Effects of maternal folic acid supplementation during the second and third trimesters of pregnancy on neurocognitive development in the child: an 11-year follow-up from a randomised controlled trial

BACKGROUND

Maternal folic acid (FA) supplementation before and in early pregnancy prevents neural tube defects (NTD), but it is uncertain whether continuing FA after the first trimester has benefits on offspring health. We aimed to evaluate the effect of FA supplementation throughout pregnancy on cognitive performance and brain function in the child.

METHODS

Follow-up investigation of 11-year-old children, residing in Northern Ireland, whose mothers had participated in a randomised trial of Folic Acid Supplementation in the Second and Third Trimesters (FASSTT) in pregnancy and received 400 μg/day FA or placebo from the 14th gestational week. Cognitive performance (Full Scale Intelligence Quotient, Verbal Comprehension, Working Memory, Perceptual Reasoning, and Processing Speed) was assessed using the Wechsler Intelligence Scale for Children. Neuronal function was assessed using magnetoencephalographic (MEG) brain imaging.

RESULTS

Of 119 mother-child pairs in the FASSTT trial, 68 children were assessed for neurocognitive performance at 11-year follow-up (Dec 2017 to Nov 2018). Children of mothers randomised to FA compared with placebo scored significantly higher in two Processing Speed tests, i.e. symbol search (mean difference 2.9 points, 95% CI 0.3 to 5.5, p = 0.03) and cancellation (11.3 points, 2.5 to 20.1, p = 0.04), whereas the positive effect on Verbal Comprehension was significant in girls only (6.5 points, 1.2 to 11.8, p = 0.03). MEG assessment of neuronal responses to a language task showed increased power at the Beta (13-30 Hz, p = 0.01) and High Gamma (49-70 Hz, p = 0.04) bands in children from FA-supplemented mothers, suggesting more efficient semantic processing of language.

CONCLUSIONS

Continued FA supplementation in pregnancy beyond the early period currently recommended to prevent NTD can benefit neurocognitive development of the child. MEG provides a non-invasive tool in paediatric research to objectively assess functional brain activity in response to nutrition and other interventions.

TRIAL REGISTRATION

ISRCTN ISRCTN19917787 . Registered on 15 May 2013.

Dynamic relationships between phonological memory and reading: A five year longitudinal study from age 4 to 9

We reconcile competing theories of the role of phonological memory in reading development, by uncovering their dynamic relationship during the first 5 years of school. Phonological memory, reading and phoneme awareness were assessed in 780 phonics-educated children at age 4, 5, 6 and 9. Confirmatory factor analyses demonstrated that phonological memory loaded onto two factors: verbal short-term memory (verbal STM; phonological tasks that loaded primarily on serial order memory) and nonword repetition. Using longitudinal structural equation models, we found that verbal STM directly predicted early word-level reading from age 4 to 6, reflecting the importance of serial-order memory for letter-by-letter decoding. In contrast, reading had no reciprocal influence on the development of verbal STM. The relationship between nonword repetition and reading was bidirectional across the 5 years of study: nonword repetition and reading predicted each other both directly and indirectly (via phoneme awareness). Indirect effects from nonword repetition (and verbal STM) to reading support the view that phonological memory stimulates phonemically detailed representations through repeated encoding of complex verbal stimuli. Similarly, the indirect influence of reading on nonword repetition suggests that improved reading ability promotes the phoneme-level specificity of phonological representations. Finally, the direct influence from reading to nonword repetition suggests that better readers use orthographic cues to help them remember and repeat new words accurately. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=70LZfTR0BjE.

Auditory frequency discrimination in developmental dyslexia: A meta-analysis

Auditory frequency discrimination has been used as an index of sensory processing in developmental language disorders such as dyslexia, where group differences have often been interpreted as evidence for a basic deficit in auditory processing that underpins and constrains individual variability in the development of phonological skills. Here, we conducted a meta-analysis to evaluate the cumulative evidence for group differences in frequency discrimination and to explore the impact of some potential moderator variables that could contribute to variability in effect-size estimations across studies. Our analyses revealed mean effect sizes for group differences on frequency discrimination tasks on the order of three-quarters of a standard deviation, but in the presence of substantial inter-study variability in their magnitude. Moderator variable analyses indicated that factors related both to participant variability on behavioural and cognitive variables associated with the dyslexia phenotype, and to variability in the task design, contributed to differences in the magnitude of effect size across studies. The apparently complex pattern of results was compounded by the lack of concurrent, standardised metrics of cognitive and reading component skills across the constituent studies. Differences on sensory processing tasks are often reported in studies of developmental disorders, but these need to be more carefully interpreted in the context of non-sensory factors, which may explain significant inter- and intra-group variance in the dependent measure of interest.

