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Can studying the brain help us


understand dyslexia?
Dorothy V. M. Bishop
University of Oxford

anet and ohn, circa 1957

Visuospatial ability
Q: Which pattern can be folded to make the cube at the top?

$o what's going on in the brain in


dyslexia?
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"Continuum of reproductive casualty

s there "minimal brain damage


around the time of birth?
Popular theory in the 1970s:
ANOXA
death severe handicap specific learning difficulties
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Chiarello et al (00 case TF
Compensated dyslexic graduate student in social sciences
No gross signs of brain damage or maIformation on MRI scan

DZ twins: share 50% of polymorphic


genes
Question:
s concordance for disorder higher
in MZ than in DZ twins?
Most studies of dyslexia find $
%in $tudy Method
MZ twins: genetically identical
Twins growing up together are expected to resemble each other
Grigorenko, E. L. (2004). Genetic bases of developmental dyslexia: A
capsule review of heritability estimates. Enfance, 56, 273-288.
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opyright: www.artoonStock.com
n fact, genetic variants influencing dyslexia are common in the
population and each has a very small effect
Total genetic influence reflects combined action of many genes
with environmental factors
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How can genes affect brain
development?
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mbryonic brain deveIopment
green = cortical plate neurons; blue = young neurons
Figure from: http://www.dene.ucl.ac.be/primer_reelin.html
Reeler mouse: has drastic ataxia and tremor, and often dies around weaning
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Galaburda & Kemper 1979
$ingle post mortem case showing
polymicrogyria and areas of displaced
neurons (ectopias in the left cerebral
hemisphere
N.B. the patient also had language delay
and developed epilepsy in teenage years
further cases added 195; limited
detail on these cases, but one had
substantial language problems and
one was late to talk; all had ectopias
but in different places, most on L side
lack dots
are ectopias;
Shaded area is
polymicrogyria
Neuronal migration abnormalities in dyslexic brains
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Genes associated with dyslexia
affect neuronal migration
Paracchini et al (00
KAA019 gene
Gene expressed in fetal
brain (rat and human
'Risk' version of gene has
lower expression
nterference with gene in
rat affects neuronal
migration
Migration distance after
interfering with RNA
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Other dyslexia risk genes affect
neural migration
Galaburda et al (00
"the causes of the malformations in the dyslexic
brain remained unclear until four candidate
dyslexia susceptibility genes were reported
DYX1X1, KAA019, DCDC and ROBO1
which are involved in neuronal migration and
other developmental processes. Experimental
interference with these genes leads to neuronal
migration anomalies. (p. 11
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Need for caution
Dyslexia 'risk' genes are not mutations! They are variant
forms of genes, common in the population
Their association with dyslexia is statistically significant
but very weak, e.g. KAA019:
variant A in 9% of normal readers, 5% dyslexics;
variant B in 0% of normal readers, 5% dyslexics.
Original reports of ectopias based on just nine cases,
and poorly controlled.
Many MR studies of dyslexia in recent years: no reports
of high levels of ectopias
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Which brain regions have been found to differ
structurally in dyslexics vs normal readers?
cerebellum
(automatisation of skill
auditory cortex
(hearing
inferior frontal
gyrus (speech
production
precentral gyrus (motor control
A. auditory cortex
B. cerebellum
C. precentral gyrus
D. inferior frontal gyrus
E. all of the above
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$tructural brain features identified in dyslexics
Corpus callosum size
White matter gyral depth
Right cerebellum grey matter
Temporal lobe auditory cortex size
Precentral gyrus grey matter
Reduced asymmetry of planum temporale
ncreased asymmetry of planum temporale
Pars triangularis, frontal lobe, size and shape
$ylvian fissure length/position
Temporo-parietal white matter microstructure
Relative proportion of frontal and posterior cortex
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Why so much variation?
$ome findings may be chance, but also
Variation in dyslexics
Adults/children
$everity of dyslexia
Associated symptoms: language, attention, motor
ntervention
Methods
Manual analysis vs. automated
Regions investigated
And genuine differences from case to case
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Functional brain imaging
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Children with
reading disability
display under-
activation of
a network of left-
lateralized areas
during reading,
including
occipito-temporal,
temporo-parietal,
and inferior frontal
cortical regions
$haywitz, 00
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Cause or consequence of
reading problems?

