Neural systems predicting long-term outcome in dyslexia
Neural systems predicting long-term outcome in dyslexia
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DOI：
10.1073/pnas.1008950108
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发表时间：
2011-01-04
影响因子：
11.1
通讯作者：
Gabrieli, John D. E.
中科院分区：
文献类型：
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作者：
Hoeft, Fumiko;McCandliss, Bruce D.;Gabrieli, John D. E.
发展性阅读障碍的个体在提高阅读技能的能力方面各不相同，但改善的大脑基础在很大程度上仍然未知。我们在有阅读障碍（n = 25）或无阅读障碍（n = 20）的儿童中进行了一项为期2.5年的前瞻性纵向研究，以发现初始行为或大脑测量，包括功能性MRI（fMRI）和扩散张量成像（DTI），是否可以预测阅读障碍的未来长期阅读增益。没有行为测量，包括广泛使用的和标准化的阅读和语言测试，可靠地预测未来的阅读增益阅读障碍。在要求语音意识和上级纵束（包括弓状束）白质组织的阅读任务中，更大的右前额叶激活显著预测了阅读障碍患者未来的阅读收益。使用线性支持向量机（SVM）和交叉验证对这两种大脑测量进行多变量模式分析（MVPA），预测特定儿童是否会提高阅读技能（行为测量是偶然的）的概率显著高于概率（72%的准确率）。语音加工全脑激活模式MVPA预测2.5年后阅读障碍儿童阅读技能提高的准确率> 90%。这些发现确定了右前额叶脑机制，可能是关键的阅读改善阅读障碍，可能不同于典型的阅读发展。在某些情况下，预测未来行为结果的大脑测量（神经预后）可能比现有的行为测量更准确。
Individuals with developmental dyslexia vary in their ability to improve reading skills, but the brain basis for improvement remains largely unknown. We performed a prospective, longitudinal study over 2.5 y in children with dyslexia (n = 25) or without dyslexia (n = 20) to discover whether initial behavioral or brain measures, including functional MRI (fMRI) and diffusion tensor imaging (DTI), can predict future long-term reading gains in dyslexia. No behavioral measure, including widely used and standardized reading and language tests, reliably predicted future reading gains in dyslexia. Greater right prefrontal activation during a reading task that demanded phonological awareness and right superior longitudinal fasciculus (including arcuate fasciculus) white-matter organization significantly predicted future reading gains in dyslexia. Multivariate pattern analysis (MVPA) of these two brain measures, using linear support vector machine (SVM) and cross-validation, predicted significantly above chance (72% accuracy) which particular child would or would not improve reading skills (behavioral measures were at chance). MVPA of whole-brain activation pattern during phonological processing predicted which children with dyslexia would improve reading skills 2.5 y later with > 90% accuracy. These findings identify right prefrontal brain mechanisms that may be critical for reading improvement in dyslexia and that may differ from typical reading development. Brain measures that predict future behavioral outcomes (neuroprognosis) may be more accurate, in some cases, than available behavioral measures.