An evaluation of kurtosis beamforming in magnetoencephalography to localize the epileptogenic zone in drug resistant epilepsy patients

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Objective localizations of interictal spikes using a kurtosis beamformer.

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Kurtosis Beamforming can provide confidence to scattered dipoles.

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Kurtosis beamforming can assist in localizing the epileptogenic zone.

Objective

Kurtosis beamforming is a useful technique for analysing magnetoencephalograpy (MEG) data containing epileptic spikes. However, the implementation varies and few studies measure concordance with subsequently resected areas. We evaluated kurtosis beamforming as a means of localizing spikes in drug-resistant epilepsy patients.

Methods

We retrospectively applied kurtosis beamforming to MEG recordings of 22 epilepsy patients that had previously been analysed using equivalent current dipole (ECD) fitting. Virtual electrodes were placed in the kurtosis volumetric peaks and visually inspected to select a candidate source. The candidate sources were compared to the ECD localizations and resection areas.

Results

The kurtosis beamformer produced interpretable localizations in 18/22 patients, of which the candidate source coincided with the resection lobe in 9/13 seizure-free patients and in 3/5 patients with persistent seizures. The sublobar accuracy of the kurtosis beamformer with respect to the resection zone was higher than ECD (56% and 50%, respectively), however, ECD resulted in a higher lobar accuracy (75%, 67%).

Conclusions

Kurtosis beamforming may provide additional value when spikes are not clearly discernible on the sensors and support ECD localizations when dipoles are scattered.

Significance

Kurtosis beamforming should be integrated with existing clinical protocols to assist in localizing the epileptogenic zone.

Psychophysical measurements in children: challenges, pitfalls, and considerations

Measuring sensory sensitivity is important in studying development and developmental disorders. However, with children, there is a need to balance reliable but lengthy sensory tasks with the child’s ability to maintain motivation and vigilance. We used simulations to explore the problems associated with shortening adaptive psychophysical procedures, and suggest how these problems might be addressed. We quantify how adaptive procedures with too few reversals can over-estimate thresholds, introduce substantial measurement error, and make estimates of individual thresholds less reliable. The associated measurement error also obscures group differences. Adaptive procedures with children should therefore use as many reversals as possible, to reduce the effects of both Type 1 and Type 2 errors. Differences in response consistency, resulting from lapses in attention, further increase the over-estimation of threshold. Comparisons between data from individuals who may differ in lapse rate are therefore problematic, but measures to estimate and account for lapse rates in analyses may mitigate this problem.

The auditory evoked-gamma response and its relation with the N1m

This study explored the patterns of oscillatory activity that underpin the N1m auditory evoked response. Evoked gamma activity is a small and relatively rarely-reported component of the auditory evoked response, and the objective of this work was to determine how this component relates to the larger and more prolonged changes in lower frequency bands. An event-related beamformer analysis of MEG data from monaural click stimulation was used to reconstruct volumetric images and virtual electrode time series. Group analysis of localisations showed that activity in the gamma band originated from a source that was more medial than those for activity in the theta-to-beta band, and virtual-electrode analysis showed that the source of the gamma activity could be statistically dissociated from the lower-frequency response. These findings are in accordance with separate functional roles for the activity in each frequency band, and provide evidence that the oscillatory activity that underpins the auditory evoked response may contain important information about the physiological basis of the macroscopic signals recorded by MEG in response to auditory stimulation.

