On the relationship between degree of hand-preference and degree of language lateralization

White matter microstructure alterations in type 2 diabetes mellitus and its correlation with cerebral small vessel disease and cognitive performance

Microstructural abnormalities of white matter fiber tracts are considered as one of the etiology of diabetes-induced neurological disorders. We explored the cerebral white matter microstructure alteration accurately, and to analyze its correlation between cerebral small vessel disease (CSVD) burden and cognitive performance in type 2 diabetes mellitus (T2DM). The clinical-laboratory data, cognitive scores [including mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), California verbal learning test (CVLT), and symbol digit modalities test (SDMT)], CSVD burden scores of the T2DM group (n = 34) and healthy control (HC) group (n = 21) were collected prospectively. Automatic fiber quantification (AFQ) was applied to generate bundle profiles along primary white matter fiber tracts. Diffusion tensor images (DTI) metrics and 100 nodes of white matter fiber tracts between groups were compared. Multiple regression analysis was used to analyze the relationship between DTI metrics and cognitive scores and CSVD burden scores. For fiber-wise and node-wise, DTI metrics in some commissural and association fibers were increased in T2DM. Some white matter fiber tracts DTI metrics were independent predictors of cognitive scores and CSVD burden scores. White matter fiber tracts damage in patients with T2DM may be characterized in specific location, especially commissural and association fibers. Aberrational specific white matter fiber tracts are associated with visuospatial function and CSVD burden.

Functional MRI applications for intra-axial brain tumours: uses and nuances in surgical practise

PURPOSE

Functional MRI (fMRI) has well-established uses to inform risks and plan maximally safe approaches in neurosurgery. In the field of brain tumour surgery, however, fMRI is currently in a state of clinical equipoise due to debate around both its sensitivity and specificity.

MATERIALS AND METHODS

In this review, we summarise the role and our experience of fMRI in neurosurgery for gliomas and metastases. We discuss nuances in the conduct and interpretation of fMRI that, based on our practise, most directly impact fMRI's usefulness in the neurosurgical setting.

RESULTS

Illustrated examples in which fMRI in our hands directly influences the neurosurgical treatment of brain tumours include evaluating the probability and nature of functional risks, especially for language functions. These presurgical risk assessments, in turn, help to predict the resectability of tumours, select or deselect patients for awake surgery, indicate the need for neurophysiological monitoring and guide the optimal use of intra-operative stimulation mapping. A further emerging application of fMRI is in measuring functional adaptation of functional networks after (partial) surgery, of potential use in the timing of further surgery.

CONCLUSIONS

In appropriately selected patients with a clearly defined surgical question, fMRI offers a valuable complementary tool in the pre-surgical evaluation of brain tumours. However, there is a great need for standards in the administration and analysis of fMRI as much as in the techniques that it is commonly evaluated against. Surprisingly little data exists that evaluates the accuracy of fMRI not just against complementary methods, but in terms of its ultimate clinical aim of minimising post-surgical morbidity.

Assessing non-right-handedness and atypical cerebral lateralisation as predictors of paediatric mental health difficulties

Research utilising handedness as a proxy for atypical language lateralisation has invoked the latter to explain increased mental health difficulties in left-/mixed-handed children. The current study investigated unique associations between handedness and language lateralisation, handedness and mental health, and language lateralisation and mental health, in children, to elucidate the role of cerebral lateralisation in paediatric mental health. Participants were N = 64 (34 females [52%]; MAge  = 8.56 years; SDAge  = 1.33; aged 6-12 years) typically developing children. Hand preference was assessed via a reaching task, language lateralisation was assessed using functional transcranial Doppler ultrasonography (fTCD) during an expressive language task, and mental health was assessed with the Strengths and Difficulties Questionnaire. As hypothesised, leftward hand preference predicted increased general mental health issues in children, with a strong relationship noted between leftward hand preference and the emotional symptoms subscale. Contrary to expectation, no relationship was found between direction of language lateralisation and general mental health issues, although exploratory analyses of subscales showed rightward lateralisation to predict conduct problems. Hand preference and direction of language lateralisation were also not significantly associated. The relatively weak relationship between manual and language laterality coupled with discrepancy regarding the predictive scope of each phenotype (i.e., hand preference predicts overall mental health, whereas language laterality predicts only conduct problems) suggests independent developmental pathways for these phenotypes. The role of manual laterality in paediatric mental health warrants further investigation utilising a neuroimaging method with higher spatial resolution.

Comparison of fMRI language laterality with and without sedation in pediatric epilepsy

Functional MRI is an essential component of presurgical language mapping. In clinical settings, young children may be sedated for the MRI with the functional stimuli presented passively. Research has found that sedation changes language activation in healthy adults and children. However, there is limited research comparing sedated and unsedated functional MRI in pediatric epilepsy patients. We compared language activation patterns in children with epilepsy who received sedation for functional MRI to the ones who did not. We retrospectively identified the patients with focal epilepsy who underwent presurgical functional MRI including Auditory Descriptive Decision Task at Boston Children's Hospital from 2014 to 2022. Patients were divided into sedated and awake groups, based on their sedation status during functional MRI. Auditory Descriptive Decision Task stimuli were presented passively to the sedated group per clinical protocol. We extracted language activation maps contrasted against a control task (reverse speech) in the Frontal and Temporal language regions and calculated separate language laterality indexes for each region. We considered positive laterality indexes as left dominant, negative laterality indexes as right dominant, and absolute laterality indexes <0.2 as bilateral. We defined 2 language patterns: typical (i.e., primarily left-sided) and atypical. Typical pattern required at least one left dominant region (either frontal or temporal) and no right dominant region. We then compared the language patterns between the sedated and awake groups. Seventy patients met the inclusion criteria, 25 sedated, and 45 awake. Using the Auditory Descriptive Decision Task paradigm, when adjusted for age, handedness, gender, and laterality of lesion in a weighted logistic regression model, the odds of the atypical pattern were 13.2 times higher in the sedated group compared to the awake group (Confidence Interval: 2.55-68.41, p-value < 0.01). Sedation may alter language activation patterns in pediatric epilepsy patients. Language patterns on sedated functional MRI with passive tasks may not represent language networks during wakefulness, sedation may differentially suppress some networks, or require a different task or method of analysis to capture the awake language network. Given the critical surgical implication of these findings, additional studies are needed to better understand how sedation impacts the functional MRI blood oxygenation level-dependent signal. Consistent with current practice, sedated functional MRI should be interpreted with greater caution and requires additional validation as well as research on post-surgical language outcomes.

