Resodys Institute and Department of Neurology, University Hospitals of Marseille, Marseille, France.
Handb Clin Neurol. 2020;174:47-59. doi: 10.1016/B978-0-444-64148-9.00004-1.
Developmental dyslexia is the commonest "specific learning disorder" (DSM-5) or "developmental learning disorder with impairment in reading" (ICD-11). This impairment in reading acquisition is related to a defect in the installation of cognitive precursors necessary to master the grapheme-phoneme conversion. Its origin is largely genetic, but many environmental factors seem capable of modulating symptom intensity. Three types of presentation, roughly equal in occurrence, are useful to distinguish according to the associated disorders (language, attentional, and/or motor coordination), thus suggesting, at least in part, potentially different mechanisms at their origin. In adolescence and adulthood the clinical presentation tends to bear a more uniform pattern, covering a large range of severity depending on each person's ability to compensate for their deficit. Research has demonstrated dysfunction of specific brain areas during reading-related tasks (using fMRI), essentially in the left cerebral hemisphere, but also atypical patterns of connectivity (using diffusion imaging), further supplemented by functional connectivity studies at rest. The current therapeutic recommendations emphasize the need for multidisciplinary care, giving priority, depending on the clinical form, to the language, psychomotor, or neuropsychologic aspects of rehabilitation. Various training methods whose effectiveness has been scientifically tested are reviewed, emphasizing those exploiting the hypothesis of a lack of intermodal connectivity between separate cognitive systems.
发展性阅读障碍是最常见的“特定学习障碍”（DSM-5）或“阅读障碍伴学习损伤”（ICD-11）。这种阅读获取损伤与掌握语音-字形转换所需的认知前体的安装缺陷有关。其起源主要是遗传的，但许多环境因素似乎能够调节症状的严重程度。根据相关障碍（语言、注意力和/或运动协调），三种大致相等的表现类型有助于区分，这至少部分表明，其起源可能存在不同的潜在机制。在青少年和成年期，临床表现往往更为一致，根据每个人弥补其缺陷的能力，严重程度差异很大。研究表明，在与阅读相关的任务中（使用 fMRI），大脑特定区域的功能出现异常，主要在左半球，但连接的模式也不典型（使用弥散成像），进一步通过静息状态下的功能连接研究得到补充。目前的治疗建议强调需要多学科护理，根据临床形式，优先考虑语言、心理运动或神经心理康复方面。还回顾了各种经过科学测试的有效性的训练方法，重点强调了那些利用认知系统之间缺乏模态间连接的假设的方法。