Behavioral and Molecular Genetics of Reading-Related AM and FM Detection Thresholds

Auditory detection thresholds for certain frequencies of both amplitude modulated (AM) and frequency modulated (FM) dynamic auditory stimuli are associated with reading in typically developing and dyslexic readers. We present the first behavioral and molecular genetic characterization of these two auditory traits. Two extant extended family datasets were given reading tasks and psychoacoustic tasks to determine FM 2 Hz and AM 20 Hz sensitivity thresholds. Univariate heritabilities were significant for both AM (h ²  = 0.20) and FM (h ²  = 0.29). Bayesian posterior probability of linkage (PPL) analysis found loci for AM (12q, PPL = 81 %) and FM (10p, PPL = 32 %; 20q, PPL = 65 %). Bivariate heritability analyses revealed that FM is genetically correlated with reading, while AM was not. Bivariate PPL analysis indicates that FM loci (10p, 20q) are not also associated with reading.

GABA-mediated changes in inter-hemispheric beta frequency activity in early-stage Parkinson's disease

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In PD, contralateral M1 showed greater beta power than ipsilateral M1.

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Zolpidem reduced contralateral beta power while ipsilateral power was increased.

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This resulted in a hemispheric power ratio that approached parity.

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Changes were reflected in pre-movement desynchronization and post-movement rebound.

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These changes underlie the symptomatic improvements afforded by zolpidem.

In Parkinson’s disease (PD), elevated beta (15–35 Hz) power in subcortical motor networks is widely believed to promote aspects of PD symptomatology, moreover, a reduction in beta power and coherence accompanies symptomatic improvement following effective treatment with l-DOPA. Previous studies have reported symptomatic improvements that correlate with changes in cortical network activity following GABA_A receptor modulation. In this study we have used whole-head magnetoencephalography to characterize neuronal network activity, at rest and during visually cued finger abductions, in unilaterally symptomatic PD and age-matched control participants. Recordings were then repeated following administration of sub-sedative doses of the hypnotic drug zolpidem (0.05 mg/kg), which binds to the benzodiazepine site of the GABA_A receptor. A beamforming based ‘virtual electrode’ approach was used to reconstruct oscillatory power in the primary motor cortex (M1), contralateral and ipsilateral to symptom presentation in PD patients or dominant hand in control participants. In PD patients, contralateral M1 showed significantly greater beta power than ipsilateral M1. Following zolpidem administration contralateral beta power was significantly reduced while ipsilateral beta power was significantly increased resulting in a hemispheric power ratio that approached parity. Furthermore, there was highly significant correlation between hemispheric beta power ratio and Unified Parkinson’s Disease Rating Scale (UPDRS). The changes in contralateral and ipsilateral beta power were reflected in pre-movement beta desynchronization and the late post-movement beta rebound. However, the absolute level of movement-related beta desynchronization was not altered. These results show that low-dose zolpidem not only reduces contralateral beta but also increases ipsilateral beta, while rebalancing the dynamic range of M1 network oscillations between the two hemispheres. These changes appear to underlie the symptomatic improvements afforded by low-dose zolpidem.

Magnetoencephalography in the study of epilepsy and consciousness

The neural bases of altered consciousness in patients with epilepsy during seizures and at rest have raised significant interest in the last decade. This exponential growth has been supported by the parallel development of techniques and methods to investigate brain function noninvasively with unprecedented spatial and temporal resolution. In this article, we review the contribution of magnetoencephalography to deconvolve the bioelectrical changes associated with impaired consciousness during seizures. We use data collected from a patient with refractory absence seizures to discuss how spike-wave discharges are associated with perturbations in optimal connectivity within and between brain regions and discuss indirect evidence to suggest that this phenomenon might explain the cognitive deficits experienced during prolonged 3/s spike-wave discharges.

Gamma oscillatory amplitude encodes stimulus intensity in primary somatosensory cortex

Gamma oscillations have previously been linked to pain perception and it has been hypothesized that they may have a potential role in encoding pain intensity. Stimulus response experiments have reported an increase in activity in the primary somatosensory cortex (SI) with increasing stimulus intensity, but the specific role of oscillatory dynamics in this change in activation remains unclear. In this study, Magnetoencephalography (MEG) was used to investigate the changes in cortical oscillations during four different intensities of a train of electrical stimuli to the right index finger, ranging from low sensation to strong pain. In those participants showing changes in evoked oscillatory gamma in SI during stimulation, the strength of the gamma power was found to increase with increasing stimulus intensity at both pain and sub-pain thresholds. These results suggest that evoked gamma oscillations in SI are not specific to pain but may have a role in encoding somatosensory stimulus intensity.

