Rosch Keri S, Khashab Masa, Ghanaiem Sanad, Farah Rola, Horowitz-Kraus Tzipi
Center for Neurodevelopmental and Imaging Research and Center for Neuropsychological and Psychological Assessment, Kennedy Krieger Institute, Baltimore, MD, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Int Neuropsychol Soc. 2025 Jan;31(1):75-85. doi: 10.1017/S1355617724000717. Epub 2024 Dec 27.
Reading difficulties (RD) frequently co-occur with attention-deficit/hyperactivity disorder (ADHD), and children with both RD + ADHD often demonstrate greater challenges in reading and executive functions (EF) than those with RD-only.
This study examined the effect of a 4-week EF-based reading intervention on behavioral and neurobiological correlates of EF among 8-12 y.o. English-speaking children with RD + ADHD (n = 19), RD-only (n = 18), and typically developing children (n = 18). Behavioral and resting-state fMRI data were collected from all participants before and after 4 weeks of the EF-based reading computerized program. Group (RD + ADHD, RD-only, typical readers) x Test (pre- and post-intervention) repeated measures ANOVAs were conducted for reading, EF, and brain functional connectivity (FC) measures.
Across groups, reading (fluency, comprehension) and EF (inhibition, speed of processing) behavioral performance improved following the intervention. Exploratory subgroup comparisons revealed that children with RD + ADHD, but not RD-only, showed significant gains in reading comprehension, whereas inhibition improved in both RD groups, but not among typical readers. Furthermore, across groups, FC between the frontoparietal (FP) and cingulo-opercular (CO) networks decreased following the intervention. Exploratory subgroup comparisons revealed that children with RD + ADHD, but not RD-only, showed a significant decrease in FC of FP-CO and FP-dorsal attention network.
These results support the differential response to an EF-based reading intervention of children with RD with and without comorbid ADHD at brain and behavioral levels.
阅读困难（RD）常与注意力缺陷/多动障碍（ADHD）并发，同时患有RD + ADHD的儿童在阅读和执行功能（EF）方面往往比仅患有RD的儿童面临更大挑战。
本研究考察了一项为期4周、基于执行功能的阅读干预对8至12岁患有RD + ADHD（n = 19）、仅患有RD（n = 18）以及发育正常的儿童（n = 18）的执行功能的行为和神经生物学相关性的影响。在基于执行功能的阅读计算机程序进行4周前后，收集了所有参与者的行为和静息态功能磁共振成像数据。对阅读、执行功能和脑功能连接（FC）测量进行组（RD + ADHD、仅患有RD、典型阅读者）×测试（干预前后）重复测量方差分析。
在所有组中，干预后阅读（流畅性、理解能力）和执行功能（抑制、处理速度）的行为表现均有所改善。探索性子组比较显示，患有RD + ADHD的儿童，而非仅患有RD的儿童，在阅读理解方面有显著提高，而两个RD组的抑制能力均有所改善，但典型阅读者组没有。此外，在所有组中，干预后额顶叶（FP）和扣带回 - 岛盖（CO）网络之间的功能连接性降低。探索性子组比较显示，患有RD + ADHD的儿童，而非仅患有RD的儿童，在FP - CO和FP - 背侧注意网络的功能连接性上有显著降低。
这些结果支持了在大脑和行为水平上，患有和未患有共病ADHD的RD儿童对基于执行功能的阅读干预的不同反应。