Greater volumes of a callosal sub-region terminating in posterior language-related areas predict a stronger degree of language lateralization: A tractography study

Language lateralization is the most intriguing trait of functional asymmetry for cognitive functions. Nowadays, ontogenetic determinants of this trait are largely unknown, but there are efforts to find its anatomical correlates. In particular, a white matter interhemispheric connection-the corpus callosum-has been proposed as such. In the present study, we aimed to find the association between the degree of language lateralization and metrics of the callosal sub-regions. We applied a sentence completion fMRI task to measure the degree of language lateralization in a group of healthy participants balanced for handedness. We obtained the volumes and microstructural properties of callosal sub-regions with two tractography techniques, diffusion tensor imaging (DTI) and constrained spherical deconvolution (CSD). The analysis of DTI-based metrics did not reveal any significant associations with language lateralization. In contrast, CSD-based analysis revealed that the volumes of a callosal sub-region terminating in the core posterior language-related areas predict a stronger degree of language lateralization. This finding supports the specific inhibitory model implemented through the callosal fibers projecting into the core posterior language-related areas in the degree of language lateralization, with no relevant contribution of other callosal sub-regions.

Repetitive transcranial magnetic stimulation modulates action naming over the left but not right inferior frontal gyrus

fMRI language mapping studies report right-hemispheric contribution to language in healthy individuals. However, it remains unclear whether these right-hemispheric patterns of activity are critical for language, which is highly relevant for clinical preoperative language mapping. The available findings are controversial. In this study, we first measured individual patterns of language lateralization with an fMRI language localizer in healthy participants with different handedness (N = 31). Then, the same participants received rTMS over the individual coordinates of peak fMRI-based activation in the left and right inferior frontal gyri. During rTMS, participants performed a picture naming task. It included both objects and actions to test whether naming of nouns and verbs would be equally modulated by rTMS. Stimulation of the left inferior frontal gyrus resulted in accuracy facilitation of verb production regardless of individual language lateralization. No modulation of object naming was found at any stimulation site in terms of accuracy nor reaction time. This study causally confirmed the critical contribution of the left, but not the right hemisphere to verb production regardless of the language lateralization patterns observed with fMRI. Also, the results stress that action rather than object naming is the task of choice for mapping language in the frontal lobe.

Handedness in bipolar disorders is associated with specific neurodevelopmental features: results of the BD-FACE cohort

OBJECTIVES

High rates of non-right-handedness (NRH) and mixed-handedness exist in neurodevelopmental disorders. Dysfunctional neurodevelopmental pathways may be implicated in the underlying pathophysiology of bipolar disorders (BD), at least in some subgroups. Yet little is known about correlates of NRH and mixed-handedness in BD. The objectives of this national study are to determine (i) the prevalence of NRH and mixed-handedness in a well-stabilized sample of BD individuals; (ii) if NRH/mixed-handedness in BD is associated with a different clinical, biological and neurocognitive profile.

METHODS

We included 2174 stabilized individuals. Participants were tested with a comprehensive battery of neuropsychological tests. Handedness was assessed using a single oral question. Learning and/or language disorders and obstetrical complications were recorded using childhood records. Common environmental, clinical and biological parameters were assessed.

RESULTS

The prevalence of NRH and mixed-handedness were, respectively, 11.6 and 2.4%. Learning/language disorders were found in 9.7% out of the total sample and were associated with atypical handedness (only dyslexia for mixed-handedness (p < 0.01), and dyslexia and dysphasia for NRH (p = 0.01 and p = 0.04, respectively). In multivariate analyses, NRH was associated with a younger age of BD onset (aOR 0.98 (95% CI 0.96-0.99) and lifetime substance use disorder (aOR 1.40 (95% CI 1.03-1.82) but not with any of the cognitive subtasks. Mixed-handedness was associated in univariate analyses with lifetime substance use disorder, lifetime cannabis use disorder (all p < 0.01) and less mood stabilizer prescription (p = 0.028). No association was found between NRH or mixed-handedness and the following parameters: trauma history, obstetrical complications, prior psychotic symptoms, bipolar subtype, attention deficit/hyperactivity disorder, peripheral inflammation or body mass index.

CONCLUSIONS

Handedness may be associated with specific features in BD, possibly reflecting a specific subgroup with a neurodevelopmental load.

Cerebral laterality of writing in right- and left- handers: A functional transcranial Doppler ultrasound study

The cerebral lateralization of written language has received very limited research attention in comparison to the wealth of studies on the cerebral lateralization of oral language. The purpose of the present study was to further our understanding of written language lateralization, by elucidating the relative contribution of language and motor functions. We compared written word generation with a task that has equivalent visuomotor demands but does not include language: the repeated drawing of symbols. We assessed cerebral laterality using functional transcranial Doppler ultrasound (fTCD), a non-invasive, perfusion-sensitive neuroimaging technique in 23 left- and 31 right-handed participants. Findings suggest that the linguistic aspect of written word generation recruited more left-hemispheric areas during writing, in right-handers compared to left-handers. This difference could be explained by greater variability in cerebral laterality patterns within left-handers or the possibility that the areas subserving language in left-handers are broader than in right-handers. Another explanation is that the attentional demands of the more novel symbol copying task (compared to writing) contributed more right-hemispheric activation in right-handers, but this could not be captured in left-handers due to ceiling effects. Future work could investigate such attentional demands using both simple and complex stimuli in the copying condition.

Developmental Language Disorder as Syntactic Prediction Impairment

We provide evidence that children with Developmental Language Disorder (DLD) are impaired in predictive syntactic processing. In the current study, children listened passively to auditorily-presented sentences, where the critical condition included an unexpected "filled gap" in the direct object position of the relative clause verb. A filled gap is illustrated by the underlined phrase in "The zebra that the hippo kissed the camel on the nose…", rather than the expected "the zebra that the hippo kissed [e] on the nose", where [e] denotes the gap. Brain responses to the filled gap were compared to a control condition using adverb-relative clauses with identical substrings: "The weekend that the hippo kissed the camel on the nose [e]…". Here, the same noun phrase is not unexpected because the adverb gap occurs later in the structure. We hypothesized that a filled gap would elicit a prediction error brain signal in the form of an early anterior negativity, as we have previously observed in adults. We found an early (bilateral) anterior negativity to the filled gap in a control group of children with Typical Development (TD), but the children with DLD exhibited no brain response to the filled gap during the same early time window. This suggests that children with DLD fail to predict that a relativized object should correspond to an empty position after the relative clause verb, suggesting an impairment in predictive processing. We discuss how this lack of a prediction error signal can interact with language acquisition and result in DLD.