Probing the neurocognitive trajectories of children's reading skills

Emerging evidence of the high variability in the cognitive skills and deficits associated with reading achievement and dysfunction promotes both a more dimensional view of the risk factors involved, and the importance of discriminating between trajectories of impairment. Here we examined reading and component orthographic and phonological skills alongside measures of cognitive ability and auditory and visual sensory processing in a large group of primary school children between the ages of 7 and 12 years. We identified clusters of children with pseudoword or exception word reading scores at the 10th percentile or below relative to their age group, and a group with poor skills on both tasks. Compared to age-matched and reading-level controls, groups of children with more impaired exception word reading were best described by a trajectory of developmental delay, whereas readers with more impaired pseudoword reading or combined deficits corresponded more with a pattern of atypical development. Sensory processing deficits clustered within both of the groups with putative atypical development: auditory discrimination deficits with poor phonological awareness skills; impairments of visual motion processing in readers with broader and more severe patterns of reading and cognitive impairments. Sensory deficits have been variably associated with developmental impairments of literacy and language; these results suggest that such deficits are also likely to cluster in children with particular patterns of reading difficulty.

A novel binaural pitch elicited by phase-modulated noise: MEG and psychophysical observations

Binaural pitches are auditory percepts that emerge from combined inputs to the ears but that cannot be heard if the stimulus is presented to either ear alone. Here, we describe a binaural pitch that is not easily accommodated within current models of binaural processing. Convergent magnetoencephalography (MEG) and psychophysical measurements were used to characterize the pitch, heard when band-limited noise had a rapidly changing interaural phase difference. Several interesting features emerged: First, the pitch was perceptually lateralized, in agreement with the lateralization of the evoked changes in MEG spectral power, and its salience depended on dichotic binaural presentation. Second, the frequency of the pure tone that matched the binaural pitch lay within a lower spectral sideband of the phase-modulated noise and followed the frequency of that sideband when the modulation frequency or center frequency and bandwidth of the noise changed. Thus, the binaural pitch depended on the processing of binaural information in that lower sideband.

Childhood auditory processing disorder as a developmental disorder: the case for a multi-professional approach to diagnosis and management

Auditory processing disorder (APD) is diagnosed when a patient presents with listening difficulties which can not be explained by a peripheral hearing impairment or higher-order cognitive or language problems. This review explores the association between auditory processing disorder (APD) and other specific developmental disorders such as dyslexia and attention-deficit hyperactivity disorder. The diagnosis and aetiology of APD are similar to those of other developmental disorders and it is well established that APD often co-occurs with impairments of language, literacy, and attention. The genetic and neurological causes of APD are poorly understood, but developmental and behavioural genetic research with other disorders suggests that clinicians should expect APD to co-occur with other symptoms frequently. The clinical implications of co-occurring symptoms of other developmental disorders are considered and the review concludes that a multi-professional approach to the diagnosis and management of APD, involving speech and language therapy and psychology as well as audiology, is essential to ensure that children have access to the most appropriate range of support and interventions.

Interhemispheric differences of spectral power in expressive language: a MEG study with clinical applications

In the last decade we have seen an exponential growth of functional imaging studies investigating multiple aspects of language processing. These studies have sparked an interest in applying some of the paradigms to various clinically relevant questions, such as the identification of the cortical regions mediating language function in surgical candidates for refractory epilepsy. Here we present data from a group of adult control participants in order to investigate the potential of using frequency specific spectral power changes in MEG activation patterns to establish lateralisation of language function using expressive language tasks. In addition, we report on a paediatric patient whose language function was assessed before and after a left hemisphere amygdalo-hippocampectomy. Our verb generation task produced left hemisphere decreases in beta-band power accompanied by right hemisphere increases in low beta-band power in the majority of the control group, a previously unreported phenomenon. This pattern of spectral power was also found in the patient's post-surgery data, though not her pre-surgery data. Comparison of pre and post-operative results also provided some evidence of reorganisation in language related cortex both inter- and intra-hemispherically following surgery. The differences were not limited to changes in localisation of language specific cortex but also changes in the spectral and temporal profile of frontal brain regions during verb generation. While further investigation is required to establish concordance with invasive measures, our data suggest that the methods described may serve as a reliable lateralisation marker for clinical assessment. Furthermore, our findings highlight the potential utility of MEG for the investigation of cortical language functioning in both healthy development and pathology.

