1 INSERM EMI-U 9926, Faculté de Médecine, Marseilles, France, 2 INSERM U455, Hôpital Purpan, Toulouse, France and 3 Hôpital La Timone, Department of Pediatric Neurology, Marseilles, France
Address correspondence to Catherine Liégeois-Chauvel, INSERM EMI U9926, Laboratoire de Neurophysiologie et Neuropsychologie, Faculté de Médecine, 27, Bd Jean Moulin, 13005 Marseille, France. Email: Catherine.liegeois{at}medecine.univ-mrs.fr.
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Abstract |
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Key Words: auditory evoked potentials categorical perception dyslexia speech voice onset time (VOT)
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Introduction |
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Evidence has accumulated over the last decade showing that developmental dyslexics are impaired on a number of different psychoacoustic measures of auditory processing: categorical perception tests involving natural phonemes or speech-like stimuli (Manis et al., 1997; Breier et al., 2001
; Serniclaes et al., 2001
, 2004
), auditory temporal order judgements involving pure tone or syllable pairs (Tallal, 1980
; Reed, 1989
; Heath et al., 1999
; Heirvang et al., 2002
; Brethelton and Holmes, 2003
), frequency discrimination (Witton et al., 1998
; Talcott et al., 1999
; Hill et al., 1999
; McAnally et al., 2000
), binaural processing (McAnally and Stein, 1996
), backward masking (Rosen and Manganari, 2001
) and perception of amplitude modulation (Goswami et al., 2002
). Electroencephalographic (Schulte-Korne et al., 1999
) and magnoencephalographic (Nagarajan et al., 1999
) data, too, suggest that dyslexics suffer an enduring dysfunction in low-level auditory processing. Likewise, anatomical and MRI evaluations of dyslexic brains suggest striking alterations in regions that straddle the temporal bank of the left sylvian fissure, such as the planum temporale (Galaburda et al., 1985
; Larsen et al., 1990
) and Heschl's gyrus (Leonard et al., 2001
). These findings militate strongly in favour of a central auditory deficit in dyslexic children and adults (Amitay et al., 2002
; Bailey and Snowling, 2002
), but considerable controversy exists over the mechanisms linking auditory dysfunction to phonological and reading disorders. Whereas several researchers have emphasized the high incidence of auditory deficits and suggest a causal link (Tallal, 1980
; Goswami, 2003
; King et al., 2003
), others argue that these deficits cannot be considered a major factor in dyslexia because not all dyslexics display them (Ramus et al., 2003
; Rosen, 2003
).
Here, we investigate the integrity of auditory processing in developmental dyslexic adults with persistent reading, spelling, and phonological deficits using auditory evoked potentials (AEPs). AEPs can provide an objective means of evaluating, with high temporal precision, how the auditory cortex codes acoustico-phonetic cues crucial to speech and language processing. One such cue is the voice onset time (VOT), which constitutes the basis of the voiced/voiceless speech contrast and refers to the temporal relationship between voicing and another phonetically relevant supralaringeal event. In a study using intracerebral AEPs in non-language-impaired subjects, Liégeois-Chauvel et al. (1999) found that VOT-differing voiced and voiceless stop consonantvowel (CV) syllables were coded in a temporal fashion in the left auditory cortex, with AEP components time-locked to the successive acoustic events in these sounds. In the present study, AEPs were used to explore how these same speech sounds, which developmental dyslexics often have difficulty distinguishing during development, are coded in dyslexic adults and non-dyslexic controls.
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Materials and Methods |
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Eight male adult developmental dyslexics with persistent reading, spelling and phonological deficits (aged 2249 years; mean 32 years) and ten non-dyslexic male controls (aged 2138 years; mean 28.2 years) participated in the study. All subjects reported themselves as strongly right-handed on the Edinburgh Handedness Inventory (Oldfield, 1971). All were native French speakers, had normal hearing on an audiogram and had an IQ [converted from Raven's Standard Progressive Matrices (PM) (Raven et al., 1992
)] of >90, with no known history of neurological, psychiatric, motivational or sensorial antecedents. All gave written informed consent to participate in the study.
