Authors :
Presenting Author: Dror Kraus, MD, PhD – Schneider Children's Medical Center of Israel, Petah-Tikva, Israel
Raya Meri, MSc – Faculty of Education in Science and Technology, Technion - Israel Institute of Technology, Haifa, Israel; Rola Farah, PhD – Faculty of Education in Science and Technology, Technion - Israel Institute of Technology, Haifa, Israel; Lital Cohen-Vig, MD – Schneider Children's Medical Center of Israel, Petah-Tikva, Israel; Mika Shapira, MD – Schneider Children's Medical Center of Israel, Petah-Tikva, Israel; Tzipi Horowitz Kraus, PhD – Faculty of Education in Science and Technology, Technion - Israel Institute of Technology, Haifa, Israel
Rationale:
Children with Self-limited Epilepsy with CentroTemporal Spikes (SeLECTS) have been repeatedly shown to have increased rates of reading difficulties as well as impaired executive functioning (EF). Yet, there are no data comparing reading difficulties in children with SeLECTS to children with dyslexia, the prototypic reading disorder. From a mechanistic viewpoint, no studies have focused on EF as a potential contributor to reading difficulties in SeLECTS. This study aimed to characterize reading and EF profiles among Hebrew-speaking children with SeLECTS and compare them to children with dyslexia and to typical readers (TR).
Methods:
Behavioral measures included the following: 1) Reading measures: word and non-word reading, contextual reading, and reading and narrative comprehension. 2) EF measures: working memory, inhibition, switching and visual attention.
Resting state fMRI data was acquired using the Inscape paradigm for 5 min (TR/TE = 1000/28ms, voxel size= 2×2×2mm). Anatomical data (T1) was acquired for 2.5 min (TR/TE = 1000/28ms, voxel size= 1×1×1mm).
Functional connectivity of within and between the networks were generated from the resting-state data and associated with narrative comprehension as well as reading comprehension abilities while controlling for attention abilities (Fig. 1).
Results:
Behavioral measures: Children with SeLECTS displayed lower contextual reading accuracy and comprehension [F(2,59)=9.048, p=.0], and visual attention scores (using the ‘Diamond’ task; F(2,59)=5.244, p=.008], followed by children with dylexia and TR groups. Resting state fMRI correlations with narrative comprehension measures (Fig. 2). TR vs SeLECTS: Significantly decreased correlations between narrative comprehension scores and functional connectivity within CO (z=2.25, p=.012), within visual (z=2.42, p=0), between FP-DAN (z=1.64, p=.05), and between FP-CO (z=1.62, p=.05) in the SELECTS group. Dyslexia vs SeLECTS: Significantly greater correlations between narrative comprehension scores and functional connectivity within VAN (z=3.7, p=0), within auditory (z=1.79, p=.03), within visual (z=2.8, p=.003), between auditory-VAN (z=2.6, p=.005), and auditory-CO (z=1.66, p=.04) in the SeLECTS group. Results below p=.002 survived the correction for multiple comparisons and are bolded in the text. Similar analyses regarding reading comprehension failed to show significant differences between the groups.
Conclusions:
Narrative comprehension deficits were less pronounced in children with SeLECTS compared to children with dyslexia.
While processing narratives, the SeLECTS group engaged EF networks more than children with dyslexia. This may theoretically represent a compensation mechanism used by children with SeLECTS.
This is the first study to systematically characterize the interaction between SeLECTS, reading difficulties and EF. This approach may improve identification and classification of children with SeLECTS and reading difficulties.
In the long run, syndrome-specific characteristics as those shown here may set the stage for applications to identify reading impairments, and to propose tailored remedial interventions for children with SeLECTS.
Funding:
The study was funded by the Waterloo Foundation (UK).