汉语发展性阅读障碍儿童小脑灰质体积的结构分析
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摘要
发展性阅读障碍(DD)的小脑缺陷理论认为阅读障碍者存在小脑功能缺陷。小脑功能失调导致动作技能自动化困难、阅读和书写能力的不足。以往行为研究发现,阅读障碍儿童和成人在完成与小脑有关的时间估计、动作平衡、速度加工、自动化加工等认知任务时会表现出一定的困难。神经影像学研究发现,阅读障碍者在执行已经学习过的动作序列、或在学习新的序列时右侧小脑的激活低下。脑结构研究发现阅读障碍者右侧小脑的灰质结构存在缺陷,灰质体积减少。以上都是来自拼音文字的研究证据,本课题组前期的行为研究采用系列反应时任务发现,DD儿童在使用左手反应时没有表现出内隐动作的学习,而在右手反应时表现正常。随后的脑成像研究发现汉语DD儿童在系列反应时任务中表现出左侧小脑的激活异常,比同年龄正常组的激活更强。本研究采用基于体素的形态学分析方法(VBM),通过比较汉语阅读障碍儿童和同年龄正常儿童脑结构的差异,探讨汉语DD儿童的小脑结构缺陷。研究发现汉语儿童的左侧小脑灰质体积显著小于同年龄正常儿童(P<0.001,alphaSim校正),并且左侧小脑的灰质体积与个体阅读成绩呈正相关。本研究发现汉语发展性阅读障碍儿童的左侧小脑结构存在缺陷,并且汉语DD儿童的阅读困难与其左侧小脑的结构缺陷之间可能存在紧密的联系。
The cerebellar deficit hypothesis suggests that children with dyslexia have a disorder of cerebellar development that causes problems in performing skills automatically, and impairments in reading and writing. Poor performance of cognitive ability, such as time estimation, automatic balance, speed processing, and implicit motor learning, is related to cerebellar function in children and adults with dyslexia. Using positron emission tomography, researcher found abnormaly activation of the right cerebellar cortex during execution of the prelearned sequence, and during learning novel sequences in adults with dyslexia. Structural magnetic resonance imaging(MRI) studies of cerebellar abnormalities in dyslexia found regional gray matter reductions in the right cerebellum. The studies listed above came from research in alphabetic languages. Our previous behavioral study found that Chinese children with developmental dyslexia have an absence of implicit motor learning effects when they respond with their left hands. Then an neuroimaging study found that children with dyslexia have significantly higher activity in the left cerebellum compared with age-matched children during implicit motor learning, suggesting left cerebellar abnormality in Chinese dyslexia. Using voxel-based morphometry, this study aimed to determine whether there were structural abnormalities in the left cerebellum in Chinese dyslexia. The results revealed Chinese children with dyslexia exhibited decreased gray matter volume in the left cerebellum(P < 0.001, alpha Sim correctio). Moreover, the regional graymatter was significantly correlated with reading scores, suggesting the abnormal structure in the left cerebellum is highly associated with reading disability in Chinese children with dyslexia.
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