Dyslexics were referred to our clinic by the National Association for Parents of Dyslexic Children in France or by a clinical neuropsychologist who had made a previous diagnosis of developmental dyslexia. Dyslexic respondents were administered a questionnaire on personal and family history of developmental language-specific and other impairments, scholastic background and medical history, and were retained in the study if they (i) suffered a long history of debilitating developmental learning impairments specific to reading and writing with a previous diagnosis of developmental dyslexia documented or reported; (ii) reported significant persistent reading, spelling, and/or language deficits; and (iii) achieved a reading age (RA) of more than two years short of the adult RA (i.e. <12.3 years, adult RA being >14.3 years) on a French-language-standardized reading test, with at least 2 SD lower than the adult norm on either a word or pseudoword spelling test despite having a normal non-verbal IQ as evaluated by Raven's PM. All but two dyslexics also reported having persistent difficulties with oral speech sounds (i.e. substitutions involving primarily voiced and voiceless sounds of a minimal pair) and all but two reported having more than one close family member with declared developmental language deficits.
Non-dyslexics were administered the same questionnaire as dyslexics and were included in the study if they (i) had no personal or family history of reading or language impairment; (ii) reported consistently achieving scores of average or better on spelling tests and in French language lessons in grade school; (iii) demonstrated normal reading and language function as assessed by a neuropsychologist; and (iv) had normal non-verbal IQ as evaluated by Raven's PM.
RAs were calculated on the basis of reading speed and number of errors on the Alouette standardized reading test (Lefavrais, 1967). Other language tests administered to dyslexics and non-dyslexics were: (i) word spelling (12 items); (ii) pseudoword spelling (11 items); (iii) a phoneme deletion task (40 items); (iv) an odd word out phoneme task, in which one of four orally presented words differs from the other three with respect to one speech sound (19 items); and (v) a syllable deletion task (20 items). Performance on all of these tests was highly correlated with RAs across all subjects (r = 0.68 or greater; P < 0.05, Pearson product-moment). Dyslexics were significantly impaired on reading and all other language tests compared with non-dyslexics, in spite of normal non-verbal intellectual function (see Table 1).
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Data Acquisition
AEPs were recorded using acquisition software and a 64-channel SynAmps EEG/EP amplication system from Neuro Scan Labs (Neurosoft, Inc.). A 64-electrode cap [QuickCap (Neuromedical Supplies, Inc.)] with scalp locations based on the 1010 International System was used. The site of the reference was the right mastoid.
During acquisition, the EEG signal was amplified with a digital band-pass filter (0.5200 Hz) and digitized at a rate of 1 kHz per channel (and a resolution of 1 ms per sample). Recordings were carried out while subjects sat comfortably in a chair in an electrically isolated and sound attenuating room and read a self-chosen book. Subjects were instructed to refrain from making movements and clenching muscles.
Stimuli and Procedure
The stimuli used were the endpoints taken from the voiced (/ba/) and voiceless (/pa/) CV continuum described above. During EEG acquisition, each subject was administered five 8 min blocks of 450 trials of one of two stimuli, followed by the same number of blocks and presentations of the other stimulus. Testing order of /ba/ and /pa/ block groups was counterbalanced across subjects. The stimuli in each block were presented binaurally through headphones (Sennheiser HD 25) at a comfortable listening level adjusted to 70 dB SL (sensation level, relative to the threshold at 1000 Hz) for each subject and were administered at regular intervals of 1030 ms using Labview. Subjects were instructed not to attend to stimuli while reading and were allowed to rest between blocks.
Data Analysis
EEG recordings were sectioned into 820 ms epochs (82 ms pre-stimulus and 738 ms post-stimulus) and a baseline correction using the pre-stimulus portion of the signal was carried out. AEPs for each stimulus were averaged for each subject and grand-averaged across subjects. Epochs that were contaminated by muscle or eye-blink artefacts were automatically rejected from the averaging procedure. Averaged AEPs were then mean-referenced and digitally band-pass filtered (high-pass cut-off frequency = 1 Hz, slope = 24 dB/octave; low-pass cut-off frequency = 30 Hz, slope = 48dB/octave).
Analysis of AEP Timecourses
AEP timecourses for /ba/ and /pa/ were analyzed using ASA (Advanced Source Analysis, A.N.T. Software BV). For each subject, AEP activity from all 63 electrodes was first superposed and the global field power (GFP) calculated, in order to isolate and identify AEP components. The number and latencies of components were subsequently recorded for each stimulus and subject. Scalp potential topographic maps were generated using a standard three-dimensional head model and a three-dimensional spherical spline interpolation.
Categorical Perception (CP)
All subjects were administered identification and discrimination subtests of a CP task using CV stimuli taken from a synthetically created, natural speech voicedvoiceless (/ba//pa/) continuum. To obtain the stimuli in this continuum, the voiced CV, /ba/, was recorded by a female native French speaker then modified by extracting progressively longer segments of the initial low frequency activity characterizing voicing (i.e. <500 Hz) from the spectrum. In this way, 14 stimuli differing in VOT and ranging from /ba/ (total duration = 380 ms; VOT = 110 ms) to /pa/ (total duration = 270 ms; VOT = +40 ms) were obtained. These stimuli were tested and validated in a previous study (Laguitton et al., 1997).