Abnormality of mismatch negativity in response to tone omission in dyslexic adults

Evidence of abnormalities in the perception of rapidly presented sounds in dyslexia has been interpreted as evidence of a prolonged time window within which sounds can influence the perception of temporally surrounding sounds. We recorded the magnetic mismatch negativity (MMNm) to infrequent tone omissions in a group of six dyslexic adults and six IQ and age-matched controls. An MMNm is only elicited in response to a complete stimulus omission when successive inputs fall within the temporal window of integration (stimulus onset asynchrony (SOA) approximately 160 ms). No MMNm responses were recorded in either experimental group when stimuli were presented at SOAs falling just outside the temporal window of integration (SOA = 175 ms). However, while presentation rates of 100 ms resulted in MMNm responses for all control participants, the same stimulus omissions elicited an MMNm response in only one of the six dyslexic participants. These results cannot support the hypothesis of a prolonged time window of integration, but rather indicate auditory grouping deficits in the dyslexic population.

Imaging the dynamics of the auditory steady-state evoked response

This study used magnetoencephalography (MEG) to examine the dynamic patterns of neural activity underlying the auditory steady-state response. We examined the continuous time-series of responses to a 32-Hz amplitude modulation. Fluctuations in the amplitude of the evoked response were found to be mediated by non-linear interactions with oscillatory processes both at the same source, in the alpha and beta frequency bands, and in the opposite hemisphere.

Sensory processing, reading, IQ, and attention

Detection thresholds for two visual- and two auditory-processing tasks were obtained for 73 children and young adults who varied broadly in reading ability. A reading-disabled subgroup had significantly higher thresholds than a normal-reading subgroup for the auditory tasks only. When analyzed across the whole group, the auditory tasks and one of the visual tasks, coherent motion detection, were significantly related to word reading. These effects were largely independent of ADHD ratings; however, none of these measures accounted for significant variance in word reading after controlling for full-scale IQ. In contrast, phoneme awareness, rapid naming, and nonword repetition each explained substantial, significant word reading variance after controlling for IQ, suggesting more specific roles for these oral language skills in the development of word reading.

Impaired sensitivity to dynamic stimuli in poor readers of a regular orthography

The mappings from grapheme to phoneme are much less consistent in English than they are for most other languages. Therefore, the differences found between English-speaking dyslexics and controls on sensory measures of temporal processing might be related more to the irregularities of English orthography than to a general deficit affecting reading ability in all languages. However, here we show that poor readers of Norwegian, a language with a relatively regular orthography, are less sensitive than controls to dynamic visual and auditory stimuli. Consistent with results from previous studies of English-readers, detection thresholds for visual motion and auditory frequency modulation (FM) were significantly higher in 19 poor readers of Norwegian compared to 22 control readers of the same age. Over two-thirds (68.4%) of the children identified as poor readers were less sensitive than controls to either or both of the visual coherent motion or auditory 2Hz FM stimuli.

The perception of "sine-wave speech" by adults with developmental dyslexia

Numerous studies have shown that, as a group, children or adults with developmental dyslexia perceive isolated syllables or words abnormally. Continuous speech containing reduced acoustic information also might prove perceptually difficult to such listeners. They might, however, exploit the intact syntactic and semantic features present in whole utterances, thereby compensating fully for impaired speech perception. "Sine-wave speech" sentences afford a test of these competing possibilities. The sentences contain only 4 frequency-modulated sine waves, lacking many acoustic cues present in natural speech. Adults with and without dyslexia were asked to orally reproduce 9 sine-wave utterances, each occurring in 4 immediately successive trials. Participants with dyslexia reported fewer words than did control listeners. Practice, phonological contrasts, and word position affected both groups similarly. Comprehension of sine-wave sentences seems impaired in many, but not all, adults with dyslexia. A reduced auditory memory capacity may contribute to this deficit.