Experience affects the brain


Dehaene et al, 010: compared:
1 schooled/literate adults
unschooled ex-illiterate adults
10 unschooled illiterate adults
All from Brazil or Portugal

Activation of visual word form area by written words

Activation of language areas by spoken language


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mplications for functional imaging
studies of dyslexia
f we find group differences, need to
consider if they could be consequences of
poor reading, rather than causes

$howing how intervention affects


the brain
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ntervention affects brain
connectivity
Keller and ust (009
Diffusion tensor imaging: method for
measuring connectivity between brain
regions, affected by N connections and
myelination of tracts
Connectivity measured before and after
intervention, compared with control group who
had no intervention

Children from Powerkids reading


initiative (Torgesen et al
Poor readers randomly assigned to no new intervention
or (N = 1 or one of interventions (N = 5
nterventions varied in focus:
$peII Read PhonoIogicaI Auditory %raining (P.A.%.)
Corrective Reading
WiIson Reading
FaiIure Free Reading
5 days/week for 50 min/day for months: approx 100 hr
Also 5 good readers, no intervention
N.B poor readers had relatively mild problems:
score <= 0th percentile on Test of Word Reading Efficiency
> 5th percentile on the Peabody Picture Vocabulary Test
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Word Attack: Read aloud nonsense words/low frequency words
Word Identification: Read aloud isolated words
Passage Comprehension: Read short passage and identify key missing word
Results collapsed
across kinds of
reading instruction;
significant gains in
word attack
(phonological
decoding only,
regardless of
intervention type
Change in standard score from pre to post-test
Change in reading standard scores from pre
to post test
-
-
-
-1
0
1

Word attack Word D Passage


comp.
s
t
a
n
d
a
r
d

s
c
o
r
e

c
h
a
n
g
e
+intervention
no intervention
Woodcock Reading Mastery Test
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Before intervention:
brain regions showing
greater connectivity in
good readers vs poor
readers (slices at different
depths
Good readers vs. poor readers before intervention
Region showing difference
(in red is Left Anterior
Centrum $emiovale
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Left anterior centrum semiovale
$uggests brain connectivity
becomes more like that of
good readers after intervention
Could indicate increased
myelination as a result of
intervention
Treated poor readers vs. untreated poor readers
after intervention period

Can studying the brain help us


understand dyslexia?

YE$! neuroscience has taught us:


Poor reading is not just down to bad teaching - mounting
evidence of brain differences linked to genes
Large individual differences between children. Dyslexia
rarely caused by a single gene mutation, or a brain
lesion or malformation. Brain differences are subtle and
differ from child to child.
Neuronal migration abnormalities can affect brain
microstructure, and may limit ability to form connections
between areas important for reading. But unlikely to be a
general explanation. Likely to affect children with severe
and intractable problems, and/or those with associated
problems affecting oral language or motor systems.

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Can studying the brain help us
know how best to assess or
teach children with dyslexia?
A. $creening/diagnosis
B. Deciding what to teach
C. Deciding who merits extra time in exams
D. None of the above
E. All of the above
Is the research revieed today IikeIy to heIp ith:

Hirsh-Pasek & Bruer, 007


The Brain-Education Barrier
Conference on Early Education and Human rain
Development
"On day one, however, it became clear that myths about
brain-based pedagogy dominated participants' thinking.
The Chilean educators were looking to brain science for
insights about which type of preschool would be the
most effective, whether children are safe in child care,
and how best to teach reading. The brain research
presented at the conference was mute on these issues.
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Possibility of brain 'biomarker'
Diagnosis?
We are a long way from using brain imaging
to diagnose dyslexia (a biomarker and -
given the substantial differences between
children - may never get there.
$creening?
Often used to justify neuroscience studies, but
unrealistic. And we actually have pretty good
behavioural predictors!

Can neuroscience inform teaching?


Not really!
t can show that learning to read changes the brain dramatically.
t can confirm that reading involves a complex brain network,
and that different parts of that network can be problematic for
different children.
But cognitive analysis is still going to be best guide for
diagnosing what an individual child needs.
Neuroscientists may have ideas for intervention inspired
by thinking about brain circuits involved in reading -
plenty of scope for creative interactions with educators.
But carefuI anaIysis of chiIdren's reading behaviour
should guide intervention, not neurological tests.
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Thank you for listening
For references see:
http://tinyurI.com/6jazxm6
For blog see:
http://deevybee.bIogspot.com/

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