The identification task consisted of a training phase with /ba/ and /pa/ endpoint stimuli and 140 test trials of continuum stimuli (14 items x 10 repetitions) presented randomly through headphones. Subjects were instructed to identify each stimulus by pressing a BA or PA button with their right index finger. In the training phase, subjects were required to score correctly on at least eight consecutive trials to demonstrate their understanding of the task. Feedback was given on training trials, but not on test trials.
The discrimination task consisted of a training phase with same or different endpoint pairs and 100 test trials of continuum item pairs (10 pairs x 10 repetitions). After adequate training (correct performance on eight consecutive endpoint pairs with feedback), subjects were asked to make a same or different judgement (AX paradigm) upon each presentation by pressing either a SAME or a DIFFERENT button with their right index finger.
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Results |
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Table 2 summarizes latencies of /ba/ and /pa/ AEP components identified for non-dyslexics and dyslexics on the basis of the GFP.
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Dyslexic AEPs were similar to non-dyslexic AEPs with respect to the N1/P2 complex, but markedly different in several other respects. Two distinct patterns of atypical responses were observed. The first (AEP pattern I: subjects NR, AB, AS, SC) was characterized by (i) a greater number of components for both /ba/ and /pa/; (ii) an AEP termination lag of 130 ms in all subjects for /pa/ and in two subjects (NR, SC) for /ba/; and (iii) an appearance of earlier-latency components (P50), which were never present in non-dyslexics, in two subjects (AB, SC). The second dyslexic pattern (AEP pattern II: subjects PH, FL, CM, MD) was characterized by a non-appearance of the voiced CV-specific N240 supplementary component for /ba/ after the N1/P2 complex and an absence of stimulus differentiation on the basis of temporal cues. In other words, these latter subjects exhibited the same number of components before the off-response, irrespective of whether the eliciting stimulus was /ba/ or /pa/.
Figure 1A (upper panel) shows grand-averaged non-dyslexic AEPs for the voiced CV /ba/ recorded over the scalp. In the lower panel, the same responses are shown superposed from all 63 electrodes, along with the /ba/ oscillogram. As in Table 2, several components are identifiable. The first corresponds to the N1a (80 ms) and N1b (120 ms) and the second to the P2 (180 ms). This N1a,b/P2 complex is observed with the onset of voicing (or, rather, pre-voicing in the case of French voiced consonants), while the N240 component that follows (asterisk) corresponds to the processing of the other acoustic cue necessary in determining stop consonant VOT (the release burst) and vowel onset. This component was observed in all non-dyslexic /ba/ but not /pa/ AEPs, and is thought to be indicative of the sequential processing of phonetically relevant cues in voiced stop consonant perception (Liégeois-Chauvel et al., 1999). Figure 1B (upper panel) shows grand-averaged AEPs for the voiceless CV /pa/ for the same subjects. In the lower panel, the same responses are shown as the superposition of all 63 electrodes along with the /pa/ oscillogram. In this case, only an N1a,b/P2 complex is present. Here, the N1a,b culminate slightly earlier, at 70 and 115 ms, respectively. For both /ba/ and /pa/, AEP durations are roughly time-locked to stimulus duration.
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Figure 4 shows scalp distribution maps of differences in /ba/-minus-/pa/ potential over time for non-dyslexics and for AEP pattern I and II dyslexics. For non-dyslexics, a highly significant difference (t = 3.7; P < 0.001) in potential was observed at latencies around the voiced-CV-specific N240 component over left-sided temporal electrodes only, suggesting a lateralization of sequential processing underlying voiced stop consonant perception. A significant difference (t = 3.4, P < 0.001) was also observed over frontal electrodes, primarily on the left, at latencies around the P2 component (shown on the figure at 190 ms), reflecting a larger P2 amplitude in /ba/ compared with /pa/ responses over these regions. Other significant /ba/minus-/pa/ differences were observed at the latency of the /ba/ off-response over left temporal electrodes (t = 3.2; P < 0.001) and between 399 and 418 ms over bilateral fronto-central electrodes (not shown). The latter are likely related to differences in the time required for /ba/ and /pa/ responses to return to baseline (/ba/ AEPs return to baseline later than /pa/ AEPs).
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Categorical Perception Data
Figure 5A shows grand-averaged /ba//pa/ identification functions for non-dyslexics and the two dyslexic subgroups characterized on the basis of AEP data. No significant group differences were observed in boundary location (50% /ba//pa/ cross-over point) or categorization accuracy (indexed by slope).
