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Research ArticleConfirmation, Disorders of the Nervous System

Gray Matter Features of Reading Disability: A Combined Meta-Analytic and Direct Analysis Approach

Mark A. Eckert, Virginia W. Berninger, Kenneth I. Vaden Jr, Mulugeta Gebregziabher and Loretta Tsu
eNeuro 8 January 2016, 3 (1) ENEURO.0103-15.2015; DOI: https://doi.org/10.1523/ENEURO.0103-15.2015
Mark A. Eckert
1Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425
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Virginia W. Berninger
2Department of Education, University of Washington, Seattle, Washington 98195
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Kenneth I. Vaden Jr
1Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425
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Mulugeta Gebregziabher
3Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina 29425
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Loretta Tsu
1Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425
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  • Figure 1.
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    Figure 1.

    Meta-analysis results. Widespread reading disability group differences in gray matter volume reported across 11 voxel-based studies of reading disability are displayed on the MNI T1 image (top). SDM meta-analysis results demonstrated relatively consistent effects within left superior temporal sulcus, left orbitofrontal cortex, and right cerebellar hemisphere (bottom; red, p < 0.005, yellow p < 0.001, uncorrected). Jednoróg et al. (2015) was not included in the meta-analysis and did not observe cortical effects for p < 0.001 peak and p < 0.05 cluster extent thresholds. The yellow clusters were normalized into the study-specific DARTEL space of the multisite data to extract average gray matter volume estimates for the dimensional and group difference analyses.

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    Figure 2.

    Reading disability group differences in gray matter within meta-analysis ROI (n = 255). Significantly lower gray matter volume [adjusted for age, age2, gender, and site (resid)] was observed in reading disability cases compared to controls within left OFC (including pars orbitalis), and left STS. There were not significant reading disability group differences in right cerebellar hemisphere (CrbH) ROI gray matter volume, perhaps because of the increased gray matter volume variance in the reading disability group. The ROI group differences in gray matter volume were statistically dependent on total gray matter volume.

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    Figure 3.

    Gray matter variance in control and reading disability groups. A, Representative sections shows standard deviations across voxels for the smoothed gray matter images (residualized smoothed GM: after removing variance for gender, age, and research site; corrected for total GM: after removing variance for gender, age, research site and total gray matter volume). B, A voxelwise Levene test (uncorrected for multiple comparisions) demonstrated brain regions where there were reading disability group differences in gray matter variance [red: reading disability (RD) > control (CTL); blue: CTL>RD].

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    Figure 4.

    Multisite and meta-analysis results. The multisite voxel-based reading group comparison results (cyan) are presented with the meta-analysis results (yellow) from voxel-based dyslexia studies on the study specific DARTEL gray matter template (all clusters p < 0.001, uncorrected). The multisite group comparison included covariates for age, age2, gender, and research site. The left hemisphere overlap of results (red) from each analysis falls within the left posterior superior temporal sulcus and left orbitofrontal cortex. All cyan clusters were no longer present using the p < 0.001 uncorrected threshold when total gray matter volume was included as a covariate.

Tables

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    Table 1.

    Summary information for manuscripts included in the meta-analysis

    First authorControl sample sizeDyslexic sample sizeCoordinate spaceMean age dyslexia casesGender ratio M/FStatistical significance
    Brambati et al., 20041110Talairach31.6470.006
    Brown et al., 20011416Talairach24.5300.05
    Eckert et al., 20051313MNI11.41000.001
    Jednoróg et al., 20133546MNI10.3480.00004
    Kronbichler et al., 20081513MNI15.91000.004
    Menghini et al., 20081010MNI40.710^0.005
    Raschle et al., 20111010MNI5.9500.0002
    Silani et al., 20053232Talairach∼24.41000.009
    Steinbrink et al., 200888MNI20.175^0.05 FDR
    Tamboer et al., 20153757MNI20.67^0.05
    Vinckenbosch et al., 20051410Talairach17–301000.0006
    • Thresholds are reported as uncorrected thresholds based on the reported t or Z-scores, except for ^ three studies for which only the statistical threshold was reported. Ages were rounded or ∼ estimated from the mean age of multiple groups or reported as a range if mean ages were not provided.