Spinal and Cerebral Integration of Noxious Inputs in Left-handed Individuals

Some pain-related information is processed preferentially in the right cerebral hemisphere. Considering that functional lateralization can be affected by handedness, spinal and cerebral pain-related responses may be different between right- and left-handed individuals. Therefore, this study aimed to investigate the cortical and spinal mechanisms of nociceptive integration when nociceptive stimuli are applied to right -handed vs. left -handed individuals. The NFR, evoked potentials (ERP: P45, N100, P260), and event-related spectral perturbations (ERSP: theta, alpha, beta and gamma band oscillations) were compared between ten right-handed and ten left-handed participants. Pain was induced by transcutaneous electrical stimulation of the lower limbs and left upper limb. Stimulation intensity was adjusted individually in five counterbalanced conditions of 21 stimuli each: three unilateral (right lower limb, left lower limb, and left upper limb stimulation) and two bilateral conditions (right and left lower limbs, and the right lower limb and left upper limb stimulation). The amplitude of the NFR, ERP, ERSP, and pain ratings were compared between groups and conditions using a mixed ANOVA. A significant increase of responses was observed in bilateral compared with unilateral conditions for pain intensity, NFR amplitude, N100, theta oscillations, and gamma oscillations. However, these effects were not significantly different between right- and left-handed individuals. These results suggest that spinal and cerebral integration of bilateral nociceptive inputs is similar between right- and left-handed individuals. They also imply that pain-related responses measured in this study may be examined independently of handedness.

Organizing Variables Affecting fMRI Estimates of Language Dominance in Patients with Brain Tumors

Numerous variables can affect the assessment of language dominance using presurgical functional magnetic resonance (fMRI) in patients with brain tumors. This work organizes the variables into confounding and modulating factors. Confounding factors give the appearance of changed language dominance. Most confounding factors are fMRI-specific and they can substantially disrupt the evaluation of language dominance. Confounding factors can be divided into two categories: tumor-related and fMRI analysis. The tumor-related confounds further subdivide into tumor characteristics (e.g., tumor grade) and tumor-induced conditions (aphasia). The fMRI analysis confounds represent technical aspects of fMRI methods (e.g., a fixed versus an individual threshold). Modulating factors can modify language dominance without confounding it. They are not fMRI-specific, and they can impact language dominance both in healthy individuals and neurosurgical patients. The effect of most modulating factors on fMRI language dominance is smaller than that of confounding factors. Modulating factors include demographics (e.g., age) and linguistic variables (e.g., early bilingualism). Three cases of brain tumors in the left hemisphere are presented to illustrate how modulating confounding and modulating factors can impact fMRI estimates of language dominance. Distinguishing between confounding and modulating factors can help interpret the results of presurgical language mapping with fMRI.

Which hand knows the "right" word? What hand selection reveals about vocabulary in pre-and school-aged children

Research has shown that infants with increased right-hand selection for their first gestures perform better at an array of language tasks when they are tested later as toddlers. There is a smaller body of literature which focuses on preschoolers and how their right-handed movements relate to their speech and vocabulary development. Some research has established a connection between right-hand preference for grasping and speech production ability in preschool children, but the link to gestures is relatively unexplored in this age group. We investigated if lateralized gestures (pointing) are related to measures of language development (vocabulary) in a preschool-age sample. Specifically, typically developing children (aged 3-6) completed the Peabody Picture Vocabulary Test (PPVT) to assess receptive language. We recorded their hand preference for pointing during the PPVT and the incidence of mistakes (pointing to the wrong picture). Despite the length of the test, children were more likely to select a correct response with their right hand. This result suggests a relationship between lateralized communicative gestures (pointing) and receptive language. This study provides evidence for an intimate relationship between right-handed manual movement and language development. Implications of this finding include developing simple fine-motor tasks to detect and/or ameliorate delayed language development.

Hand preference and Mathematical Learning Difficulties: New data from Greece, the United Kingdom, and Germany and two meta-analyses of the literature

Increased rates of atypical handedness are observed in neurotypical individuals who are low-performing in mathematical tasks as well as in individuals with special educational needs, such as dyslexia. This is the first investigation of handedness in individuals with Mathematical Learning Difficulties (MLD). We report three new studies (N = 134; N = 1,893; N = 153) and two sets of meta-analyses (22 studies; N = 3,667). No difference in atypical hand preference between MLD and Typically Achieving (TA) individuals was found when handedness was assessed with self-report questionnaires, but weak evidence of a difference was found when writing hand was the handedness criterion in Study 1 (p = .049). Similarly, when combining data meta-analytically, no hand preference differences were detected. We suggest that: (i) potential handedness effects require larger samples, (ii) direction of hand preference is not a sensitive enough measure of handedness in this context, or that (iii) increased rates of atypical hand preference are not associated with MLD. The latter scenario would suggest that handedness is specifically linked to language-related conditions rather than conditions related to cognitive abilities at large. Future studies need to consider hand skill and degree of hand preference in MLD.

Investigating the effects of handedness on the consistency of lateralization for speech production and semantic processing tasks using functional transcranial Doppler sonography

The left hemisphere is dominant for language in most people, but lateralization strength varies between different tasks and individuals. A large body of literature has shown that handedness is associated with lateralization: left handers have weaker language lateralization on average, and a greater incidence of atypical (right hemisphere) lateralization; but typically, these studies have relied on a single measure of language lateralization. Here we consider the relationships between lateralization for two different language tasks. We investigated the influence of handedness on lateralization using functional transcranial Doppler sonography (fTCD), using an existing dataset (N = 151 adults, 21 left handed). We compared a speech production task (word generation) and a semantic association task. We demonstrated stronger left-lateralization for word generation than semantic association; and a moderate correlation between laterality indices for the two tasks (r = 0.59). Laterality indices were stronger for right than left handers, and left handers were more likely than right handers to have atypical (right hemisphere) lateralization or inconsistent lateralization between the two tasks. These results add to our knowledge of individual differences in lateralization and support the view that language lateralization is multifactorial rather than unitary.

Where next for laterality research? Looking back and looking forward

While paying attention to the recommendations of Ocklenburg, Berretz, Packheiser, and Friedrich (2020) in the target article, researchers in the field of laterality should attempt to: (1) solve the long-standing puzzle of the relationship between handedness and language lateralization; (2) further explore the genetic bases of manual and cerebral asymmetry and of their associations with psychiatric and neurodevelopmental conditions; (3) explore the adaptive significance of laterality for humans and non-humans and elucidate the relationships of asymmetry across species; and (4) embrace developing technologies to investigate the interaction between the hemispheres during the performance of everyday tasks.