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Discussion |
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Dyslexic AEPs were characterized by one of two distinct atypical patterns of response. AEP pattern I dyslexics demonstrated a differential coding of voiced and voiceless stimuli, but with a larger number of components and an overall delay in AEP termination time. Off-responses occurred much later than for non-dyslexics, consistent with the idea that a lag or sluggishness in auditory processing may be associated with reading impairment (Hari and Kiesila, 1996; Hari and Renvall, 2001
). The presence of additional components in this group may be due to an increase in synchronized onset responses coding frequency modulations along the speech signal. In a recent study, Steinschneider et al. (2004)
showed that onset responses evoked by both the first and second tones of a two-tone complex are reliably detected from tonotopically organized neuronal populations in the primary auditory cortex of the monkey at tone onset time separations of as short as 20 ms. In the same study, they demonstrated that the representation of VOT in the human auditory cortex varied in a manner that reflected the spectral composition of voiced/voiceless speech sounds and the tonotopic organization of the auditory cortex in spectral processing. Numerous distinct temporo-spectral components thus contribute to the scalp-recorded N1 (Liégeois-Chauvel 1994
), but they are generally difficult to distinguish on the basis of surface recordings. It is possible that the multiple components observed in AEP pattern I dyslexics reflect an over-synchronization of activity from the sources of these different components: because they would not overlap in time, each component could be identifiable from electrophysiological recordings. This may be due to anatomically related differences affecting the orientation of sources or may reflect the processing of extraneous cues within the speech signal (Serniclaes et al., 2001
).
Previous studies have shown a rightward functional asymmetry in spectral processing in the human auditory cortex (Liégeois-Chauvel et al., 2001; Zatorre and Belin, 2001
). Interestingly, t-test distribution maps of /ba/-minus-/pa/ activity for AEP pattern I dyslexics suggest that the regions generating the N240 component were lateralized to the right hemisphere, unlike for non-dyslexics. On a more general level, this observation suggests differences for these dyslexics in the functional organization of regions implicated in VOT perception and voiced/voiceless consonant discrimination. Numerous PET (Rumsey et al., 1992
; Brunswick et al., 1999
), fMRI (Temple et al., 2001
) and MEG (Simos et al., 2000a
,b
) studies have found decreased activation, or attenuated asymmetry, of left-hemispheric temporal or temporoparietal regions in dyslexics during phonology or reading tasks. Perhaps the atypical pattern of asymmetry observed for AEP pattern I subjects has to do with the fact they constituted part of a population of adult-aged dyslexics with persistent deficits: in these subjects, a normalization of the left-hemispheric neural circuits underlying speech, phonological and reading functions through rehabilitation is not likely to have occurred. In a recent MEG study, Simos et al. (2002)
reported that, before successful remedial training, dyslexic children differed from their non-dyslexic counterparts in that they exhibited strong activity in the right and little or no activity in the left posterior portion of the superior temporal gyrus (STGp) during pseudoword reading. After training, however, this pattern normalized and activity in the left STGp increased markedly. It is also possible that these dyslexics have developed compensatory mechanisms or strategies to aid them in speech and language processing and that this process is associated with a functional reorganization of neural systems subserving speech perception.
AEP pattern II dyslexics did not demonstrate the differential coding based on sequential phonetic cues that is typically observed for voiced and voiceless /ba//pa/ stimuli. AEPs from these dyslexics appeared almost identical due to the absence of the supplementary voiced CV-specific N240 component for /ba/. This observation may reflect a difficulty in some developmental dyslexics to process rapidly occurring acoustic events. In a magnetoencephalographic study, Nagarajan et al. (1999) found that reading-impaired adults exhibited diminished responses to the second of two rapidly successive acoustic stimuli when inter-stimulus intervals were 100200 ms, but not when they were 500 ms. Given that voiced and voiceless consonants of a minimal pair differ predominantly according VOT values which in any case fall within a relatively small (i.e. <200 ms) time window, it is conceivable that such a deficit could make a differential coding of these sounds difficult. The data for this group are evocative of the rapid auditory processing deficits cited in some behavioral studies (Tallal, 1980
; Reed, 1989
). These authors have suggested that such deficits could constitute a causal mechanism in developmental reading disorders because they could compromise the formation of clear phonemic representations necessary for sound-to-letter learning.