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    Table 2.

    Control and reading disability behavioral summaries (mean and SD) before (n=293) and after (n=255) discriminant function selection of cases

    SiteControlReading disability
    (n=Control/RD)
    (n=129/164)
    VCWIDWAPCAgeVCWIDWAPCAge
    1 (n=36/45)107.81 (14.19)105.56 (11.89)105.61 (10.26)101.74 (10.26)10.11 (1.38)91.40 (14.33)82.31 (10.22)87.18 (8.41)84.73 (12.35)9.91 (1.65)
    2 (n=34/28)†105.86 (4.03)110.85 (10.18)110.24 (11.37)112.94 (8.65)12.51 (3.06)106.01 (4.04)81.93 (7.58)87.79 (7.58)87.11 (11.24)14.27 (1.68)
    3 (n=15/15)^117.40 (14.97)117.07 (17.44)115.60 (15.98)109.93 (9.39)9.33 (2.02)96.75 (8.55)84.13 (7.51)86.60 (7.69)82.53 (9.57)9.27 (2.02)
    4 (n=10/16)121.09 (16.41)106.80 (17.71)118.10 (15.24)111.10 (14.36)11.93 (1.89)102.20 (13.73)82.44 (8.86)88.13 (8.07)84.66 (9.47)9.99 (1.87)
    5 (n=19/39)115.84 (14.07)115.47 (14.16)112.42 (12.38)107.63 (13.59)9.37 (2.66)107.73 (11.07)77.44 (9.56)89.03 (10.11)76.87 (15.89)10.10 (1.67)
    6 (n=15/21)‡117.66 (12.75)114.80 (7.51)112.93 (9.10)94.06 (4.09)10.71 (3.42)106.85 (13.43)95.19 (11.51)98.90 (9.57)93.94 (3.82)10.82 (3.49)
    All cases111.77 (13.39)110.92 (13.18)110.82 (12.34)106.35 (11.76)10.75 (2.73)101.30 (13.39)82.91 (10.69)89.26 (9.44)84.24 (12.88)10.77 (2.59)
    Discriminant function analysis selected groups
    (n=Control/RD)
    (n=105/150)
    1 (n=23/43)113.30 (11.24)112.83 (7.89)111.04 (8.06)106.38 (9.28)10.15 (1.38)89.56 (11.71)81.58 (9.85)86.63 (8.19)83.16 (10.14)9.90 (1.65)
    2 (n=32/26)†105.94 (3.98)111.94 (9.46)111.16 (11.06)113.09 (9.00)12.52 (3.12)105.88 (4.03)80.96 (6.90)86.96 (7.11)86.50 (11.40)14.19 (1.71)
    3 (n=14/15)^118.43 (14.97)118.93 (16.48)117.64 (14.40)111.36 (7.89)9.38 (2.09)96.75 (8.55)84.13 (7.51)86.60 (7.69)82.53 (9.57)9.27 (2.02)
    4 (n=7/16)123.27 (19.04)115.57 (10.95)121.57 (15.14)117.86 (8.92)11.54 (2.04)102.20 (13.73)82.44 (8.86)88.13 (8.07)84.66 (9.47)9.99 (1.87)
    5 (n=15/39)117.13 (14.10)120.20 (11.94)116.27 (10.93)111.63 (12.25)9.46 (3.00)107.73 (11.07)77.44 (9.56)89.03 (10.11)76.87 (15.89)10.10 (1.67)
    6 (n=14/11)‡118.51 (12.75)115.86 (6.54)113.93 (8.55)94.10 (4.06)10.64 (3.54)107.81 (16.61)85.91 (6.36)92.55 (7.50)94.18 (3.66)9.98 (3.68)
    Selected cases113.65 (12.66)115.01 (10.74)113.79 (11.19)108.97 (10.97)10.83 (2.90)100.52 (13.27)81.06 (9.00)87.90 (8.49)83.01 (12.46)10.65 (2.51)
    • RD, reading disability; VC, verbal comprehension; WID, word identification; WA, word attack; PC, passage comprehension.

    • †This site had complete verbal comprehension missingness. Younger controls were recruited to have reading level matches for the reading impaired cases and this produced a group difference in age (p < 0.05) that remained significant after discriminant function assignment of cases to reading groups.