An updated investigation of the multidimensional structure of language lateralization in left- and right-handed adults: a test-retest functional transcranial Doppler sonography study with six language tasks

A previous study we reported in this journal suggested that left and right-handers may differ in their patterns of lateralization for different language tasks (Woodhead et al. 2019 R. Soc. Open Sci. 6, 181801. (doi:10.1098/rsos.181801)). However, it had too few left-handers (N = 7) to reach firm conclusions. For this update paper, further participants were added to the sample to create separate groups of left- (N = 31) and right-handers (N = 43). Two hypotheses were tested: (1) that lateralization would be weaker at the group level in left-than right-handers; and (2) that left-handers would show weaker covariance in lateralization between tasks, supporting a two-factor model. All participants performed the same protocol as in our previous paper: lateralization was measured using functional transcranial Doppler sonography during six different language tasks, on two separate testing sessions. The results supported hypothesis 1, with significant differences in laterality between groups for four out of six tasks. For hypothesis 2, structural equation modelling showed that there was stronger evidence for a two-factor model in left than right-handers; furthermore, examination of the factor loadings suggested that the pattern of laterality across tasks may also differ between handedness groups. These results expand on what is known about the differences in laterality between left- and right-handers.

Handedness measures for the Human Connectome Project: Implications for data analysis

Open data initiatives such as the UK Biobank and Human Connectome Project provide researchers with access to neuroimaging, genetic, and other data for large samples of left-and right-handed participants, allowing for more robust investigations of handedness than ever before. Handedness inventories are universal tools for assessing participant handedness in these large-scale neuroimaging contexts. These self-report measures are typically used to screen and recruit subjects, but they are also widely used as variables in statistical analyses of fMRI and other data. Recent investigations into the validity of handedness inventories, however, suggest that self-report data from these inventories might not reflect hand preference/performance as faithfully as previously thought. Using data from the Human Connectome Project, we assessed correspondence between three handedness measures - the Edinburgh Handedness Inventory (EHI), the Rolyan 9-hole pegboard, and grip strength - in 1179 healthy subjects. We show poor association between the different handedness measures, with roughly 10% of the sample having at least one behavioural measure which indicates hand-performance bias opposite to the EHI score, and over 65% of left-handers having one or more mismatched handedness scores. We discuss implications for future work, urging researchers to critically consider direction, degree, and consistency of handedness in their data.

Patient Preparation and Paradigm Design in fMRI

Functional magnetic resonance imaging (fMRI) is useful for localizing eloquent cortex in the brain prior to neurosurgery. Language and motor paradigms offer a wide range of tasks to test brain regions within the language and motor networks. With the help of fMRI, hemispheric language dominance can be determined. It also is possible to localize specific motor and sensory areas within the motor and sensory gyri. These findings are critical for presurgical planning. The most important factor in presurgical fMRI is patient performance. Patient interview and instruction time are crucial to ensure that patients understand and comply with the fMRI paradigm.

Typical and atypical language brain organization based on intrinsic connectivity and multitask functional asymmetries

Based on the joint investigation in 287 healthy volunteers (150 left-Handers (LH)) of language task-induced asymmetries and intrinsic connectivity strength of the sentence-processing supramodal network, we show that individuals with atypical rightward language lateralization (N = 30, 25 LH) do not rely on an organization that simply mirrors that of typical leftward lateralized individuals. Actually, the resting-state organization in the atypicals showed that their sentence processing was underpinned by left and right networks both wired for language processing and highly interacting by strong interhemispheric intrinsic connectivity and larger corpus callosum volume. Such a loose hemispheric specialization for language permits the hosting of language in either the left and/or right hemisphere as assessed by a very high incidence of dissociations across various language task-induced asymmetries in this group.

Four meta-analyses across 164 studies on atypical footedness prevalence and its relation to handedness

Human lateral preferences, such as handedness and footedness, have interested researchers for decades due to their pronounced asymmetries at the population level. While there are good estimates on the prevalence of handedness in the population, there is no large-scale estimation on the prevalence of footedness. Furthermore, the relationship between footedness and handedness still remains elusive. Here, we conducted meta-analyses with four different classification systems for footedness on 145,135 individuals across 164 studies including new data from the ALSPAC cohort. The study aimed to determine a reliable point estimate of footedness, to study the association between footedness and handedness, and to investigate moderating factors influencing footedness. We showed that the prevalence of atypical footedness ranges between 12.10% using the most conservative criterion of left-footedness to 23.7% including all left- and mixed-footers as a single non-right category. As many as 60.1% of left-handers were left-footed whereas only 3.2% of right-handers were left-footed. Males were 4.1% more often non-right-footed compared to females. Individuals with psychiatric and neurodevelopmental disorders exhibited a higher prevalence of non-right-footedness. Furthermore, the presence of mixed-footedness was higher in children compared to adults and left-footedness was increased in athletes compared to the general population. Finally, we showed that footedness is only marginally influenced by cultural and social factors, which play a crucial role in the determination of handedness. Overall, this study provides new and useful reference data for laterality research. Furthermore, the data suggest that footedness is a valuable phenotype for the study of lateral motor biases, its underlying genetics and neurodevelopment.

Laterality effects in the haptic discrimination of verbal and non-verbal shapes

The left hemisphere is known to be generally predominant in verbal processing and the right hemisphere in non-verbal processing. We studied whether verbal and non-verbal lateralization is present in haptics by comparing discrimination performance between letters and nonsense shapes. We addressed stimulus complexity by introducing lower case letters, which are verbally identical with upper case letters but have a more complex shape. The participants performed a same-different haptic discrimination task for upper and lower case letters and nonsense shapes with the left and right hand separately. We used signal detection theory to determine discriminability (d'), criterion (c) and we measured reaction times. Discrimination was better for the left hand for nonsense shapes, close to significantly better for the right hand for upper case letters and with no difference between the hands for lower case letters. For lower case letters, right hand showed a strong bias to respond "different", while the left hand showed faster reaction times. Our results are in agreement with the right lateralization for non-verbal material. Complexity of the verbal shape is important in haptics as the lower case letters seem to be processed as less verbal and more as spatial shapes than the upper case letters.

