None listed
Conditions
Brief summary
Study background: Research is now starting to make clear what is happening in the circuitry of the brain in Dyslexia. A number of research groups have shown that regions in posterior regions of the left hemisphere of the brain, where printed words are usually analysed and converted into speech sounds (phonemes), appear to be grossly underactive during the reading process. Dyslexic individuals also appear to over activate the posterior regions of the right hemisphere of the brain, regions more concerned with non-verbal processing. The evidence suggests that the brains of Dyslexic individuals compensate for difficulty with phoneme expression by over-recruitment of non-verbal pattern recognition to process the printed word. This would explain why the acquisition of reading skills in Dyslexia remains such an effortful and less fluid process. Study rationale: Neurotherapy holds promise as a different approach to the treatment of Dyslexia. In general, neurotherapy seeks to achieve its effects by improving brain function rather than use intensive training to compensate for underdeveloped brain functionality. Relevant to the findings reported above, Neurotherapy is expressly concerned with identifying and normalising relevant regions of the brain that are under or over active during psychological function. Numerous research studies have shown that Neurotherapy results in measurable and clinically significant improvements in psychological function, including attention, impulse control, mood, anxiety and learning and memory. There are good reasons to expect that the effectiveness of the approach will generalise to Dyslexia. However, research specifically addressing this question is still in its early stages. Aims of the project: The aim of the present study is to test the effectiveness of two forms of neurotherapy in treating dyslexia (DC-Stim and Neurofeedback), and in particular those dyslexic conditions specifically associated with phonological processing difficulties. It is hypothesised that neurotherapy will produce significant improvement in reading ability. In addition, it is predicted there will be normalisation in the pattern of brain electrical activity treated by neurotherapy.
Interventions
Eligible participants will be randomly allocated to one of three groups - Arm 1 (Waitlist control), Arm 2 (DC-Stim) or Arm 3 (Neurofeedback). Those in the Waitlist control group will also be randomly allocated to receive Neurofeedback or DC-Stim following the wait period.
Arm 1: waitlist control group
Arm 2 - DC-Stim group. This is a non-invasive and safe method of brain stimulation, also called transcranial direct current stimulation (tDCS), involving the application of a weak electrical cu
Eligible participants will be randomly allocated to one of three groups - Arm 1 (Waitlist control), Arm 2 (DC-Stim) or Arm 3 (Neurofeedback). Those in the Waitlist control group will also be randomly allocated to receive Neurofeedback or DC-Stim following the wait period. Arm 1: waitlist control group Arm 2 - DC-Stim group. This is a non-invasive and safe method of brain stimulation, also called transcranial direct current stimulation (tDCS), involving the application of a weak electrical current (less than 2mA overall and less than 0.07 ma per sq cm) to focal areas of the cortex via surface electrodes placed on the scalp. This intervention has been shown to modulate cortical excitability (i.e., the rate of spontaneous action potential firing) in the brain region under the electrode. Each member of this group will complete up to 20 sessions of DC-Stim therapy (up to 60 minutes per treatment session, 3 times per week) in which one or a number of the cortical regions identified as functionally abnormal during QEEG pre-assessment will be targeted. During DC-Stim treatment, which is a passive activity, the participant is kept occupied with computer based exercises. QEEG pre-assessment identifies the spatial coordinates of the cortical locations of potential target regions based on the Montreal Neurological Institute reference brain using the LORETA software program. The final selection of region(s) for neurotherapy will be based on clinical judgment by Professor Clark and Dr Hill, drawing on their knowledge of the dyslexia literature, including its known functional anatomy based on the presentation of their QEEG mapping. Arm 3- Neurofeedback Group. During Neurofeedback training, subjects will complete computer exercises. In preparation, sensors are placed on the scalp to detect, amplify and record brain activity identified during assessment as dysregulated. The brain regions’ electrical activity (or brainwaves) is measured by the computer software. The computer then gives positive video and audio feedback (games and imagery) when the activation level is within the desired range. The reinforcement parameters are controlled by the therapist, who monitors the corresponding real-time measures of brain activity. Each member of this group will complete up to 20 sessions of Neurofeedback therapy (up to 60 minutes per session, 3 times per week) in which one or a number of the cortical regions identified as functionally abnormal during QEEG assessment will be targeted. QEEG pre-assessment is able to identify the spatial coordinates of the cortical locations of potential target regions based on the Montreal Neurological Institute reference brain using the LORETA software program. The final selection of region(s) will be based on clinical judgment by Professor Clark and Dr Hill, drawing on their knowledge of the dyslexia literature, including its known functional anatomy.
Sponsors
Flinders University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
7 Years to 15 Years
Healthy volunteers
No
Inclusion criteria
First language – English Discrepancy criteria – Reading ability must be significantly lower than expected based on IQ (i.e.>1 SD difference) Age range: 7 – 15 years Remedial reading instruction
Exclusion criteria
Deficits in hearing or visual acuity Oral language impairment IQ < 80 Motor impairment Personal history of neurological, psychiatric or specified psychological impairment (e.g. epilepsy, traumatic brain injury, chronic ill health) Psychoactive medication
Outcome results
None listed