    • ^Gender was missing for 1 case.

    • ‡ This site had complete passage comprehension missingness. Significant group differences were observed for all variables between reading disability and control groups (p < 0.001), with the exception of age (n.s.). There were no significant differences in the distribution of gender within sites or across the multisite sample before or after discriminant function analysis selection of cases. The standardized scores are age-normed values.

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    Table 3.

    T1-weighted image parameters from the six study sites

    SiteManufacturerField strength, TImage dimensions, mmSlice thickness, mmTR, msTE, msFlip angle , deg
    1Siemens1.5256 × 256×2000.80†25.004.6030‡
    2GE3.0256 × 256×1241.209.002.0015
    3Siemens3.0240 × 256×1760.902250*3.969
    4Siemens3.0128 × 256×2561.336.002.908
    5Siemens3.0256 × 256×1601.001600^3.3715
    6Philips3.0256 × 256×1001.009.884.598
    • †0.8 mm gap.

    • ‡Five of 66 cases had TR= 30 and flip angle=35. Note that the long TRs for Sites 3 and 5 were due to the use of inversion recovery.

    • *Inversion time = 900.

    • ^Inversion time = 640.

    • View popup
    Table 4.

    Pearson correlations between gray matter regions from the meta-analysis and behavioral measures across all 293 cases

    Word attackWord identificationPassage comprehensionVerbal comprehension
    Left Orbitofrontal Cortex (resid)0.17**0.17**0.20***0.11
    Confidence Intervals0.05–0.290.05–0.280.07–0.320.01–0.21
    Left Superior Temporal Sulcus (resid)0.16*0.17**0.19**0.10
    Confidence Intervals0.03–0.270.06–0.280.08–0.300.00–0.21
    Right Cerebellar Hemisphere (resid)0.15*0.110.17**0.16**
    Confidence Intervals0.02–0.27−0.01 to 0.240.04–0.290.05–0.27
    Total Gray Matter (resid)0.20***0.19***0.23***0.21***
    Confidence Intervals0.07–0.320.06–0.310.11–0.340.10–0.32
    • Shaded cells indicate correlations that survive Bonferroni correction for the number of ROI and behavior correlations (0.05/12, p < 0.004); (resid) gray matter volume residualized for site, gender, age, and age2.

    • *p < 0.05, **p < 0.01, ***p < 0.001.

    • View popup
    Table 5.

    Cohen’s d effect sizes for the reading disability group comparisons with and without cases exhibiting evidence of OWL LD based on combined verbal comprehension and total gray matter volume values that were below the combined percentile cutoffs

    Left OFCLeft STSRight CrbH
    No cases removed (N=255)0.340.370.24
    Cases <15th/25th percentile removed (N=245)0.310.330.18
    Cases <25th percentile removed (N=243)0.280.290.16
    Cases <30th percentile removed (N=240)0.280.260.15
    Cases <37th percentile removed (N=234)0.280.270.12
    • The 15th/25th percentile thresholds for classification of OWL LD were used for verbal comprehension and total gray matter volume, respectively. These thresholds were chosen based on the size of group differences reported in the literature for those variables. Otherwise, the same percentile threshold was used for both variables. The Cohen’s d values were calculated based on the mean and SD of the ROI gray matter volumes for each reading disability group.

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Gray Matter Features of Reading Disability: A Combined Meta-Analytic and Direct Analysis Approach
Mark A. Eckert, Virginia W. Berninger, Kenneth I. Vaden Jr, Mulugeta Gebregziabher, Loretta Tsu
eNeuro 8 January 2016, 3 (1) ENEURO.0103-15.2015; DOI: 10.1523/ENEURO.0103-15.2015

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Gray Matter Features of Reading Disability: A Combined Meta-Analytic and Direct Analysis Approach
Mark A. Eckert, Virginia W. Berninger, Kenneth I. Vaden Jr, Mulugeta Gebregziabher, Loretta Tsu
eNeuro 8 January 2016, 3 (1) ENEURO.0103-15.2015; DOI: 10.1523/ENEURO.0103-15.2015
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Keywords

  • dyslexia
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