Source: https://faculty.washington.edu/toddr/dyslexic.htm
Timestamp: 2019-04-19 07:07:26+00:00

Document:
The UW Learning Disability Center (PI - Dr. Virginia Berninger) was funded in a competitive renewal from the National Institute of Child Health and Human Development (NICHD) in 2000. The brain imaging project (Project IV - Functional Brain Imaging of Reading and Writing Disabilities) is directed by Dr. Todd Richards.
Here are some of the scientific accomplishments of that project over the last 5 years.
The current goals of Project IV of the Learning Disability Center (brain imaging) are to (a) understand the neural substrates differentiating dyslexics (specific word reading and spelling disability), dysgraphics (specific spelling disability only), and normal controls (good readers and spellers) on language tasks performed during scanning that are theoretically linked to genetic constraints and effective treatment, (b) investigate how these neural substrates may or may not change as a function of specific kinds of treatment provided for the dyslexics and/or dysgraphics and as a function of passing time for the controls imaged at the same time points as the dyslexics/dysgraphics, and (c) evaluate whether previous findings for fMRS and/or fMRI are reproducible.
We have used both functional magnetic resonance spectroscopy and functional MRI to non-invasively measure language activation in children with dyslexia. The fMRS is performed using proton echoplanar spectroscopic imaging (PEPSI) technique and is an alternative approach for detecting regional brain activation and measures tissue-based lactate changes (a direct measure of metabolism) produced by a temporary mismatch of oxygen delivery and consumption in response to neuronal activation. In our 1999 and 2000 publications, we reported that dyslexic boys demonstrated a greater area of brain lactate elevation compared to a control group during a phonological task in the left anterior quadrant of the brain. Following completion of the prior fMRS study, the dyslexic boys entered into a treatment program designed to improve their phonological abilities. Both the dyslexic boys and the control boys were re-imaged a year after the initial imaging session. Our main finding was that after treatment, the dyslexic children had a reduction in the regional distribution of metabolic activation, characterized by the number of voxels with elevated lactate in the left anterior quadrant during the phonological task. This finding demonstrated that successful treatment of dyslexia was accompanied by functional brain imaging changes as well as changes in performance on behavioral tasks in young children with a developmental rather than an acquired disorder.
In our 2001 publications, we compared fMRI with PEPSI during language processing in children and also measured the difference in fMRI brain activation between normal and dyslexic children. During fMRI, dyslexic and control boys completed auditory language tasks (judging whether pairs of real and/or pseudo words rhymed or were real words) in 30 second “on” conditions alternating with a 30 second “off” condition (judging whether tone pairs were same). During phonological judgment, dyslexics had more activity than controls in right than left inferior temporal gyrus and in left precentral gyrus. During lexical judgment, dyslexics were less active than controls in bilateral middle frontal gyrus and more active than controls in left orbital frontal cortex. Individual dyslexics were reliably less active than controls in left insula and left inferior temporal gyrus. Dyslexic and control children differ in brain activation during auditory language processing skills that do not require reading.
In our 2002 publication, the aim was to replicate previously reported functional neuroimaging differences between dyslexics and controls and effects of treatment for dyslexic children as detected by proton echo-planar spectroscopic imaging (PEPSI). We measured PEPSI brain lactate activation at two different time points (1 to 2 months apart) during two language tasks (phonological and lexical) and a control task (passive listening) in dyslexic participants (n=10) and in control participants (n=8). The dyslexics and controls (boys and girls, 9-12 years old) were matched in age, Verbal IQ, and valid PEPSI voxels. In contrast to the multi-component treatment used in past research, the dyslexics received either a phonological or morphological (meaning based) intervention (to which they were randomly assigned) between the first and second scan. Before treatment, the dyslexics showed significantly greater lactate elevation than controls in the left anterior quadrant during the phonological task, and dyslexics and controls differed significantly in the right posterior lactate activation during both tasks. After treatment, dyslexics and control groups did not differ significantly in any brain region during either task, but individuals given morphological treatment were significantly more likely to have reduced left anterior lactate activation during the phonological task. The previous finding of greater left anterior lactate elevation in dyslexic than control children during a phonological judgment task replicated, and brain activation changed as a result of treatment, but the morphological component was responsible for the treatment effect.
