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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 23:1678-1685, November-December 2002
© 2002 American Society of Neuroradiology

PEDIATRICS

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

Todd L. Richards^a,c, Virginia W. Berninger^d, Elizabeth H. Aylward^a, Anne L. Richards^a, Jennifer B. Thomson^d, William E. Nagy^e, Joanne F. Carlisle^f, Stephen R. Dager^a,b,c and Robert D. Abbott^d

^a Department of Radiology, University of Washington, Seattle
^b Department of Psychiatry and Behavioral Science, University of Washington, Seattle
^c Department of Bioengineering, University of Washington, Seattle
^d Department of Education, University of Washington, Seattle
^e the School of Education at Seattle Pacific University, Seattle, WA
^f the School of Education at the University of Michigan, Ann Arbor

Address reprint requests to Todd L. Richards, PhD, Radiology Department, Box 357115, University of Washington, Seattle, WA 98195-7155

BACKGROUND AND PURPOSE: 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.

CONCLUSION: 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.

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