Reproducibility of proton MR spectroscopic imaging (PEPSI): comparison of dyslexic and normal-reading children and effects of treatment on brain lactate levels during language tasks.
OBJECTIVE
We repeated a proton echo-planar spectroscopic imaging (PEPSI) study to test the hypothesis that children with dyslexia and good readers differ in brain lactate activation during a phonologic judgment task before but not after instructional treatment.


METHODS
We measured PEPSI brain lactate activation (TR/TE, 4000/144; 1.5 T) at two points 1-2 months apart during two language tasks (phonologic and lexical) and a control task (passive listening). Dyslexic participants (n = 10) and control participants (n = 8) (boys and girls aged 9-12 years) were matched in age, verbal intelligence quotients, and valid PEPSI voxels. In contrast to patients in past studies who received combined treatment, our patients were randomly assigned to either phonologic or morphologic (meaning-based) intervention between the scanning sessions.


RESULTS
Before treatment, the patients showed significantly greater lactate elevation in the left frontal regions (including the inferior frontal gyrus) during the phonologic task. Both patients and control subjects differed significantly in the right parietal and occipital regions during both tasks. After treatment, the two groups did not significantly differ in any brain region during either task, but individuals given morphologic treatment were significantly more likely to have reduced left frontal lactate activation during the phonologic task.


CONCLUSIONS
The previous finding of greater left frontal lactate elevation in children with dyslexia during a phonologic judgment task was replicated, and brain activation changed as a result of treatment. However, the treatment effect was due to the morphologic component rather than the phonologic component.
Richards
Todd L
TL
Department of Radiology, University of Washington, Seattle, WA 98195, USA.
Berninger
Virginia W
VW
Aylward
Elizabeth H
EH
Richards
Anne L
AL
Thomson
Jennifer B
JB
Nagy
William E
WE
Carlisle
Joanne F
JF
Dager
Stephen R
SR
Abbott
Robert D
RD
D000367:Age Factors; D001184:Articulation Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015415:Biomarkers / Q000032:analysis; D001923:Brain Chemistry; D002648:Child; D002669:Child Welfare; D004410:Dyslexia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D007807:Language Tests; D007858:Learning / Q000502:physiology; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D010296:Parietal Lobe / Q000378:metabolism; D011237:Predictive Value of Tests; D011522:Protons; D011594:Psychometrics; D011932:Reading; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D011522:Protons; D019344:Lactic Acid