Detection and direction-discrimination of diotic and dichotic ramp modulations in amplitude and phase

When the source of a tone moves with respect to a listener's ears, dichotic (or interaural) phase and amplitude modulations (PM and AM) are produced. Two experiments investigated the psychophysical characteristics of dichotic linear ramp modulations in phase and amplitude, and compared them with the psychophysics of diotic PM and AM. In experiment 1, subjects were substantially more sensitive to dichotic PM than diotic PM, but AM sensitivity was equivalent in the dichotic and diotic conditions. Thresholds for discriminating modulation direction were smaller than detection thresholds for dichotic AM, and both diotic AM and PM. Dichotic PM discrimination thresholds were similar to detection thresholds. In experiment 2, the effects of ramp duration were examined. Sensitivity to dichotic AM and PM, and diotic AM increased as duration was increased from 20 ms to 200 ms. The functions relating sensitivity to ramp duration differed across the stimuli; sensitivity to dichotic PM increased more rapidly than sensitivity to dichotic or diotic AM. This was also reflected in shorter time-constants and minimum integration times for dichotic PM detection. These findings support the hypothesis that the analysis of dichotic PM and AM rely on separate mechanisms.

On the relationship between dynamic visual and auditory processing and literacy skills; results from a large primary-school study

Three hundred and fifty randomly selected primary school children completed a psychometric and psychophysical test battery to ascertain relationships between reading ability and sensitivity to dynamic visual and auditory stimuli. The first analysis examined whether sensitivity to visual coherent motion and auditory frequency resolution differed between groups of children with different literacy and cognitive skills. For both tasks, a main effect of literacy group was found in the absence of a main effect for intelligence or an interaction between these factors. To assess the potential confounding effects of attention, a second analysis of the frequency discrimination data was conducted with performance on catch trials entered as a covariate. Significant effects for both the covariate and literacy skill was found, but again there was no main effect of intelligence, nor was there an interaction between intelligence and literacy skill. Regression analyses were conducted to determine the magnitude of the relationship between sensory and literacy skills in the entire sample. Both visual motion sensitivity and auditory sensitivity to frequency differences were robust predictors of children's literacy skills and their orthographic and phonological skills.

Comments on 'The dyslexia ecosystem': a reply to Nicolson

The central issue facing the dyslexia community, and the underlying theme of Nicolson's 'The Dyslexia Ecosystem' (Nicolson, 2002, Dyslexia, 8, 55-66), is how we can best translate what we know about this particular developmental disorder into practice to give each child the greatest opportunity of acquiring the enabling skill of literacy. To achieve this, and notwithstanding Nicolson's caveat on this point, we have to consider how we can best move from our sphere of expertise to a greater sphere of influence, both as individuals and as a community of research practitioners. In our response, we first consider aspects of Nicolson's general analysis of 'The Dyslexia Ecosystem' and then examine some of the specific objectives that have been proposed.

Separate influences of acoustic AM and FM sensitivity on the phonological decoding skills of impaired and normal readers

Developmental dyslexia is associated with deficits in the processing of basic auditory stimuli. Yet it is unclear how these sensory impairments might contribute to poor reading skills. This study better characterizes the relationship between phonological decoding skills, the lack of which is generally accepted to comprise the core deficit in reading disabilities, and auditory sensitivity to amplitude modulation (AM) and frequency modulation (FM). Thirty-eight adult subjects, 17 of whom had a history of developmental dyslexia, completed a battery of psychophysical measures of sensitivity to FM and AM at different modulation rates, along with a measure of pseudoword reading accuracy and standardized assessments of literacy and cognitive skills. The subjects with a history of dyslexia were significantly less sensitive than controls to 2-Hz FM and 20-Hz AM only. The absence of a significant group difference for 2-Hz AM shows that the dyslexics do not have a general deficit in detecting all slow modulations. Thresholds for detecting 2-Hz and 240-Hz FM and 20-Hz AM correlated significantly with pseudoword reading accuracy. After accounting for various cognitive skills, however, multiple regression analyses showed that detection thresholds for both 2-Hz FM and 20-Hz AM were significant and independent predictors of pseudoword reading ability in the entire sample. Thresholds for 2-Hz AM and 240-Hz FM did not explain significant additional variance in pseudoword reading skill. It is therefore possible that certain components of auditory processing of modulations are related to phonological decoding skills, whereas others are not.

