Cognitive Requirements of the Phonological Tests Affect Their Ability to Discriminate Children With and Without Developmental Dyslexia.

PURPOSE: The main purpose of this study was to investigate whether the performance on each of seven phonological processing (PP) tests from the Russian Test of Phonological Processing (RuToPP), with their varying levels of linguistic complexity and composite phonological indices, are significant predictors of developmental dyslexia (DD) and can reliably differentiate children with and without reading impairment. Additionally, we examined the general contribution of phonological skills to text reading fluency in children with various levels of reading performance. METHOD: A total of 173 Russian-speaking 7- to 11-year-old children participated in this study: 124 who were typically developing (TD) and 49 who had been diagnosed with DD. We assessed reading fluency with a standardized reading test and PP with the RuToPP. We investigated the potential of phonological skills to predict the presence or absence of a dyslexia diagnosis using multinomial logistic regression, receiver operating characteristic (ROC) curve analysis, and calculations of the sensitivity and specificity of each test and index. The contribution of phonological skills to reading fluency was also assessed in a mixed group of children. RESULTS: Six of seven RuToPP tests were significant predictors of dyslexia. However, while the RuToPP correctly identified 93%-99% of TD children, for children with dyslexia, it ranged from 4% to 47% depending on the test. In a mixed group of children with and without dyslexia, performance in the more complex phonological tests was a stronger predictor of reading fluency. CONCLUSIONS: Our findings are consistent with the literature on predictors of literacy skills and dyslexia while uniquely demonstrating the impact of the complexity level of the phonological tests on the classification outcome. PP is a significant and necessary predictor of reading skills, but it is not sufficient for diagnostic purposes. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20779294.

'Moderate global aphasia': A generalized decline of language processing caused by glioma surgery but not stroke.

Unlike stroke, neurosurgical removal of left-hemisphere gliomas acts upon a reorganized language network and involves brain areas rarely damaged by stroke. We addressed whether this causes the profiles of neurosurgery- and stroke-induced language impairments to be distinct. K-means clustering of language assessment data (neurosurgery cohort: N = 88, stroke cohort: N = 95) identified similar profiles in both cohorts. But critically, a cluster of individuals with specific phonological deficits was only evident in the stroke but not in the neurosurgery cohort. Thus, phonological deficits are less clearly distinguished from other language deficits after glioma surgery compared to stroke. Furthermore, the correlations between language production and comprehension scores at different linguistic levels were more extensive in the neurosurgery than in the stroke cohort. Our findings suggest that neurosurgery-induced language impairments do not correspond to those caused by stroke, but rather manifest as a 'moderate global aphasia' - a generalized decline of language processing abilities.

Functional linguistic specificity of the left frontal aslant tract for spontaneous speech fluency: Evidence from intraoperative language mapping.

The left frontal aslant tract (FAT) has been proposed to be relevant for language, and specifically for spontaneous speech fluency. However, there is missing causal evidence that stimulation of the FAT affects spontaneous speech, and not language production in general. We present a series of 12 neurosurgical cases with awake language mapping of the cortex near the left FAT. Tasks for language mapping included the commonly used action picture naming, and sentence completion, tapping more specifically into spontaneous speech. A task dissociation was found in 10 participants: while being stimulated on specific sites, they were able to name a picture but could not complete a sentence. Overlaying of these sites on preoperative white-matter tract reconstructions revealed that in each individual case they were located on cortical terminations of the FAT. This corroborates the language functional specificity of the left FAT as a tract underlying fluent spontaneous speech.

Left frontal aslant tract and lexical selection: Evidence from frontal lobe lesions.

The frontal aslant tract (FAT) is a white-matter tract connecting the inferior frontal gyrus (IFG) and the supplementary motor complex (SMC). Damage to either component of the network causes spontaneous speech dysfluency, indicating its critical role in language production. However, spontaneous speech dysfluency may stem from various lower-level linguistic deficits, precluding inferences about the nature of linguistic processing subserved by the IFG-SMC network. Since the IFG and the SMC are attributed a role in conceptual and lexical selection during language production, we hypothesized that these processes rely on the IFG-SMC connectivity via the FAT. We analysed the effects of FAT volume on conceptual and lexical selection measures following frontal lobe stroke. The measures were obtained from the sentence completion task, tapping into conceptual and lexical selection, and the picture-word interference task, providing a more specific measure of lexical selection. Lower FAT volume was not associated with lower conceptual or lexical selection abilities in our patient cohort. Current findings stand in marked discrepancy with previous lesion and neuroimaging evidence for the joint contribution of the IFG and the SMC to lexical and conceptual selection. A plausible explanation reconciling this discrepancy is that the IFG-SMC connectivity via the FAT does contribute to conceptual and/or lexical selection but its disrupted function undergoes reorganisation over the course of post-stroke recovery. Thus, our negative findings stress the importance of testing the causal role of the FAT in lexical and conceptual selection in patients with more acute frontal lobe lesions.