Both groups of dyslexics also differed from non-dyslexics with respect to the P2 component: while /ba/-minus-/pa/ activity for P2 was observed over (primarily left) frontal regions for non-dyslexics, no such activity was observed for dyslexics. The P2 is a positive-going component thought to reflect both exogenous and endogenous processing (Dunn et al., 1998; see also Crowley and Colrain, 2004
), and may be an indicator of processes underlying feature detection (Luck and Hillyard, 1994
) and early sensory stage item encoding (Dunn et al., 1998
). Its amplitude is typically maximal over fronto-central regions of the scalp and its generators have been localized to the auditory cortex (secondary and associative areas) (Hari et al., 1987
; Verkindt et al., 1994
; Godey et al., 2001
). That dyslexics of both groups in the present study exhibited anomalous P2 activity in the passive listening to voiced and voiceless speeech may suggest auditory processing deficits in feature detection and item encoding in these subjects. Similar findings have been reported in other studies (Breznitz and Meyler, 2003
).
Consistent with our AEP data, psychophysical data from the categorical perception task revealed impaired discrimination functions in our dyslexics especially those with pattern II AEPs. In all dyslexics, poor categorical discrimination was the result of flatter and wider discrimination peaks observed at category boundaries and/or better within-category discrimination performance. Previous investigations on the categorical perception of stop consonants have similarly demonstrated that both dyslexic children (Godfrey et al., 1981; Werker and Tees, 1987
; Serniclaes et al., 2001
) and adults (Steffens et al., 1992
) often exhibit flatter or wider inter-categorical discrimination peaks and, in some cases, better within-category discrimination. These findings corroborate our AEP data suggesting that developmental dyslexics with persistent reading and language deficits may also exhibit auditory processing anomalies in VOT discrimination. It is important to note, however, that, while the dyslexics in the present study exhibited impaired discrimination functions, they were not significantly impaired at identifying the same stimuli. The reasons for this are unclear, although similar findings have been reported in previous studies (Maassen et al., 2001
).
The electrophysiological and psychophysical anomalies reported in this study likely reflect differences in the functional organization of speech and language regions in dyslexics. These may ultimately arise from, or be associated with, differences in structural organization. Post-mortem (Galaburda et al., 1985) and brain imaging data (Hynd et al., 1990
; Humphreys et al., 1990
; Kushch et al., 1993
) have suggested a reduction in, or an absence of, the usual left-greater-than-right asymmetry of the planum temporale (PT) and/or neighbouring areas. More recently, Leonard et al. (2001)
reported a duplicated Heschl's gyrus (HG) in seven out of nine adult dyslexics with a specific phonological deficit. A duplicated left-hemispheric HG is uncommon in the normal population (Penhune et al., 1996
) and has been associated, along with other perisylvian anomalies, with poor phonological performance (Leonard et al., 1993
). Given that all the dyslexic subjects in the present study exhibited a specific phonological impairment (in addition to their reading and spelling deficit), it may be conceivable that their deficits are related to underlying anatomical anomalies. It should kept in mind, however, that other studies have failed to demonstrate anomalies in PT asymmetry and/or HG duplication in dyslexics [although this may due to differences in subject selection criteria and to heterogeneity in this population (see Eckert, 2004
)]. Nonetheless, the use of brain imaging techniques in a future study may provide a neuroanatomical correlate to the auditory/speech processing anomalies observed here.
The mechanisms underlying auditory processing deficits and their role in dyslexia are subject to much debate (Habib, 2000), but most current views tend to implicate a single one. Our observations suggest, instead, that more than one dysfunctional mechanism may be implicated in different dyslexics: one related to the processing of extraneous acoustic cues in the speech signal and/or a sluggishness in auditory processing (AEP pattern I), and another to an inability to code crucial, sequentially occurring cues differentiating voiced/voiceless speech sounds (AEP pattern II). Both of these were associated with significant reading, spelling, and phonological impairments persisting into adulthood. Other auditory processing dysfunctions likely exist, such as would underlie impairments in rhythm timing a slow-moving feature of the speech signal (Goswami et al., 2002
). Put together, these observations may explain some inconsistencies found in the literature (Ramus et al., 2003
; Rosen, 2003
), since the tasks used in different studies to demonstrate auditory deficits may only reveal one subtype of dysfunction. Our data also suggest that auditory processing dysfunctions can be identified objectively on the basis of AEP recordings. It is hoped that future investigations in this direction will shed light on the role of auditory processing deficits in developmental language disorders and provide a plausible explanation as to why only a proportion of dyslexics show evidence of speech perception deficits and/or central auditory dysfunction (Tallal, 1980
; King et al., 2003
; Rosen, 2003
), when virtually all suffer phonological impairments.
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Acknowledgments |
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