A tractography study in dyslexia: neuroanatomic correlates of orthographic, phonological and speech processing.

Diffusion tensor imaging tractography is a structural magnetic resonance imaging technique allowing reconstruction and assessment of the integrity of three dimensional white matter tracts, as indexed by their fractional anisotropy. It is assumed that the left arcuate fasciculus plays a crucial role for reading development, as it connects two regions of the reading network, the left temporoparietal region and the left inferior frontal gyrus, for which atypical functional activation and lower fractional anisotropy values have been reported in dyslexic readers. In addition, we explored the potential role of the left inferior fronto-occipital fasciculus, which might connect a third region of the reading network, the left ventral occipitotemporal region with the left inferior frontal gyrus. In the present study, 20 adults with dyslexia and 20 typical reading adults were scanned using diffusion tensor imaging, and the bilateral arcuate fasciculus and the left inferior fronto-occipital fasciculus were delineated. Group comparisons show a significantly reduced fractional anisotropy in the left arcuate fasciculus of adults with dyslexia, in particular in the segment that directly connects posterior temporal and frontal areas. This fractional anisotropy reduction might reflect a lower degree of myelination in the dyslexic sample, as it co-occurred with a group difference in radial diffusivity. In contrast, no significant group differences in fractional anisotropy were found in the right arcuate fasciculus or in the left inferior fronto-occipital fasciculus. Correlational analyses (controlled for reading status) demonstrated a specific relation between performance on phoneme awareness and speech perception and the integrity of left arcuate fasciculus as indexed by fractional anisotropy, and between orthographic processing and fractional anisotropy values in left inferior fronto-occipital fasciculus. The present study reveals structural anomalies in the left arcuate fasciculus in adults with dyslexia. This finding corroborates current hypotheses of dyslexia as a disorder of network connections. In addition, our study demonstrates a correlational double dissociation, which might reflect neuroanatomical correlates of the dual route reading model: the left arcuate fasciculus seems to sustain the dorsal phonological route underlying grapheme-phoneme decoding, while the left inferior fronto-occipital fasciculus seems to sustain the ventral orthographic route underlying reading by direct word access.