Dyslexia and Brain Connectivity: Insights from Periventricular Nodular Heterotopia

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One theory of dyslexia is that it stems from abnormal brain connectivity -- that faulty connections between different language areas result in reading difficulty. Now, some evidence from another condition offers some support for this theory.

Periventricular nodular heterotopia (PNH) is a neurological condition in which neurons don’t migrate to the correct location during brain development. Instead of moving to the cortex where they belong, neurons stay close to the ventricles, the fluid filled cavities in the center of the brain. The results in tiny nodules of gray matter along the ventricles, hence the name of the condition. People with PNH tend to suffer from adolescent onset epilepsy, although their intelligence and cognitive functioning is within the average range.



Bernard Chang and colleagues found that a strikingly large proportion of PNH patients had low scores on reading related tests, specifically reading fluency (timed reading) and rapid naming (remember the previous post on rapid naming?). In a smaller proportion of patients they also observed a deficit in processing speed.

In addition to behavioral measures, the authors also used diffusion tensor imaging to measure the integrity of the white matter tracts that link different brain regions. They found that white matter integrity in the PNH patients was correlated with reading fluency.

But wait, PNH has to do with nodules of gray matter near the ventricles. What does that have to do with white matter integrity? It turns out that these gray matter nodules are disrupting the nearby white tracts. Fiber tracts deviated around these nodules, and no fiber tracts projected into or from them.

There are certainly limitations to the conclusions we can draw from one study. The study is correlationial by nature, so it can’t prove whether the connectivity issues cause the reading difficulties. Also, it remains to be seen whether and how PNH patients differ from dyslexic people without PNH. But these are interesting findings. Yet another piece of the puzzle.


Chang, B., Katzir, T., Liu, T., Corriveau, K., Barzillai, M., Apse, K., Bodell, A., Hackney, D., Alsop, D., Wong, S., & Walsh, C. (2007). A structural basis for reading fluency: White matter defects in a genetic brain malformation Neurology, 69 (23), 2146-2154 DOI: 10.1212/01.wnl.0000286365.41070.54