A large-scale estimate on the relationship between language and motor lateralization

Human language is dominantly processed in the left cerebral hemisphere in most of the population. While several studies have suggested that there are higher rates of atypical right-hemispheric language lateralization in left-/mixed-handers, an accurate estimate of this association from a large sample is still missing. In this study, we comprised data from 1,554 individuals sampled in three previous studies in which language lateralization measured via dichotic listening, handedness and footedness were assessed. Overall, we found a right ear advantage indicating typical left-hemispheric language lateralization in 82.1% of the participants. While we found significantly more left-handed individuals with atypical language lateralization on the categorical level, we only detected a very weak positive correlation between dichotic listening lateralization quotients (LQs) and handedness LQs using continuous measures. Here, only 0.4% of the variance in language lateralization were explained by handedness. We complemented these analyses with Bayesian statistics and found no evidence in favor of the hypothesis that language lateralization and handedness are related. Footedness LQs were not correlated with dichotic listening LQs, but individuals with atypical language lateralization also exhibited higher rates of atypical footedness on the categorical level. We also found differences in the extent of language lateralization between males and females with males exhibiting higher dichotic listening LQs indicating more left-hemispheric language processing. Overall, these findings indicate that the direct associations between language lateralization and motor asymmetries are much weaker than previously assumed with Bayesian correlation analyses even suggesting that they do not exist at all. Furthermore, sex differences seem to be present in language lateralization when the power of the study is adequate suggesting that endocrinological processes might influence this phenotype.

Evidence for Reciprocal Structural Network Interactions Between Bilateral Crus Lobes and Broca's Complex

While the proximal dentatothalamocortical tracts are considered pivotal in the occurrence of cerebellar mutism syndrome (CMS) after medulloblastoma resection, how the cerebellum participates in motor–speech networks through direct structural connectivity is still unclear. Via tractography, we provide evidence of cerebellar streamlines projecting into the left inferior frontal gyrus majorly connecting Broca’s complex and the bilateral Crus lobes. The streamlines, named Crus–Broca tracts, originated from the bilateral Crus lobes, synapsed onto the dentate nucleus, ascended into the superior cerebellar peduncle (where these streamlines were closely superior to the superior border of the supratonsillar cleft and the superolateral roof of the fourth ventricle), surprisingly bypassed the left red nucleus and the left thalamus, and ended at the subregions of Broca’s complex. The streamlines, named Broca–Crus tracts, originated from the subregions of Broca’s complex and ended predominantly at the right Crus lobes. If verified, the existence of these connections would support the notion of the bilateral cerebellums’ participation in motor–speech planning, and the anatomical relationship of Broca–Crus tracts with the supratonsillar cleft would merit consideration for further studies aimed at further elucidating CMS mechanisms.

Functional lateralization of arithmetic processing in the intraparietal sulcus is associated with handedness

Functional lateralization is established for various cognitive functions, but was hardly ever investigated for arithmetic processing. Most neurocognitive models assume a central role of the bilateral intraparietal sulcus (IPS) in arithmetic processing and there is some evidence for more pronounced left-hemispheric activation for symbolic arithmetic. However, evidence was mainly obtained by studies in right-handers. Therefore, we conducted a functional near-infrared spectroscopy (fNIRS) study, in which IPS activation of left-handed adults was compared to right-handed adults in a symbolic approximate calculation task. The results showed that left-handers had a stronger functional right-lateralization in the IPS than right-handers. This finding has important consequences, as the bilateral IPS activation pattern for arithmetic processing seems to be shaped by functional lateralization and thus differs between left- and right-handers. We propose three possible accounts for the observed functional lateralization of arithmetic processing.

Development of handedness, anatomical and functional brain lateralization

The present chapter offers a report on the recent literature on the neural bases of hemispheric specialization (HS), anatomical and functional developmental timecourse of HS, and on the available knowledge of their relationships with the development of handedness. Strong anatomical asymmetries can be seen located along the end of the sylvian fissure and the superior temporal sulcus (STS) as soon as the 23rd gestational week. They correspond to a leftward sulcal depth asymmetry of the Sylvian fissure coupled with a rightward asymmetry of STS. These neonatal asymmetries targeting speech processing areas do not further change with development. Different from these anatomical asymmetries, the functional asymmetries of language areas develop during childhood. Such a development is characterized at birth by a predominant interhemispheric intrinsic connectivity between homotopic areas that will evolve toward left hemisphere intrahemispheric intrinsic connectivity between anterior and posterior language poles. The development of such a typical architecture of language networks in the left hemisphere dominant for language in more than 90% of humans translates into a continuous increase in the leftward asymmetries of activation during language production throughout childhood. With regard to the rightward cerebral lateralization for visuospatial functions, neuroimaging studies tend to indicate an increase in rightward lateralization of frontal-parietal network with age during visuospatial memory and visuospatial search tasks. In addition, the spatial-attentional behavioral asymmetries emerge early (in preschool children) and, then, can be modulated by factors linked to motor asymmetry and handedness. Finally, the study of manual lateralization in relation to language development has shown the importance of considering several characteristics of manual activities. In particular, the dissociation between manipulative activities and communicative gestures in young children may open further perspectives for future research on HS.

Structural Asymmetry in the Frontal and Temporal Lobes Is Associated with PCSK6 VNTR Polymorphism

The nodal cascade influences the development of bodily asymmetries in humans and other vertebrates. The gene PCSK6 has shown a regulatory function during left-right axis formation and is therefore thought to influence bodily left-right asymmetries. However, it is not clear if variation in this gene is also associated with structural asymmetries in the brain. We genotyped an intronic 33bp PCSK6 variable number tandem repeat (VNTR) polymorphism that has been associated with handedness in a cohort of healthy adults. We acquired T1-weighted structural MRI images of 320 participants and defined cortical surface and thickness for each HCP region. The results demonstrate a significant association between PCSK6 VNTR genotypes and gray matter asymmetry in the superior temporal sulcus, which is involved in voice perception. Heterozygous individuals who carry a short (≤ 6 repeats) and a long (≥ 9 repeats) PCSK6 VNTR allele show stronger rightward asymmetry. Further associations were evident in the dorsolateral prefrontal cortex. Here, individuals homozygous for short alleles show a more pronounced asymmetry. This shows that PCSK6, a gene that has been implicated in the ontogenesis of bodily asymmetries by regulating the nodal cascade, is also relevant for structural asymmetries in the human brain.

