Brain mechanisms for reading and language processing in spina bifida meningomyelocele: a combined magnetic source- and structural magnetic resonance imaging study.

Simos PG, Papanicolaou AC, Castillo EM, Juranek J, Cirino PT, Rezaie R, Fletcher JM. (2011) Brain mechanisms for reading and language processing in spina bifida meningomyelocele: a combined magnetic source- and structural magnetic resonance imaging study. Neuropsychology. 2011 Sep;25(5):590-601.


OBJECTIVE:
The development of the ability to process spoken and written language depends upon a network of left hemisphere temporal, parietal, and frontal regions. The present study explored features of brain organization in children with spina bifida meningomyelocele (SBM) and shunted hydrocephalus, who commonly present with precocious development of word reading skills and preservation of vocabulary and grammar skills.

METHOD:
Eight children with SBM were compared with 15 IQ and reading-level matched, typically developing controls on MRI-based morphometric and Magnetic Source Imaging-derived neurophysiological profiles.

RESULTS:
Children with SBM showed reduced magnetic activity in left inferior parietal regions during spoken word recognition and pseudoword reading tasks. We also noted reduced surface area/volume in inferior parietal and posterior temporal regions in SBM and increased gray matter volumes in left middle frontal regions and gyral complexity in left posterior temporal and inferior parietal regions.

CONCLUSIONS:
A complex pattern of changes in cortical morphology and activation may serve as evidence for structural and functional brain reorganization ensuring preservation of language and decoding abilities in children with SBM.

PMID: 21574714

Children with cerebral palsy, spina bifida and pragmatic language impairment: Differences and similarities in pragmatic ability.

Holck P, Nettelbladt U, Sandberg AD. Children with cerebral palsy, spina bifida and pragmatic language impairment: Differences and similarities in pragmatic ability.
Research in Developmental Disabilities. 2009 Feb 25.

Pragmatically related abilities were studied in three clinical groups
of children from 5 to 11 years of age; children with cerebral palsy
(CP; n = 10), children with spina bifida and hydrocephalus (SBH;
n = 10) and children with pragmatic language impairment (PLI;
n = 10), in order to explore pragmatic abilities within each group. A
range of pragmatic, linguistic and cognitive assessments were
performed, and comparisons between the groups were made. In
addition, connections between variables were studied. The most
salient result was the many similarities and the lack of clear
boundaries between the groups. The only significant differences
found concerned short-term memory and inference ability, where
all three groups experienced problems but to varying extent.
Different patterns of variance were found in the groups, indicating
that different underlying abilities such as reception of grammar,
inferential comprehension and lexical comprehension seem to
affect pragmatic ability in somewhat different ways. The results
suggest that the children with CP and SBH in this study shared a
number of pragmatically related traits, being more similar than
would be expected according to earlier research. Finally, it is
suggested that pragmatic assessment is further subdivided into a
socially versus a linguistically related assessment.

PMID: 19249190

Language development in children with spina bifida

Fletcher JM, Barnes M, Dennis M. Language development in children with spina bifida. Seminars in Pediatric Neurology. 2002 Sep;9(3):201-8. Review.

Spina bifida meningomyelocele (SBM) is the most common severely disabling birth defect in North America. It is a disorder of the central nervous system that includes, in addition to the defining spinal dysraphism, congenital malformations of the cerebellum and corpus callosum that, along with hydrocephalus, produces a range of cognitive and motor difficulties, including language. In the language domain, many children with SBM demonstrate adequate development of language at the level of form and content (grammar and lexicon). However, most children with SBM experience significant difficulties in the construction of meaning and in pragmatic communication, both of which require flexible language processing in real time. Assessment and intervention should specifically attend to the development of meaning construction and semantic-pragmatic communication.

PMID: 12350041

Idiom comprehension deficits in relation to corpus callosum agenesis and hypoplasia in children with spina bifida meningomyelocele.

Huber-Okrainec J, Blaser SE, Dennis M. Idiom comprehension deficits in relation to corpus callosum agenesis and hypoplasia in children with spina bifida meningomyelocele. Brain & Language. 2005 Jun;93(3):349-68. Epub 2005 Jan 28.

Idioms are phrases with figurative meanings that are not directly derived from the literal meanings of the words in the phrase. Idiom comprehension varies with: literality, whether the idiom is literally plausible; compositionality, whether individual words contribute to a figurative meaning; and contextual bias. We studied idiom comprehension in children with spina bifida meningomyelocele (SBM), a neurodevelopmental disorder associated with problems in discourse comprehension and agenesis and hypoplasia of the corpus callosum. Compared to age peers, children with SBM understood decomposable idioms (which are processed more like literal language) but not non-decomposable idioms (which require contextual analyses for acquisition). The impairment in non-decomposable idioms was related to congenital agenesis of the corpus callosum, which suggests that the consequences of impaired interhemispheric communication, whether congenital or acquired in adulthood, are borne more by configurational than by compositional language.

PMID: 15862859