A callosal transfer deficit in children with developmental language disorder

Advanced diffusion imaging for assessing normal white matter development in neonates and characterizing aberrant development in congenital heart disease

Background

Elucidating developmental trajectories of white matter (WM) microstructure is critically important for understanding normal development and regional vulnerabilities in several brain disorders. Diffusion Weighted Imaging (DWI) is currently the method of choice for in-vivo white matter assessment. A majority of neonatal studies use the standard Diffusion Tensor Imaging (DTI) model although more advanced models such as the Neurite Orientation Dispersion and Density Imaging (NODDI) model and the Gaussian Mixture Model (GMM) have been used in adult population. In this study, we compare the ability of these three diffusion models to detect regional white matter maturation in typically developing control (TDC) neonates and regional abnormalities in neonates with congenital heart disease (CHD).

Methods

Multiple b-value diffusion Magnetic Resonance Imaging (dMRI) data were acquired from TDC neonates (N = 16) at 38 to 47 gestational weeks (GW) and CHD neonates (N = 19) aged 37 weeks to 41 weeks. Measures calculated from the diffusion signal included not only Mean Diffusivity (MD) and Fractional Anisotropy (FA) derived from the standard DTI model, but also three advanced diffusion measures, namely, the fiber Orientation Dispersion Index (ODI), the isotropic volume fraction (Viso), and the intracellular volume fraction (Vic) derived from the NODDI model. Further, we used two novel measures from a non-parametric GMM, namely the Return-to-Origin Probability (RTOP) and Return-to-Axis Probability (RTAP), which are sensitive to axonal/cellular volume and density respectively. Using atlas-based registration, 22 white matter regions (6 projection, 4 association, and 1 callosal pathways bilaterally in each hemisphere) were selected and the mean value of all 7 measures were calculated in each region. These values were used as dependent variables, with GW as the independent variable in a linear regression model. Finally, we compared CHD and TDC groups on these measures in each ROI after removing age-related trends from both the groups.

Results

Linear analysis in the TDC population revealed significant correlations with GW (age) in 12 projection pathways for MD, Vic, RTAP, and 11 pathways for RTOP. Several association pathways were also significantly correlated with GW for MD, Vic, RTAP, and RTOP. The right callosal pathway was significantly correlated with GW for Vic. Consistent with the pathophysiology of altered development in CHD, diffusion measures demonstrated differences in the association pathways involved in language systems, namely the Uncinate Fasciculus (UF), the Inferior Fronto-occipital Fasciculus (IFOF), and the Superior Longitudinal Fasciculus (SLF). Overall, the group comparison between CHD and TDC revealed lower FA, Vic, RTAP, and RTOP for CHD bilaterally in the a) UF, b) Corpus Callosum (CC), and c) Superior Fronto-Occipital Fasciculus (SFOF). Moreover, FA was lower for CHD in the a) left SLF, b) bilateral Anterior Corona Radiata (ACR) and left Retrolenticular part of the Internal Capsule (RIC). Vic was also lower for CHD in the left Posterior Limb of the Internal Capsule (PLIC). ODI was higher for CHD in the left CC. RTAP was lower for CHD in the left IFOF, while RTOP was lower in CHD in the: a) left ACR, b) left IFOF and c) right Anterior Limb of the Internal Capsule (ALIC).

Conclusion

In this study, all three methods revealed the expected changes in the WM regions during the early postnatal weeks; however, GMM outperformed DTI and NODDI as it showed significantly larger effect sizes while detecting differences between the TDC and CHD neonates. Future studies based on a larger sample are needed to confirm these results and to explore clinical correlates.

Revisiting Strephosymbolie: The Connection between Interhemispheric Transfer and Developmental Dyslexia

The hypothesis that an atypical hemispheric specialization is associated to developmental dyslexia (DD) is receiving renewed interest, lending some support to Orton’s theory. In this article, we investigated whether interhemispheric transfer processes (IHT) are likely to be involved in developmental dyslexia. In this study, we tested 13 children with developmental dyslexia and 13 matched controls (aged 8 to 13 years) in four different tasks. In a tactile transfer task, the dyslexic children’s performance was less accurate. In a standard Poffenberger paradigm, dyslexic children performed slower than the controls in all conditions and did not show any difference between crossed and uncrossed conditions. Furthermore, they showed an increased asymmetry of performance according to the responding hand, while controls gave more coherent responses. In a visual task of object orientation discrimination, dyslexic children had slower Response Times (RTs) than controls, especially for mirror-reversed objects in the right visual field. Finally, a higher number of dyslexic children showed mirror-drawing or mirror-writing with respect to controls. Our results as a whole show that children with DD are impaired in interhemispheric transfer, although the differences in performance among dyslexic individuals suggest the impairment of different psychophysiological mechanisms. As such, a common origin in terms of connectivity problems is proposed.