Building an Asymmetrical Brain: The Molecular Perspective

The brain is one of the most prominent examples for structural and functional differences between the left and right half of the body. For handedness and language lateralization, the most widely investigated behavioral phenotypes, only a small fraction of phenotypic variance has been explained by molecular genetic studies. Due to environmental factors presumably also playing a role in their ontogenesis and based on first molecular evidence, it has been suggested that functional hemispheric asymmetries are partly under epigenetic control. This review article aims to elucidate the molecular factors underlying hemispheric asymmetries and their association with inner organ asymmetries. While we previously suggested that epigenetic mechanisms might partly account for the missing heritability of handedness, this article extends this idea by suggesting possible alternatives for transgenerational transmission of epigenetic states that do not require germ line epigenetic transmission. This is in line with a multifactorial model of hemispheric asymmetries, integrating genetic, environmental, and epigenetic influencing factors in their ontogenesis.

Approach motivation in human cerebral cortex

Different regions of the human cerebral cortex are specialized for different emotions, but the principles underlying this specialization have remained unknown. According to the sword and shield hypothesis, hemispheric specialization for affective motivation, a basic dimension of human emotion, varies across individuals according to the way they use their hands to perform approach- and avoidance-related actions. In a test of this hypothesis, here we measured approach motivation before and after five sessions of transcranial direct current stimulation to increase excitation in the left or right dorsolateral prefrontal cortex, in healthy adults whose handedness ranged from strongly left-handed to strongly right-handed. The strength and direction of participants' handedness predicted whether electrical stimulation to frontal cortex caused an increase or decrease in their experience of approach-related emotions. The organization of approach motivation in the human cerebral cortex varies across individuals as predicted by the organization of the individuals' motor systems. These results show that the large-scale cortical organization of abstract concepts corresponds with the way people use their hands to interact with the world. Affective motivation may re-use neural circuits that evolved for performing approach- and avoidance-related motor actions.This article is part of the theme issue 'Varieties of abstract concepts: development, use and representation in the brain'.

DNA methylation of dopamine-related gene promoters is associated with line bisection deviation in healthy adults

Handedness and language lateralization are the most investigated phenotypes among functional hemispheric asymmetries, i.e. differences in function between the left and the right half of the human brain. Both phenotypes are left hemisphere-dominant, while investigations of the molecular factors underlying right hemisphere-dominant phenotypes are less prominent. In the classical line bisection task, healthy subjects typically show a leftward attentional bias due to a relative dominance of the right hemisphere for visuospatial attention. Based on findings of variations in dopamine-related genes affecting performance in the line bisection task, we first tested whether DNA methylation in non-neuronal tissue in the promoter regions of DBH, SLC6A3, and DRD2 are associated with line bisection deviation. We replicated the typical behavioral pattern and found an effect of DNA methylation in the DBH promoter region on line bisection deviation in right-aligned trials. A second exploratory analysis indicated that an overall DNA methylation profile of genes involved in dopamine function predicts line bisection performance in right-aligned trials. Genetic variation in dopamine-related genes has been linked to attention deficit hyperactivity disorder (ADHD), a neurodevelopmental trait associated with rightward attentional bias. Overall, our findings point towards epigenetic markers for functional hemispheric asymmetries in non-neuronal tissue not only for left hemisphere-dominant, but also for right hemisphere-dominant phenotypes.

Tone language experience-dependent advantage in pitch representation in brainstem and auditory cortex is maintained under reverberation

Long-term language and music experience enhances neural representation of temporal attributes of pitch in the brainstem and auditory cortex in favorable listening conditions. Herein we examine whether brainstem and cortical pitch mechanisms-shaped by long-term language experience-maintain this advantage in the presence of reverberation-induced degradation in pitch representation. Brainstem frequency following responses (FFR) and cortical pitch responses (CPR) were recorded concurrently from Chinese and English-speaking natives, using a Mandarin word exhibiting a high rising pitch (/yi²/). Stimuli were presented diotically in quiet (Dry), and in the presence of Slight, Mild, and Moderate reverberation conditions. Regardless of language group, the amplitude of both brainstem FFR (F0) and cortical CPR (NaPb) responses decreased with increases in reverberation. Response amplitude for Chinese, however, was larger than English in all reverberant conditions. The Chinese group also exhibited a robust rightward asymmetry at temporal electrode sites (T8 > T7) across stimulus conditions. Regardless of language group, direct comparison of brainstem and cortical responses revealed similar magnitude of change in response amplitude with increasing reverberation. These findings suggest that experience-dependent brainstem and cortical pitch mechanisms provide an enhanced and stable neural representation of pitch-relevant information that is maintained even in the presence of reverberation. Relatively greater degradative effects of reverberation on brainstem (FFR) compared to cortical (NaPb) responses suggest relatively stronger top-down influences on CPRs.

Combining rTMS With Intensive Language-Action Therapy in Chronic Aphasia: A Randomized Controlled Trial

Neuromodulation technologies, such as transcranial magnetic stimulation (TMS), are promising tools for neurorehabilitation, aphasia therapy included, but not yet in common clinical use. Combined with behavioral techniques, in particular treatment-efficient Intensive Language-Action Therapy (ILAT, previously CIAT or CILT), TMS could substantially amplify the beneficial effect of such behavioral therapy alone (Thiel et al., 2013; Martin et al., 2014; Mendoza et al., 2016; Kapoor, 2017). In this randomized study of 17 subjects with post-stroke aphasia in the chronic stage, we studied the combined effect of ILAT and 1-Hz placebo-controlled navigated repetitive TMS (rTMS) to the right-hemispheric inferior frontal cortex—that is, to the anterior part of the non-dominant hemisphere's homolog Broca's area (pars triangularis). Patients were randomized to groups A and B. Patients in group A received a 2-week period of rTMS during naming training where they named pictures displayed on the screen once every 10 s, followed by 2 weeks of rTMS and naming combined with ILAT. Patients in group B received the same behavioral therapy but TMS was replaced by sham stimulation. The primary outcome measures for changes in language performance were the Western Aphasia Battery's aphasia quotient AQ; the secondary outcome measures were the Boston naming test (BNT) and the Action naming test (Action BNT, ANT). All subjects completed the study. At baseline, no statistically significant group differences were discovered for age, post-stroke time or diagnosis. ILAT was associated with significant improvement across groups, as documented by both primary and secondary outcome measures. No significant effect of rTMS could be documented. Our results agree with previous results proving ILAT's ability to improve language in patients with chronic aphasia. In contrast with earlier claims, however, a beneficial effect of rTMS in chronic post-stroke aphasia rehabilitation was not detected in this study.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03629665

Weaker semantic language lateralization associated with better semantic language performance in healthy right-handed children

INTRODUCTION

The relationship between language abilities and language lateralization in the developing brain is important for our understanding of the neural architecture of language development.

