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. 2022 Oct;28(5):419-431.
doi: 10.1080/13554794.2022.2145905. Epub 2022 Nov 30.

Visual and social differences in dyslexia: deep phenotyping of four cases with spared phonology

Eleanor R Palser  1   2 , Zachary A Miller  1   2 , Abigail E Licata  1   2 , Nicole A Yabut  1   2 , Swati P Sudarsan  1   2 , Boon Lead Tee  1   2 , Jessica A Deleon  1   2 , Maria Luisa Mandelli  1   2 , Eduardo Caverzasi  1   2 , Virginia E Sturm  1   2   3 , Robert Hendren  2   3 , Katherine L Possin  1 , Bruce L Miller  1 , Maria Luisa Gorno Tempini  1   2   3 , Christa Watson Pereira  1   2
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Visual and social differences in dyslexia: deep phenotyping of four cases with spared phonology

Eleanor R Palser et al. Neurocase. 2022 Oct.

Abstract

Diagnostic criteria for dyslexia describe specific reading difficulties, and single-deficit models, including the phonological deficit theory, have prevailed. Children seeking diagnosis, however, do not always show phonological deficits, and may present with strengths and challenges beyond reading. Through extensive neurological, neuropsychological, and academic evaluation, we describe four children with visuospatial, socio-emotional, and attention impairments and spared phonology, alongside long-standing reading difficulties. Diffusion tensor imaging revealed white matter alterations in inferior longitudinal, uncinate, and superior longitudinal fasciculi versus neurotypical children. Findings emphasize that difficulties may extend beyond reading in dyslexia and underscore the value of deep phenotyping in learning disabilities.

Keywords: Neurodevelopment; case series; comorbidity; reading; specific learning disability.

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Figures

Figure 1:
Figure 1:
Radar plot of key percentile scores across cognitive, language, and academic domains in the four cases of dyslexia.
Figure 2:
Figure 2:
The four atypical presentations of dyslexia showed significantly greater structural asymmetry in the inferior longitudinal fasciculus (ILF) relative to neurotypical controls. Groups were matched on age, sex, and handedness. Asterisk denotes significant difference relative to neurotypical controls at *p<.05.
Figure 3:
Figure 3:
The four atypical presentations of dyslexia showed significantly lower fractional anisotropy (FA) in the left uncinate fasciculus (B), and significantly greater FA bilaterally in the temporoparietal superior longitudinal fasciculus (SLF-TP) (C & D). Groups were matched on age, sex, and handedness. Asterisks denote significant differences relative to neurotypical controls at *p<.05; **p<.001.
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