Atypical Callosal Morphology in Children with Speech Sound Disorder

Speech sound disorder (SSD) is common, yet its neurobiology is poorly understood. Recent studies indicate atypical structural and functional anomalies either in one hemisphere or both hemispheres, which might be accompanied by alterations in inter-hemispheric connectivity. Indeed, abnormalities of the corpus callosum - the main fiber tract connecting the two hemispheres - have been linked to speech and language deficits in associated disorders, such as stuttering, dyslexia, aphasia, etc. However, there is a dearth of studies examining the corpus callosum in SSD. Here, we investigated whether a sample of 18 children with SSD differed in callosal morphology from 18 typically developing children carefully matched for age. Significantly reduced dimensions of the corpus callosum, particularly in the callosal anterior third, were observed in children with SSD. These findings indicating pronounced callosal aberrations in SSD make an important contribution to an understudied field of research and may suggest that SSD is accompanied by atypical lateralization of speech and language function.

Regional brain volume reduction and cognitive outcomes in preterm children at low risk at 9 years of age

OBJECTIVE

More information is needed on "low-risk" preterm infants' neurological outcome so that they can be included in follow-up programs. A prospective study was performed to examine the regional brain volume changes compared to term children and to assess the relationship between the regional brain volumes to cognitive outcome of the low-risk preterm children at 9 years of age.

PATIENTS

Subjects comprised 22 preterm children who were determined to be at low risk for neurodevelopmental deficits with a gestational age between 28 and 33 weeks without a major neonatal morbidity in the neonatal period and 24 age-matched term control children term and matched for age, sex, and parental educational and occupational status.

METHODS

Regional volumetric analysis was performed for cerebellum, hippocampus, and corpus callosum area. Cognitive outcomes of both preterm and control subjects were assessed by Weschler Intelligence Scale for Children Revised (Turkish version), and attention and executive functions were assessed by Wisconsin Card Sorting Test and Stroop Test TBAG version.

RESULTS

Low-risk preterm children showed regional brain volume reduction in cerebellum, hippocampus, and corpus callosum area and achieved statistical significance when compared with term control. When the groups were compared for all WISC-R subscale scores, preterm children at low risk had significantly lower scores on information, vocabulary, similarities, arithmetics, picture completion, block design, object assembly, and coding compared to children born at term. Preterm and term groups were compared on the Stroop Test for mistakes and corrections made on each card, the time spent for completing each card, and total mistakes and corrections. In the preterm group, we found a positive correlation between regional volumes with IQ, attention, and executive function scores. Additionally, a significant correlation was found between cerebellar volume and attention and executive function scores in the preterm group.

CONCLUSION

Low-risk preterm children achieve lower scores in neurophysiological tests than children born at term. Preterm birth itself has a significant impact on regional brain volumes and cognitive outcome of children at 9 years of age. It is a risk factor for regional brain volume reductions in preterm children with low risk for neurodevelopmental deficits. The significant interaction between cerebellar volume reduction and executive function and attention may suggest that even in preterm children at low risk can have different trajectories in the growth and development of overall brain structure.

Contralateral targeting of the corpus callosum in normal and pathological brain function

The corpus callosum connects the two cortical hemispheres of the mammalian brain and is susceptible to structural defects during development, which often result in significant neuropsychological dysfunction. To date, such individuals have been studied primarily with regards to the integrity of the callosal tract at the midline. However, the mechanisms regulating the contralateral targeting of the corpus callosum, after midline crossing has occurred, are less well understood. Recent evidence suggests that defects in contralateral targeting can occur in isolation from midline-tract malformations, and may have significant functional implications. We propose that contralateral targeting is a crucially important and relatively under-investigated event in callosal development, and that defects in this process may constitute an undiagnosed phenotype in several neurological disorders.

Down syndrome: the brain in trisomic mode

Down syndrome is the most common form of intellectual disability and results from one of the most complex genetic perturbations that is compatible with survival, trisomy 21. The study of brain dysfunction in this disorder has largely been based on a gene discovery approach, but we are now moving into an era of functional genome exploration, in which the effects of individual genes are being studied alongside the effects of deregulated non-coding genetic elements and epigenetic influences. Also, new data from functional neuroimaging studies are challenging our views of the cognitive phenotypes associated with Down syndrome and their pathophysiological correlates. These advances hold promise for the development of treatments for intellectual disability.