Selective deficits of vibrotactile sensitivity in dyslexic readers

Developmental dyslexia is a disability of literacy skill that has also been associated with sensory processing deficits, primarily for the detection of dynamic auditory and visual stimuli. Here we examined whether analogous deficits extend into the domain of somatosensory perception. Detection thresholds for each of three frequencies of vibration were obtained for 11 readers with a prior history of dyslexia and 14 similarly aged adult controls. The poor readers were significantly less sensitive to vibration at 3 Hz (P<0. 01) but not at either 30 or 100 Hz. Detection of each of these three vibration rates is mediated primarily by a separate somatosensory fiber tract; deficits selective to 3 Hz therefore suggest an impairment within the slow-adapting I (SAI) fiber system beginning with Merkel-cell mechanoreceptors in the glabrous skin. Such evidence is compatible with the hypothesis of a generalized, multisensory deficit of temporal processing functions in dyslexia.

Monaural and binaural detection of sinusoidal phase modulation of a 500-Hz tone

The detectability of phase modulation was measured for three subjects in two-alternative temporal forced-choice experiments. In experiment 1, the detectability of sinusoidal phase modulation in a 1500-ms burst of an 80-dB (SPL), 500-Hz sinusoidal carrier presented to the left ear (monaural condition) was measured. The experiment was repeated with an 80-dB, 500-Hz static (unmodulated) tone at the right ear (dichotic condition). At a modulation rate of 1 Hz, subjects were an order of magnitude more sensitive to phase modulation in the dichotic condition than in the monaural condition. The dichotic advantage decreased monotonically with increasing modulation rate. Subjects ceased to detect movement in the dichotic stimulus above 10 Hz, but a dichotic advantage remained up to a modulation rate of 40 Hz. Thus, although sound movement detection is sluggish, detection of internal phase modulation is not. In experiment 2, thresholds for detecting 2-Hz phase modulation were measured in the dichotic condition as a function of the level of the pure tone in the right ear. The dichotic advantage persisted even when the level of the pure tone was reduced by 50 dB or more. The findings demonstrate a large dichotic advantage which persists to high modulation rates and which depends very little on interaural level differences.

Dynamic sensory sensitivity and children's word decoding skills

The relationship between sensory sensitivity and reading performance was examined to test the hypothesis that the orthographic and phonological skills engaged in visual word recognition are constrained by the ability to detect dynamic visual and auditory events. A test battery using sensory psychophysics, psychometric tests, and measures of component literacy skills was administered to 32 unselected 10-year-old primary school children. The results suggest that children's sensitivity to both dynamic auditory and visual stimuli are related to their literacy skills. Importantly, after controlling for intelligence and overall reading ability, visual motion sensitivity explained independent variance in orthographic skill but not phonological ability, and auditory FM sensitivity covaried with phonological skill but not orthographic skill. These results support the hypothesis that sensitivity at detecting dynamic stimuli influences normal children's reading skills. Vision and audition separately may affect the ability to extract orthographic and phonological information during reading.

Can sensitivity to auditory frequency modulation predict children's phonological and reading skills?

Understanding how letter units represent particular speech sounds is a crucial skill for developing competent reading skills. However it is not known whether such phonological ability is constrained by basic auditory capacities such as those necessary for detecting the frequency modulations characteristic of many phonemes. Here we show that nearly 40% of the variability in normal children's phonological and reading skills can be predicted from their sensitivity to 2 Hz frequency modulated (FM) tones. This relationship does not hold for sensitivity to 240 Hz FM. Because lower but not higher rates of FM provide information important for speech comprehension, dynamic auditory sensitivity is likely to play an important role in children's phonological and reading skill development.