In 2003, we published an fMRI paper showing treatment effects in dyslexic children. Title: Instructional treatment associated with changes in brain activation in children with dyslexia. Aylward EH, Richards TL, Berninger VW, Nagy WE, Field KM, Grimme AC, Richards AL, Thomson JB, Cramer SC. Neurology. 2003 Jul 22;61(2):212-219. OBJECTIVE: To assess the effects of reading instruction on fMRI brain activation in children with dyslexia. BACKGROUND: fMRI differences between dyslexic and control subjects have most often involved phonologic processing tasks. However, a growing body of research documents the role of morphologic awareness in reading and reading disability. METHODS: The authors developed tasks to probe brain activation during phoneme mapping (assigning sounds to letters) and morpheme mapping (understanding the relationship of suffixed words to their roots). Ten children with dyslexia and 11 normal readers performed these tasks during fMRI scanning. Children with dyslexia then completed 28 hours of comprehensive reading instruction. Scans were repeated on both dyslexic and control subjects using the same tasks. RESULTS: Before treatment, children with dyslexia showed less activation than controls in left middle and inferior frontal gyri, right superior frontal gyrus, left middle and inferior temporal gyri, and bilateral superior parietal regions for phoneme mapping. Activation was significantly reduced for children with dyslexia on the initial morpheme mapping scan in left middle frontal gyrus, right superior parietal, and fusiform/occipital region. Treatment was associated with improved reading scores and increased brain activation during both tasks, such that quantity and pattern of activation for children with dyslexia after treatment closely resembled that of controls. The elimination of group differences at follow-up was due to both increased activation for the children with dyslexia and decreased activation for controls, presumably reflecting practice effects. CONCLUSION: These results suggest that behavioral gains from comprehensive reading instruction are associated with changes in brain function during performance of language tasks. Furthermore, these brain changes are specific to different language processes and closely resemble patterns of neural processing characteristic of normal readers.
Four sets of word-form tasks were administered during fMRI scanning to 18 child dyslexics and 21 controls to identify unique brain activation associated with four kinds of mapping—orthographic, morpheme with and without phonological shift, and phoneme—before treatment, and to measure the effect on each kind of mapping after orthographic and morphological spelling treatment (to which dyslexics were randomly assigned). Dyslexics and/or controls showed significant pretreatment activation in group maps in 18 brain regions during one or more of the mapping tasks. Average fMRI z-scores were used to determine for each kind of fMRI mapping which of the 18 brain areas (a) differentiated dyslexics and controls before treatment; (b) showed significant pre- to post-treatment activation change in dyslexics; (c) showed post-treatment ‘normalization’ of activation; and (d) changed differently for dyslexics as a function of the kind of treatment received. Dyslexics in orthographic treatment showed reliable change, normalization, and treatment-specific response in right inferior frontal gyrus and right posterior parietal gyrus.
4) Basic research testing the influence of brain activation on fMRS.
One of our future goals is to examine interrelationships among multiple levels of analysis of biological constraints on reading and spelling: genetic, neuranatomical, resting-state connectivity, and neurolinguistic (cognitive). In other words, we will investigate the relationship between functional brain imaging with genetic analysis and structural brain imaging in children with learning disabilities.
1. Berninger, V., & Richards, T. (2002). Brain literacy for educators and psychologists. New York: Academic Press.
1. Corina, D., Richards, T., Serafini, S., Richards, A., Steury, K., Abbott, R., Echelard, D., Maravilla, K., & Berninger, V. (2001). fMRI auditory language differences between dyslexic and able reading children. Neuroreport,12, 1195-1201.
2. Serafini, S., Steury, K., Richards, T., Corina, D., Abbott, R., & Berninger, V. (2001). Comparison of fMRI and PEPSI during language processing in children. Magnetic Resonance in Medicine, 45, 217-225.
3. Richards, T. L. (2001). Functional magnetic resonance imaging and spectroscopic imaging of the brain: Application of fMRI and fMRS to reading disabilities and education. Learning Disability Quarterly, 24, 189-203.
4. Berninger VW, Abbott RD, Abbott SP, Graham S, Richards T, Writing and reading: Connections between language by hand and language by eye, Journal of Learning Disabilities, 35, 39-56, 2002.
4. Richards, T., Berninger, V., Aylward, E., Richards, A., Thomson, J., Nagy, W., Carlisle, J., Dager, S., & Abbott, R. (2002). Reproducibility of proton MR spectroscopic imaging (PEPSI): Comparison of dyslexic and normal reading children and effects of treatment on brain lactate levels during language tasks. American Journal of Neuroradiology. 23, 1678-1685.
5. Cordes, D., Haughton, V., Carew, J., Arfanakis, K., & Maravilla, K. (2002). Hierarchial clustering to measure connectivity in fMRI resting-state data. Magnetic Resonance Imaging, 20, 305-317.
6. Eckert, M., Leonard, C., Richards, T., Aylward, E., Thomson, J., & Berninger, V. (2003). Anatomical correlates of dyslexia: Frontal and cerebellar findings. Brain, 126 (no. 2), 482-494.
7. Aylward, E., Richards, T., Berninger, V., Nagy, W., Field, K., Grimme, A., Richards, A., Thomson, J., & Cramer, S. (2003). Instructional treatment associated with changes in brain activation in children with dyslexia. Neurology, 61, 212-219.
8. Nandy, R., & Cordes, D. (2003). Novel nonparametric approach to canonical correlation analysis with applications to low CNR functional MRI data. Magnetic Resonance in Medicine, 50, 354-365.
9. Nandy, R., & Cordes, D. (2003). Novel ROC-type method for testing the efficiency of multivariate statistical methods in fMRI. Magnetic Resonance in Medicine, 49, 1152-1162.
