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Neural impact of Skill and Goal-based Training in Adults with Dyslexia: A Randomized Trial
Poster D47 in Poster Session D, Wednesday, October 25, 4:45 - 6:30 pm CEST, Espace Vieux-Port
Kulpreet Cheema1, Thi Huynh2, Bill Hodgetts2, Jacqueline Cummine1,2; 1Neuroscience and Mental health Institute, University of Alberta, Canada, 2Faculty of Rehabilitation Medicine, University of Alberta, Canada
Background. Developmental Dyslexia is a lifelong, neurodevelopmental disorder characterized by difficulties in sound processing, inaccurate word recognition and slow reading speed. In addition, there is evidence for reduced brain activation and connectivity in reading-related brain areas in adults with Dyslexia. To date, adult-based reading intervention programs have primarily targeted skill improvement in phonics, morphology, and fluency; however, the behavioural and neural consequences of these skill-based programs remain small-to-moderate. Furthermore, adults have unique contexts like work, education and social lives, which makes it challenging to implement appropriate and feasible interventions. Interventions that go beyond skill-based literacy training to a more holistic, personalized framework are a potential avenue to increase remediation success. In this study, we investigated the neurobiological impact of two intervention programs-a prescriptive, skilled-based training and a personalized, goal-based training- in adults with Dyslexia. Methods. Twenty-one participants with Dyslexia were randomly assigned to one of the training programs: Skill Group (N= 12) and Goal Group (N= 9). Participants completed pre-intervention behavioural (i.e., standardized assessments of reading fluency and decoding and comprehension) and functional near-infrared spectroscopy (fNIRS) (i.e., sound awareness (phoneme deletion task) and comprehension (sentence comprehension)) tasks. Participants then started their respective training programs for eight weeks. In the skill-based training, participants completed training/testing modules on phonology, orthography, morphology and reading fluency. In the Goal-based training, each participant completed the Goal Attainment Scaling measure to identify four literacy-based goals and completed activities to target those goals. After the eight weeks of training, participants completed the same behavioural and fNIRS tasks (with different stimuli). Analysis. The fNIRS data was first assessed for signal quality and then subjected to a standardized preprocessing pipeline (e.g., downsampling, optical density conversion, motion correction, etc.). Next, oxygenated and deoxygenated hemoglobin concentrations for eight brain regions were extracted, including bilateral fusiform gyrus, superior temporal gyrus, medial prefrontal cortex and supramarginal gyrus. A series of 2 (time: pre and post) x 2 (group: skill and goal) mixed measures ANOVA were conducted to identify any significant training effects on the concentration values. Results. Significant improvement in reading fluency, decoding and passage comprehension was found for both intervention groups. During the phoneme deletion task, there was increased brain activity in the left fusiform gyrus (FFG) and right superior temporal gyrus (STG) for the Skill-based group. During the reading comprehension task, decreased brain oxygenation was found in the left medial prefrontal cortex (MPFC) for both training groups. These findings demonstrate that the training was associated with normalizing activity in literacy-based brain areas (left FFG), compensatory activity in right-hemispheric literacy brain areas (right STG and FFG) and disengagement of the default mode network (left MPFC). Conclusion. This study found evidence for normalizing (i.e., significant activation in the typical reading network) and compensatory changes (i.e., significant activation in the regions outside the reading network) in the brain. Moreover, we provided preliminary evidence for the usefulness of goal-based intervention for adults with Dyslexia.
Topic Areas: Disorders: Developmental, Reading