Aylward E H, Richards T L, Berninger V W, Nagy W E, Field K M, Grimme A C, Richards A L, Thomson J B, Cramer S C
Department of Radiology, University of Washington, Seattle 98195, USA.
Neurology. 2003 Jul 22;61(2):212-9. doi: 10.1212/01.wnl.0000068363.05974.64.
To assess the effects of reading instruction on fMRI brain activation in children with dyslexia.
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.
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.
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.
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.
评估阅读指导对诵读困难儿童功能磁共振成像（fMRI）脑激活的影响。
诵读困难者与对照组受试者之间的fMRI差异大多涉及语音处理任务。然而，越来越多的研究记录了形态意识在阅读和阅读障碍中的作用。
作者开发了一些任务，以探究音素映射（将声音与字母匹配）和词素映射（理解后缀词与其词根的关系）过程中的脑激活情况。10名诵读困难儿童和11名正常阅读者在fMRI扫描期间执行这些任务。诵读困难儿童随后完成了28小时的综合阅读指导。使用相同任务对诵读困难组和对照组受试者再次进行扫描。
治疗前，诵读困难儿童在音素映射任务中，左侧额中回和额下回、右侧额上回、左侧颞中回和颞下回以及双侧顶上叶区域的激活程度低于对照组。在初始词素映射扫描中，诵读困难儿童在左侧额中回、右侧顶上叶以及梭状回/枕叶区域的激活明显减少。治疗与阅读成绩提高以及两项任务期间脑激活增加相关，使得治疗后诵读困难儿童的激活量和模式与对照组非常相似。随访时组间差异的消除是由于诵读困难儿童的激活增加以及对照组的激活减少，这可能反映了练习效应。
这些结果表明，综合阅读指导带来的行为改善与语言任务执行过程中的脑功能变化有关。此外，这些脑变化特定于不同的语言过程，并且与正常阅读者的神经处理模式非常相似。