Interhemispheric temporal lobe connectivity predicts language impairment in adolescents born preterm

Although language difficulties are common in children born prematurely, robust neuroanatomical correlates of these impairments remain to be established. This study investigated whether the greater prevalence of language problems in preterm (versus term-born) children might reflect injury to major intra- or interhemispheric white matter pathways connecting frontal and temporal language regions. To investigate this, we performed a comprehensive assessment of language and academic abilities in a group of adolescents born prematurely, some of whom had evidence of brain injury at birth (n = 50, mean age: 16 years, mean gestational age: 27 weeks) and compared them to a term-born control group (n = 30). Detailed structural magnetic resonance imaging and diffusion-tractography analyses of intrahemispheric and interhemispheric white matter bundles were performed. Analysis of intrahemispheric pathways included the arcuate fasciculus (dorsal language pathway) and uncinate fasciculus/extreme capsule (ventral language pathway). Analysis of interhemispheric pathways (in particular, connections between the temporal lobes) included the two major commissural bundles: the corpus callosum and anterior commissure. We found language impairment in 38% of adolescents born preterm. Language impairment was not related to abnormalities of the arcuate fasciculus (or its subsegments), but was associated with bilateral volume reductions in the ventral language pathway. However, the most significant volume reduction was detected in the posterior corpus callosum (splenium), which contains interhemispheric connections between the occipital, parietal and temporal lobes. Diffusion tractography showed that of the three groups of interhemispheric fibres within the splenium, only those connecting the temporal lobes were reduced. Crucially, we found that language impairment was only detectable if the anterior commissure (a second temporal lobe commissural pathway) was also small. Regression analyses showed that a combination of anatomical measures of temporal interhemispheric connectivity (through the splenium of the corpus callosum and anterior commissure) explained 57% of the variance in language abilities. This supports recent theories emphasizing the importance of interhemispheric connections for language, particularly in the developing brain.

Procedural visual learning in children with specific language impairment

PURPOSE

According to the procedural deficit hypothesis (PDH), difficulties in the procedural learning (PL) system may contribute to the language difficulties observed in children with specific language impairment (SLI).

METHOD

Fifteen children with SLI and their typically developing (TD) peers were compared on visual PL tasks-specifically, deterministic serial reaction time (SRT) tasks. In the first experiment, children with SLI and their TD peers performed the classical SRT task using a keyboard as response mode. In the second experiment, they performed the same SRT task but gave their responses through a touchscreen (instead of a keyboard) to reduce the motor and cognitive demands of the task.

RESULTS

Although in Experiment 1, children with SLI demonstrated learning, they were slower and made more errors than did their TD peers. Nevertheless, these relative weaknesses disappeared when the nature of the response mode changed ( Experiment 2).

CONCLUSIONS

In this study, the authors report that children with SLI may exhibit sequential learning. Moreover, the generally slower reaction times observed in previous deterministic SRT studies may be explained by the response mode used. Thus, our findings are not consistent with the predictions of the PDH, and these findings suggest that language impairments in SLI are not sustained by poor procedural learning abilities.

Principles underlying the Bilingual Aphasia Test (BAT) and its uses

The Bilingual Aphasia Test (BAT) is designed to be objective (so it can be administered by a lay native speaker of the language) and equivalent across languages (to allow for a comparison between the languages of a given patient as well as across patients from different institutions). It has been used not only with aphasia but also with any condition that results in language impairment (Alzheimer's, autism, cerebellar lesions, developmental language disorders, mild cognitive impairment, motor neuron disease, multiple sclerosis, Parkinson's, vascular dementia, etc.). It has also been used for research purposes on non-brain-damaged unilingual and bilingual populations. By means of its 32 tasks, it assesses comprehension and production of implicit linguistic competence and metalinguistic knowledge (which provide indications for apposite rehabilitation strategies). Versions of the BAT are available for free download at www.mcgill.ca/linguistics/research/bat/.

Developmental malformation of the corpus callosum: a review of typical callosal development and examples of developmental disorders with callosal involvement

This review provides an overview of the involvement of the corpus callosum (CC) in a variety of developmental disorders that are currently defined exclusively by genetics, developmental insult, and/or behavior. I begin with a general review of CC development, connectivity, and function, followed by discussion of the research methods typically utilized to study the callosum. The bulk of the review concentrates on specific developmental disorders, beginning with agenesis of the corpus callosum (AgCC)-the only condition diagnosed exclusively by callosal anatomy. This is followed by a review of several genetic disorders that commonly result in social impairments and/or psychopathology similar to AgCC (neurofibromatosis-1, Turner syndrome, 22q11.2 deletion syndrome, Williams yndrome, and fragile X) and two forms of prenatal injury (premature birth, fetal alcohol syndrome) known to impact callosal development. Finally, I examine callosal involvement in several common developmental disorders defined exclusively by behavioral patterns (developmental language delay, dyslexia, attention-deficit hyperactive disorder, autism spectrum disorders, and Tourette syndrome).