METHODS

We investigated 35 right-handed children and adolescents aged 7-16 years with a functional magnetic resonance imaging language paradigm and a comprehensive language and verbal memory examination.

RESULTS

We found that less lateralized language was significantly correlated with better language performance across areas of the brain and across different language tasks. Less lateralized language in the overall brain was associated with better in-scanner task accuracy on a semantic language decision task and out-of-scanner vocabulary and verbal fluency. Specifically, less lateralized frontal lobe language dominance was associated with better in-scanner task accuracy and out-of-scanner verbal fluency. Furthermore, less lateralized parietal language was associated with better out-of-scanner verbal memory across learning, short- and long-delay trials. In contrast, we did not find any relationship between temporal lobe language laterality and verbal performance.

CONCLUSIONS

This study suggests that semantic language performance is better with some involvement of the nondominant hemisphere.

Evidence of a Right Ear Advantage in the absence of auditory targets

The Right Ear Advantage effect (REA) was explored in a white noise speech illusion paradigm: binaural white noise (WN) could be presented i) in isolation (WN condition), ii) overlapped to a voice pronouncing the vowel /a/ presented in the left ear (LE condition), iii) overlapped to a voice pronouncing the vowel /a/ presented in the right ear (RE condition). Participants were asked to report in which ear the voice has been perceived. The voice could be female or male, and it could be presented at 4 different intensities. Participants carried out the task correctly both in LE and in RE conditions. Importantly, in the WN condition the “right ear” responses were more frequent with respect to both the chance level and the “left ear” responses. A perceptual REA was confirmed both in LE and RE conditions. Moreover, when the voice was presented at low intensities (masked by WN), it was more frequently reported in the right than in the left ear (“illusory” REA). A positive correlation emerged between perceptual and illusory REA. Potential links of the REA effects with auditory hallucinations are discussed.

Cognitive, Neuroanatomical, and Genetic Predictors of Executive Function in Healthy Children and Adolescents

The Dimensional Change Card Sort (DCCS) is a measure of cognitive flexibility for children, which requires rule-use and shifting. Demographic, cognitive, regional cortical thickness, and genetic variables, including those related to language and executive function, were used to build predictive models of DCCS scores in 556 healthy pediatric participants. Gender, age, frontal, and temporal lobe regions of interest, and measures of sustained attention, inhibition, and word reading were selected as the best predictors of DCCS performance. Results indicated that DCCS performance is related to a broad range of cognitive functions and anatomic regions associated with various levels of cognitive function.

Crossed aphasia following cerebral infarction in a right-handed patient with atypical cerebral language dominance

OBJECTIVE

Crossed aphasia (CA), usually referred to as an acquired language disturbance, is caused by a lesion in the cerebral hemisphere ipsilateral to the dominant hand, and the exact mechanism is not clear. The development of handedness is influenced by education and training and the impact of habitualization, while language is more susceptible to the impact of speech habits, and it is not absolutely accurate to judge cerebral language dominance by the degree of hand preference.

METHODS

We describe a case of CA after right hemispheric stroke in a right-handed patient with atypical language dominance and attempt to analyze the mechanism of CA based on functional imaging methods, including arterial spin labeling (ASL) and positron emission tomography/magnetic resonance imaging (PET-MRI).

RESULTS

Brain MRI at 24 h after admission showed a large cerebral infarction in the right cerebral hemisphere, including the posteroinferior part of Broca's area in the right frontal lobe, the right temporal lobe, and the right occipital lobe. The patient exhibited a non-fluent aphasia on a standard language test (the Aphasia Battery of Chinese [ABC]) performed on the 7th day after onset. Thus, atypical language dominance was suspected. One week after admission, ASL imaging showed high perfusion in the infarct core zone and low perfusion in the left cerebellar hemisphere. Two months later, PET/MRI demonstrated low metabolism in the posterior frontal lobe, temporal lobe, temporal occipital junction area, and the right basal ganglia.

CONCLUSION

The findings suggest that the patient has right-sided cerebral language dominance, or that both hemispheres have linguistic functions. Not all patients show linguistic capabilities on the side opposite hand preference. The language dominance should be predicted by a combination of clinical manifestations and functional imaging techniques.

Resounding failure to replicate links between developmental language disorder and cerebral lateralisation

Background

It has been suggested that failure to establish cerebral lateralisation may be related to developmental language disorder (DLD). There has been weak support for any link with handedness, but more consistent reports of associations with functional brain lateralisation for language. The consistency of lateralisation across different functions may also be important. We aimed to replicate previous findings of an association between DLD and reduced laterality on a quantitative measure of hand preference (reaching across the midline) and on language laterality assessed using functional transcranial Doppler ultrasound (fTCD).

Methods

From a sample of twin children aged from 6;0 to 11;11 years, we identified 107 cases of DLD and 156 typically-developing comparison cases for whom we had useable data from fTCD yielding a laterality index (LI) for language function during an animation description task. Handedness data were also available for these children.

Results

Indices of handedness and language laterality for this twin sample were similar to those previously reported for single-born children. There were no differences between the DLD and TD groups on measures of handedness or language lateralisation, or on a categorical measure of consistency of left hemisphere dominance. Contrary to prediction, there was a greater incidence of right lateralisation for language in the TD group (19.90%) than the DLD group (9.30%), confirming that atypical laterality is not inconsistent with typical language development. We also failed to replicate associations between language laterality and language test scores.

Discussion and Conclusions

Given the large sample studied here and the range of measures, we suggest that previous reports of atypical manual or language lateralisation in DLD may have been false positives.

Is the planum temporale surface area a marker of hemispheric or regional language lateralization?