10. Stanberry, L., Nandy, L., & Cordes, D. (2003). Cluster analysis of fMRI data using dendrogram sharpening. Human Brain Mapping, 20, 201-219.
11. Nandy, R., & Cordes, D. (2004). New approaches to receiver operating characteristics methods in fMRI with real data using repeated trials. Magnetic Resonance in Medicine, 52:1424-1431.
12. Eckert, M., Leonard, C., Wilke, M., Eckert, M., Richards, T., Richards, A., & Berninger, V. (2005). Anatomical signature of dyslexia in children: Unique information from manual-based and voxel-based morphometry brain measures. Cortex, 41, 304-315.
13. Richards, T., Berninger, V., Nagy, W., Parsons, A., Field, K., Richards, A. (2005). Brain activation during language task contrasts in children with and without dyslexia: Inferring mapping processes and assessing response to spelling instruction. Educational and Child Psychology, 22(2), 62-80.
14. Richards, T., Aylward, E., Berninger, V., Field, K., Parsons, A., Richards, A., & Nagy, W. (2006). Individual fMRI activation in orthographic mapping and morpheme mapping after orthographic or morphological spelling treatment in child dyslexics. Journal of Neurolinguistics, 19, 56-86.
15. Richards, T., Aylward, E., Raskind, W., Abbott, R., Field,. K., Parsons, A., Richards, A., Nagy, W., Eckert, M., Leonard, C., & Berninger, V. (in press). Converging evidence for triple word form theory in child dyslexics. Developmental Neuropsychology.
16. Stanberry LI, T. Richards, V. W. Berninger, R. R. Nandy, E. Aylward, P. Stock, D. Cordes (in press) Differences between adult developmental dyslexics and normal readers in clusters functionally correlated with the cerebellum during a phoneme mapping task. Magnetic Resonance Imaging.
Overview of Writing Skills and Instruction: Carter, A., Carroll, S., Page, L., & and Romero, I. (Eds.), Helping Children at Home and School: Handouts for families and educators. Bethesda, MD: National Association of School Psychologists. See handout for parents and teachers by Berninger for Writing in Intermediate and Secondary Grades.
1. Masterson, J., Apel, K., & Wasowicz, J. (2003). SPELL. Spelling Performance Evaluation for Language and Literacy. (Spelling assessment software for grade 2 through adult) Also, SPELL-Links to Literacy—A Word Study Program for K-Adult. Learning by Design. http:www.learningbydesign.com/products/spelllinks.htm Assessment linked to instruction.
3. Dixon, R., & Englemann, S. (2001). Spelling through morphographs. DeSoto, TX: SRA/McGraw-Hill. Excellent program once students have mastered Fry program.
4. Henry, M. (2003). Unlocking literacy. Effective decoding and spelling instruction. Baltimore: Paul H. Brookes Publishing. Explains how to teach decoding of words of Anglo Saxon, Latinate, and Greek origin based on the phonological, orthographic, and morphological units in words.
for phonics, vocabulary, and spelling instruction (2nd ed.). Upper Saddle River, NJ: Merrill.
7. Berninger, V., & Abbott, S. (2003). PAL Research-Supported Reading and Writing Lessons. San Antonio, TX: Harcourt. Lesson Sets 4, 5, and 7: Phonological Stage of Spelling Development.
1. Farbman, E. (1989). Sentence sense. A writers’ guide. Boston: Houghton Mifflin.
1. Carlisle, J. (1996). Models for writing, Levels A, B, and C. Novato, CA: Academic Therapy Publications. also WWW.HIGHNOONBOOKS.COM reproducibles for classroom use.
2. Auman, M. (2003). Step up to writing (2nd ed.). Longmont, CO: Sopris West.
4. Nelson, N., Bahr, C., & Van Meter, A. (2004). The Writing Lab Approach to Language Instruction and Intervention. Baltimore, MD: Paul H. Brookes. Offers practical suggestions for teachers to use in scaffolding instruction for students with language learning disability and for using software to support the composing.
Berninger, V. & Abbott, S. (2003). Lesson Sets 13 and 14 in PAL Research-Supported Reading and Writing Lessons, Harcourt: San Antonio. Lesson Sets 8, 9, and 10 for composition only.
1. Graham, S., & Harris, K. (2005). Writing Better. Effective Strategies for Teaching Students with Learning Difficulties. Baltimore, MD: Paul H. Brookes.
This is a link to our 1st Dyslexia brain imaging paper- American Journal of Neuroradiology 20:1393-1398, September, 1999.
This is a link to our Dyslexia Treatment paper- American Journal of Neuroradiology 21:916-922, May, 2000.
The UW Press Sept 1999 release of our research can be found at http://www.washington.edu/newsroom/news/1999archive/10-99archive/k100499a.html.
The UW Press May 2000 release of our research can be found at http://www.washington.edu/newsroom/news/2000archive/05-00archive/k052400.html.
The UW Press February 2006 release of our research can be found at http://www.uwnews.org/article.asp?articleID=22402.
Download word documents and powerpoint figures http://faculty.washington.edu/toddr/Anonftp.

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