Aneuploidy: from a physiological mechanism of variance to Down syndrome

Quantitative differences in gene expression emerge as a significant source of variation in natural populations, representing an important substrate for evolution and accounting for a considerable fraction of phenotypic diversity. However, perturbation of gene expression is also the main factor in determining the molecular pathogenesis of numerous aneuploid disorders. In this review, we focus on Down syndrome (DS) as the prototype of "genomic disorder" induced by copy number change. The understanding of the pathogenicity of the extra genomic material in trisomy 21 has accelerated in the last years due to the recent advances in genome sequencing, comparative genome analysis, functional genome exploration, and the use of model organisms. We present recent data on the role of genome-altering processes in the generation of diversity in DS neural phenotypes focusing on the impact of trisomy on brain structure and mental retardation and on biological pathways and cell types in target brain regions (including prefrontal cortex, hippocampus, cerebellum, and basal ganglia). We also review the potential that genetically engineered mouse models of DS bring into the understanding of the molecular biology of human learning disorders.

Role of the corpus callosum in speech comprehension: interfacing syntax and prosody

The role of the corpus callosum (CC) in the interhemispheric interaction of prosodic and syntactic information during speech comprehension was investigated in patients with lesions in the CC, and in healthy controls. The event-related brain potential experiment examined the effect of prosodic phrase structure on the processing of a verb whose argument structure matched or did not match the prior prosody-induced syntactic structure. While controls showed an N400-like effect for prosodically mismatching verb argument structures, thus indicating a stable interplay between prosody and syntax, patients with lesions in the posterior third of the CC did not show this effect. Because these patients displayed a prosody-independent semantic N400 effect, the present data indicate that the posterior third of the CC is the crucial neuroanatomical structure for the interhemispheric interplay of suprasegmental prosodic information and syntactic information.

Dyslexia and across-hands finger localization deficits

Two experiments on finger localization are reported. Experiment 1 compared children who were poor readers with two groups of children matched to poor readers for sex and either age (CA controls) or reading age (RA controls). The participant's hands were kept out of his or her sight in a semi-open box while the fingers of one hand were lightly touched by the experimenter. The participant's task was to indicate, using the thumb of either the same hand (within-hand condition) or the opposite hand (across-hands condition) to respond, the finger(s) which had been touched by the experimenter. Performance was significantly impaired in the across-hands condition compared with the within-hand condition. Experiment 2 was carried out with dyslexic adults and a control group of normal readers. Using the same method of responding as in Experiment 1, a significant deficit in the across-hands condition compared to the within-hand condition was found for both groups. The effect was also obtained for both groups when participants were required to point to the relevant fingers on a photograph of a hand rather than use the thumb of the opposite hand to respond. The results are discussed in relation to the hypothesis of a deficit in inter-hemispheric transfer of tactile information in dyslexia.

Speech delay in children: a functional MR imaging study

PURPOSE

To determine if children with speech delay who have been sedated have patterns of activation to passive language paradigms that are different than those of children with normal speech.

MATERIALS AND METHODS

Seventeen children with speech delay (age range, 2-7 years; mean, 4.0 years) and 35 age-matched children with normal speech (age range, 2-8 years; mean, 4.2 years) were evaluated. The subjects in the control group were selected from patients referred for conventional magnetic resonance (MR) imaging. All children had absence of auditory impairment or mental retardation, and MR findings indicated that brain structure was normal. Sedation was achieved with pentobarbital (3-5 mg/kg) or chloral hydrate (75 mg/kg). Functional MR imaging was performed with a single-shot echo-planar blood oxygen-level-dependent technique and a passive block paradigm, in which the child listened to his or her mother's prerecorded voice. Statistical postprocessing of functional MR images was performed with the t test and cluster detection methods. Comparison between groups was performed depending on the type of data with a nonparametrical Mann-Whitney test, parametrical t test, or Fisher exact test.

RESULTS

Five (83%) of the six children older than 3 years with speech delay had lateralized activation of functional MR imaging signal in the right hemisphere. Ten (71%) of 14 age-matched patients with normal speech had activation in the left hemisphere when exposed to the same passive listening tasks. When these groups were compared, this difference was statistically significant. (P =.036). No statistically significant lateralization was seen across all age groups in children with activation.

CONCLUSION

Children older than 3 years with speech delay have activation in the right hemisphere more frequently than children older than 3 years with normal speech, who often have the expected finding of activation in the left hemisphere.