We investigated the association between the left planum temporale (PT) surface area or asymmetry and the hemispheric or regional functional asymmetries during language production and perception tasks in 287 healthy adults (BIL&GIN) who were matched for sex and handedness. The measurements of the PT surface area were performed after manually delineating the region using brain magnetic resonance images (MRI) and considering the Heschl's gyrus (HG) duplication pattern; the measurements either included (PT_tot) or did not include (PT_post) the second gyrus. A region encompassing both the PT and HG (HGPT) was also studied. Regardless of the ROI measured, 80% of the sample had a positive left minus right PT asymmetry. We first tested whether the PT_tot, PT_post and HGPT surface areas in the left or right hemispheres or PT asymmetries differed in groups of individuals varying in language lateralization by assessing their hemispheric index during a sentence production minus word list production task. We then investigated the association between these different measures of the PT anatomy and the regional asymmetries measured during the task. Regardless of the anatomical definition used, we observed no correlations between the left surface areas or asymmetries and the hemispheric or regional functional asymmetries during the language production task. We then performed a similar analysis using the same sample measuring language functional lateralization during speech listening tasks (i.e., listening to sentences and lists of words). Although the hemispheric lateralization during speech listening was not correlated with the left PT_tot, PT_post or HGPT surface areas or the PT asymmetries, significant positive correlations were observed between the asymmetries in these regions and the regional functional asymmetries measured in areas adjacent to the end of the Sylvian fissure while participants listened to the word lists or sentences. The PT asymmetry thus appears to be associated with the local functional asymmetries in auditory areas but is not a marker of inter-individual variability in language dominance.

Mens inversus in corpore inverso? Language lateralization in a boy with situs inversus totalis

Situs inversus totalis is a rare condition where the visceral organs are organized as a mirror image of default organ position. In this study we picture the co-development between brain and visceral organs in a case of situs inversus totalis from a fetal stage to adolescence and compare our findings to an age-, gender-, and education-matched control with normal position of thoracic and abdominal organs. We show that in this case of situs inversus, functional and structural brain lateralization do not coincide with visceral organ situs. Furthermore, cognitive development in situs inversus is normal. To our knowledge, this is the first report of antenatal cerebral origins of structural and functional brain asymmetry in a case of situs inversus totalis.

Segregating polymorphisms of FOXP2 are associated with measures of inner speech, speech fluency and strength of handedness in a healthy population

We genotyped a healthy population for three haplotype-tagging FOXP2 SNPs, and tested for associations of these SNPs with strength of handedness and questionnaire-based metrics of inner speech characteristics (ISP) and speech fluency (FLU), as derived from the Schizotypal Personality Questionnaire-BR. Levels of mixed-handedness were positively correlated with ISP and FLU, supporting prior work on these two domains. Genotype for rs7799109, a SNP previously linked with lateralization of left frontal regions underlying language, was associated with degree of mixed handedness and with scores for ISP and FLU phenotypes. Genotype of rs1456031, which has previously been linked with auditory hallucinations, was also associated with ISP phenotypes. These results provide evidence that FOXP2 SNPs influence aspects of human inner speech and fluency that are related to lateralized phenotypes, and suggest that the evolution of human language, as mediated by the adaptive evolution of FOXP2, involved features of inner speech.

Unique Neural Characteristics of Atypical Lateralization of Language in Healthy Individuals

Using functional magnetic resonance imaging (fMRI) in 63 healthy participants, including left-handed and ambidextrous individuals, we tested how atypical lateralization of language—i. e., bilateral or right hemispheric language representation—differs from the typical left-hemisphere dominance. Although regardless of their handedness, all 11 participants from the atypical group engaged classical language centers, i.e., Broca's and Wernicke's areas, the right-hemisphere components of the default mode network (DMN), including the angular gyrus and middle temporal gyrus, were also critically involved during the verbal fluency task. Importantly, activity in these regions could not be explained in terms of mirroring the typical language pattern because left-hemisphere dominant individuals did not exhibit similar significant signal modulations. Moreover, when spatial extent of language-related activity across whole brain was considered, the bilateral language organization entailed more diffuse functional processing. Finally, we detected significant differences between the typical and atypical group in the resting-state connectivity at the global and local level. These findings suggest that the atypical lateralization of language has unique features, and is not a simple mirror image of the typical left hemispheric language representation.

Language experience-dependent advantage in pitch representation in the auditory cortex is limited to favorable signal-to-noise ratios

Long-term experience enhances neural representation of temporal attributes of pitch in the brainstem and auditory cortex in favorable listening conditions. Herein we examine whether cortical pitch mechanisms shaped by language experience are more resilient to degradation in background noise, and exhibit greater binaural release from masking (BRM). Cortical pitch responses (CPR) were recorded from Mandarin- and English-speaking natives using a Mandarin word exhibiting a high rising pitch (/yi²/). Stimuli were presented diotically in Quiet, and in noise at +5, and 0 dB SNR. CPRs were also recorded in binaural conditions, SONO (where signal and noise were in phase at both ears); or S0Nπ (where signal was in phase and noise 180° out of phase at each ear), using 0 dB SNR. At Fz, both groups showed increase in CPR peak latency and decrease in amplitude with increasing noise level. A language-dependent enhancement of Na-Pb amplitude (Chinese > English) was restricted to Quiet and +5 dB SNR conditions. At T7/T8 electrode sites, Chinese natives exhibited a rightward asymmetry for both CPR components. A language-dependent effect (Chinese > English) was restricted to T8. Regarding BRM, both CPR components showed greater response amplitude for the S0Nπ condition compared to S0N0 across groups. Rightward asymmetry for BRM in the Chinese group indicates experience-dependent recruitment of right auditory cortex. Restriction of the advantage in pitch representation to the quiet and +5 SNR conditions, and the absence of group differences in the binaural release from masking, suggest that language experience affords limited advantage in the neural representation of pitch-relevant information in the auditory cortex under adverse listening conditions.

Is crossed laterality associated with academic achievement and intelligence? A systematic review and meta-analysis

Over the last century, sporadic research has suggested that people whose hand, eye, foot, or ear dominances are not consistently right- or left-sided are at special risk of suffering academic difficulties. This phenomenon is known as crossed laterality. Although the bulk of this research dates from 1960's and 1970's, crossed laterality is becoming increasingly popular in the area of school education, driving the creation of several interventions aimed at restoring or consolidating lateral dominance. However, the available evidence is fragmentary. To determine the impact of crossed laterality on academic achievement and intelligence, we conducted a systematic review and meta-analysis of articles published since 1900. The inclusion criteria for the review required that studies used one or more lateral preference tasks for at least two specific parts of the body; they included a valid measure of crossed laterality; they measured the impact of crossed laterality on academic achievement or intelligence; and they included participants between 3 and 17 years old. The final sample included 26 articles that covered a total population of 3578 children aged 5 to 12. Taken collectively, the results of these studies do not support the claim that there is a reliable association between crossed laterality and either academic achievement or intelligence. Along with this, we detected important shortcomings in the literature, such as considerable heterogeneity among the variables used to measure laterality and among the tasks utilized to measure the outcomes. The educational implications of these results are discussed.