Lévy-Rueff M, Bourgeois M, Assous A, Beauquier-Maccota B, Boucheron E, Clouard C, Dondé S, Fostini O, Pinot P, Mosser A, Rittori G, Soufflet C, Vaivre-Douret L, Golse B, Robel L
Service de pédopsychiatrie, hôpital Sainte-Anne, Paris, France.
Encephale. 2012 Sep;38(4):318-28. doi: 10.1016/j.encep.2011.12.008. Epub 2012 Jan 24.
Specific language impairment (SLI) is a primary developmental disorder in which language is significantly more impaired than other developmental domains. Abnormal electroencephalographic recordings without clinical seizures are often observed. The aim of this retrospective study was to characterize the frequency of these abnormalities, to describe them and to analyze their association with anamnestic, clinical, paraclinical and evolution characteristics.
The cases of 35 children with a diagnosis of SLI, who also underwent electroencephalography and MRI, were systematically reviewed retrospectively.
In this population, aged between 4 and 7 years, 49% (n=17) of patients exhibited a specific expressive language disorder and 51% (n=18) a specific receptive disorder. Forty-nine percent of the children featured abnormal electroencephalography results. Abnormalities were essentially localized on the left side of the brain and in two specific regions: the temporo-occipital (60%) and the frontorolandic (30%) regions. The groups with and without abnormalities were compared statistically with each other in terms of clinical, paraclinical and evolution characteristics. Evolution data were available for 24 patients through a telephone interview and for nine patients through a new complete language evaluation. The comparison of the two groups showed significant differences in terms of severity of the phonological disorder, a higher number of delayed acquisition of walking and cleanliness and a higher range of non specific psychomotor difficulties.
A large proportion of children suffering from SLI present abnormal electroencephalography recordings with no clinical seizures. This rate is much higher than in the general population and the abnormalities are essentially localized on the left side of the brain in regions known for their specific role in language development. These abnormalities are more frequent in children with a severe phonological disorder, suggesting that they may share common pathophysiological features with SLI.
The presence of EEG abnormalities in a large group of patients suffering from SLI associated with minor neurological abnormalities suggests a possible theoretical neurodevelopmental model. Minor neurodevelopmental abnormalities, genetically transmitted or acquired during the pre- or perinatal period, may create vulnerability towards SLI. This vulnerability, in conjunction with environmental influences such as family environment, linguistic stimuli, exposure to multiple languages, or transitory hearing loss, might take the form of SLI. This hypothesis underlines the importance of prevention and early detection of SLI when identifying vulnerable subjects. Monitoring the family early through parental guidance and early school support would facilitate the acquisition of language.
特定语言障碍（SLI）是一种主要的发育障碍，其中语言受损程度明显高于其他发育领域。经常观察到无临床癫痫发作的异常脑电图记录。这项回顾性研究的目的是确定这些异常的频率，对其进行描述，并分析它们与既往史、临床、辅助检查及病情演变特征之间的关联。
对35例诊断为SLI且接受了脑电图和磁共振成像（MRI）检查的儿童病例进行了系统的回顾性分析。
在这个年龄介于4至7岁的人群中，49%（n = 17）的患者表现为特定的表达性语言障碍，51%（n = 18）表现为特定的接受性语言障碍。49%的儿童脑电图结果异常。异常主要定位于大脑左侧的两个特定区域：颞枕叶（60%）和额罗兰区（30%）。对有异常和无异常的两组患者在临床、辅助检查及病情演变特征方面进行了统计学比较。通过电话访谈获得了24例患者的病情演变数据，通过新的全面语言评估获得了9例患者的相关数据。两组比较显示，在语音障碍严重程度、更多的步行和清洁技能获得延迟以及更广泛的非特异性精神运动困难方面存在显著差异。
很大一部分患有SLI的儿童存在无临床癫痫发作的异常脑电图记录。这一比例远高于普通人群，且异常主要定位于大脑左侧在语言发育中具有特定作用的区域。这些异常在患有严重语音障碍的儿童中更为常见，表明它们可能与SLI具有共同的病理生理特征。
一大组患有SLI且伴有轻微神经异常的患者中存在脑电图异常，这提示了一种可能的理论神经发育模型。轻微的神经发育异常，无论是遗传传递的还是在产前或围产期获得的，都可能导致对SLI的易感性。这种易感性，连同诸如家庭环境、语言刺激、接触多种语言或短暂性听力损失等环境影响，可能以SLI 的形式表现出来。这一假设强调了在识别易患个体时预防和早期发现SLI的重要性。通过家长指导和早期学校支持对家庭进行早期监测将有助于语言习得。