Sensitivity to dynamic auditory and visual stimuli predicts nonword reading ability in both dyslexic and normal readers

BACKGROUND

Developmental dyslexia is a specific disorder of reading and spelling that affects 3-9% of school-age children and adults. Contrary to the view that it results solely from deficits in processes specific to linguistic analysis, current research has shown that deficits in more basic auditory or visual skills may contribute to the reading difficulties of dyslexic individuals. These might also have a crucial role in the development of normal reading skills. Evidence for visual deficits in dyslexia is usually found only with dynamic and not static stimuli, implicating the magnocellular pathway or dorsal visual stream as the cellular locus responsible. Studies of such a dissociation between the processing of dynamic and static auditory stimuli have not been reported previously.

RESULTS

We show that dyslexic individuals are less sensitive both to particular rates of auditory frequency modulation (2 Hz and 40 Hz but not 240 Hz) and to dynamic visual-motion stimuli. There were high correlations, for both dyslexic and normal readers, between their sensitivity to the dynamic auditory and visual stimuli. Nonword reading, a measure of phonological awareness believed crucial to reading development, was also found to be related to these sensory measures.

CONCLUSIONS

These results further implicate neuronal mechanisms that are specialised for detecting stimulus timing and change as being dysfunctional in many dyslexic individuals. The dissociation observed in the performance of dyslexic individuals on different auditory tasks suggests a sub-modality division similar to that already described in the visual system. These dynamic tests may provide a non-linguistic means of identifying children at risk of reading failure.

Right parietal cortex is involved in the perception of sound movement in humans

Changes in the delay (phase) and amplitude of sound at the ears are cues for the analysis of sound movement. The detection of these cues depends on the convergence of the inputs to each ear, a process that first occurs in the brainstem. The conscious perception of these cues is likely to involve higher centers. Using novel stimuli that produce different perceptions of movement in the presence of identical phase and amplitude modulation components, we have demonstrated human brain areas that are active specifically during the perception of sound movement. Both functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) demonstrated the involvement of the right parietal cortex in sound movement perception with these stimuli.

Sound movement detection deficit due to a brainstem lesion

Auditory psychophysical testing was carried out on a patient with a central pontine lesion involving the trapezoid body, who presented with a deficit in sound localisation and sound movement detection. A deficit in the analysis of time and intensity differences between the ears was found, which would explain the deficit in detection of sound movement. The impaired detection of sound movement, due to a lesion interfering with convergence of auditory information at the superior olive, suggests this structure to be critical for human sound movement analysis.

Spatial and temporal auditory processing deficits following right hemisphere infarction. A psychophysical study

Higher auditory function in a patient was investigated following a right hemisphere infarction between the middle and posterior cerebral artery territories involving the insula. The patient complained of lack of musical appreciation and a battery of tests confirmed a dissociated receptive musical deficit in the presence of normal appreciation of environmental sounds and speech. The ability to detect continuous changes in sound frequency in the form of sinusoidal frequency modulation was preserved. There was, however, a deficit in the analysis of rapid temporal sequences of notes which could underlie his musical deficit. This case provides further evidence for the existence of amusia as a distinct form of auditory agnosia, but does not support the hypothesis that bilateral lesions are required to produce such a deficit. Unexpectedly, the patient was also found to have a deficit in the perception of apparent sound-source movement. We suggest that this deficit is analogous to the visual phenomenon of akinetopsia, and is in accord with PET work suggesting involvement of areas outside primary auditory cortex in sound movement perception. A possible common deficit in auditory temporal and spatial 'scene analysis' is discussed.

Evidence for a sound movement area in the human cerebral cortex

Human listeners can localize sounds by the difference in both arrival time (phase) and loudness between the two ears. Movement of the sound source modulates these cues, and responses to moving sounds have been detected in animals in primary auditory cortex and in humans in other cortical areas. Here we show that detection of changes in the interaural phase or amplitude difference occurs through a mechanism distinct from that used to detect changes in one ear alone. Moreover, a patient with a right hemisphere stroke is unable to detect sound movement, regardless of whether it is defined by phase or by loudness cues. We propose that this deficit reflects damage to a distinct cortical area, outside the classical auditory areas, that is specialized for the detection of sound motion. The deficit is analagous to cerebral akinotopsia (motion blindness) in the visual system, and so the auditory system may, like the visual system, show localization of specialized functions to different cortical regions.