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Volume 57, Number 1, July 10, 2001
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Neurology 2001;57:47-54
© 2001 American Academy of Neurology


Articles

Cortical localization of reading in normal children

An fMRI language study

W. D. Gaillard, MD;, M. Pugliese, PhD;, C. B. Grandin, MD;, S. H. Braniecki, MA;, P. Kondapaneni, BA;, K. Hunter, MD;, B. Xu, PhD;, J. R. Petrella, MD;, L. Balsamo, BA; and G. Basso, MD

From the Department of Neurology (Dr. Galliard, S. Braniecki, P. Kondapaneni, and L. Balsamo), Children’s National Medical Center, Washington, DC; Epilepsy Research Branch (Drs. Galliard, Pugliese, Grandin, Hunter, and Xu, and S. Braniecki, P. Kondapaneni, and L. Balsamo), Cognitive Neuroscience Section (Dr. Basso), Medical Neurology Branch, and Laboratory Radiology Research and Development (Dr. Petrella), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Department of Radiology (Dr. Grandin), St. Luc University Hospital, Université de Louvain, Belgium.

Address correspondence and reprint requests to Dr. W.D. Gaillard, Department of Neurology, Children’s National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010; e-mail: gaillardw{at}ninds.nih.gov

BACKGROUND: fMRI provides a noninvasive means of identifying the location and organization of neural networks that underlie cognitive functions.

OBJECTIVE: To identify, using fMRI, brain regions involved in processing written text in children.

METHODS: The authors studied nine normal right-handed native English-speaking children, aged 10.2 years (range 7.9 to 13.3 years), with two paradigms: reading Aesop’s Fables and "Read Response Naming" (reading a description of an object that was then silently named). Data were acquired using blood oxygen level-dependent fMRI. Group data were analyzed with statistical parametric mapping; individual data sets were analyzed with a region-of-interest approach from individual study t maps. The number of activated pixels was determined in brain regions and an asymmetry index (AI = [L - R]/[L + R]) calculated for each region.

RESULTS: The authors found strong activation in the left middle temporal gyrus and left midfrontal gyrus and variable activation in left inferior frontal gyrus for both reading tasks in the group analysis (z > 5.5 to 9.1). All subjects had strong left-sided lateralization for both tasks in middle/superior temporal gyrus, inferior frontal gyrus, and middle frontal gyrus (AI = 0.76 to 1.0 for t = 4). Reading Fables activated twice as many pixels in temporal cortex as the Read Response Naming task; activation in dorsolateral prefrontal cortex was similar for both tasks. Small homologous right middle temporal region activation was seen with reading a fable.

CONCLUSIONS: The neural networks that process reading appear to be lateralized and localized by middle to late childhood. Reading text paradigms may prove useful for identifying frontal and temporal language-processing areas and for determining language dominance in children experiencing epilepsy or undergoing tumor surgery.




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