Top-down processes during auditory phoneme categorization in dyslexia: a PET study.

While persistence of subtle phonological deficits in dyslexic adults is well documented, deficit of categorical perception of phonemes has received little attention so far. We studied learning of phoneme categorization during an activation H(2)O(15) PET experiment in 14 dyslexic adults and 16 normal readers with similar age, handedness and performance IQ. Dyslexic subjects exhibited typical, marked impairments in reading and phoneme awareness tasks. During the PET experiment, subjects performed a discrimination task involving sine wave analogues of speech first presented as pairs of electronic sounds and, after debriefing, as syllables /ba/ and /da/. Discrimination performance and brain activation were compared between the acoustic mode and the speech mode of the task which involved physically identical stimuli; signal changes in the speech mode relative to the acoustic mode revealed the neural counterparts of phonological top-down processes that are engaged after debriefing. Although dyslexic subjects showed good abilities to learn discriminating speech sounds, their performance remained lower than those of normal readers on the discrimination task over the whole experiment. Activation observed in the speech mode in normal readers showed a strongly left-lateralized pattern involving the superior temporal, inferior parietal and inferior lateral frontal cortex. Frontal and parietal subparts of these left-sided regions were significantly more activated in the control group than in the dyslexic group. Activations in the right frontal cortex were larger in the dyslexic group than in the control group for both speech and acoustic modes relative to rest. Dyslexic subjects showed an unexpected large deactivation in the medial occipital cortex for the acoustic mode that may reflect increased effortful attention to auditory stimuli.