine if frontal top-down modulation of visual cross-modal re-organization increased across hearing loss severity. We recorded visual evoked potentials (VEPs) in response to apparent motion stimuli in 17 adults with mild-moderate hearing loss using 128-channel high-density electroencephalography (EEG). Current density reconstructions (CDRs) were generated using sLORETA to visualize VEP generators in both groups. VEP latency and amplitude in frontal regions of interest (ROIs) were compared between groups and correlated with auditory behavioral measures. Activation of frontal networks in response to visual stimulation increased across mild to moderate hearing loss, with simultaneous activation of the temporal cortex. In addition, group differences in VEP latency and amplitude correlated with auditory behavioral measures. Overall, these findings support the hypothesis that frontal top-down modulation of visual cross-modal re-organization is dependent upon hearing loss severity.

Influence of reading skill and word length on fixation-related brain activity in school-aged children during natural reading

Word length is one of the main determinants of eye movements during reading and has been shown to influence slow readers more strongly than typical readers. The influence of word length on reading in individuals with different reading skill levels has been shown in separate eye-tracking and electroencephalography studies. However, the influence of reading difficulty on cortical correlates of word length effect during natural reading is unknown. To investigate how reading skill is related to brain activity during natural reading, we performed an exploratory analysis on our data set from a previous study, where slow reading (N = 27) and typically reading (N = 65) 12-to-13.5-year-old children read sentences while co-registered ET-EEG was recorded. We extracted fixation-related potentials (FRPs) from the sentences using the linear deconvolution approach. We examined standard eye-movement variables and deconvoluted FRP estimates: intercept of the response, categorical effect of first fixation versus additional fixation and continuous effect of word length. We replicated the pattern of stronger word length effect in eye movements for slow readers. We found a difference between typical readers and slow readers in the FRP intercept, which contains activity that is common to all fixations, within a fixation time-window of 50-300 ms. For both groups, the word length effect was present in brain activity during additional fixations; however, this effect was not different between groups. This suggests that stronger word length effect in the eye movements of slow readers might be mainly due re-fixations, which are more probable due to the lower efficiency of visual processing.

Familiarity with visual forms contributes to a left-lateralized and increased N170 response for Chinese characters

While skilled readers produce an increased and left-lateralized event-related-potential (ERP) component, known as N170, for strings of letters compared to strings of less familiar units, it remains unclear whether perceptual familiarity plays an important role in driving the increased and left-lateralized N170 for print. The present study addressed this issue by examining N170 responses for regular Chinese characters and cursive Chinese characters which are visually less familiar regarding their form, yet with phonological and semantic properties. Stroke combinations, which are with unfamiliar visual form and without phonological or semantic properties, were used as low-level control stimuli. Twenty college students (22.6 ± 1.2 years) were examined. A content-irrelevant color matching task was used to control for differences of attention load across familiar and unfamiliar stimuli. A left-lateralized N170 was evoked only by regular characters, but not by cursive characters or stroke combinations. Moreover, cursive characters, which are principally readable but visually unfamiliar, produced a lower N170 than regular characters, and no N170 difference was found compared with stroke combinations. These results suggest that visual form familiarity serves as an important driver for the increased and left-lateralized N170 response.

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

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

Altered patterns of directed connectivity within the reading network of dyslexic children and their relation to reading dysfluency

Reading is a complex cognitive skill subserved by a distributed network of visual and language-related regions. Disruptions of connectivity within this network have been associated with developmental dyslexia but their relation to individual differences in the severity of reading problems remains unclear. Here we investigate whether dysfunctional connectivity scales with the level of reading dysfluency by examining EEG recordings during visual word and false font processing in 9-year-old typically reading children (TR) and two groups of dyslexic children: severely dysfluent (SDD) and moderately dysfluent (MDD) dyslexics. Results indicated weaker occipital to inferior-temporal connectivity for words in both dyslexic groups relative to TRs. Furthermore, SDDs exhibited stronger connectivity from left central to right inferior-temporal and occipital sites for words relative to TRs, and for false fonts relative to both MDDs and TRs. Importantly, reading fluency was positively related with forward and negatively with backward connectivity. Our results suggest disrupted visual processing of words in both dyslexic groups, together with a compensatory recruitment of right posterior brain regions especially in the SDDs during word and false font processing. Functional connectivity in the brain's reading network may thus depend on the level of reading dysfluency beyond group differences between dyslexic and typical readers.

Contributions of Letter-Speech Sound Learning and Visual Print Tuning to Reading Improvement: Evidence from Brain Potential and Dyslexia Training Studies

We use a neurocognitive perspective to discuss the contribution of learning letter-speech sound (L-SS) associations and visual specialization in the initial phases of reading in dyslexic children. We review findings from associative learning studies on related cognitive skills important for establishing and consolidating L-SS associations. Then we review brain potential studies, including our own, that yielded two markers associated with reading fluency. Here we show that the marker related to visual specialization (N170) predicts word and pseudoword reading fluency in children who received additional practice in the processing of morphological word structure. Conversely, L-SS integration (indexed by mismatch negativity (MMN)) may only remain important when direct orthography to semantic conversion is not possible, such as in pseudoword reading. In addition, the correlation between these two markers supports the notion that multisensory integration facilitates visual specialization. Finally, we review the role of implicit learning and executive functions in audiovisual learning in dyslexia. Implications for remedial research are discussed and suggestions for future studies are presented.