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Short Communication NEUROMETRICS DOES NOT 426 Electr~nceFhalograFh~and clinical Neurophysiologv, 1986; 63: 426-430 NEUROMETRICS AND DJ Elsevier Scientific Publishers Ireland. Ltd. control group of 57 normal re Short communication old at the time of this study. ing criteria designed 10 emu between the two groups, U NEUROMETRICS DOES NOT DETECT ‘PURE’ DYSLEXICS psychological conditions whit ings unrelated to dyslexia p C.D. YINGLING *, D. GALIN *, G. FEIN *.**, D. PELTZMAN and L. DAVENPORT * for our control group were * University of California, Sun Francisco, CA 94143, and ** San Francisco VA Medical Center. Sun Francisco, CA 94121 (V.S.A.) scribed by John et al. (198 more severely disabled than I below). Our sample is ti (Accepted for publication: November 26. 1985) (see assess the validity of the ne brain dysfunctions specificd ties. We were able to remnt Summary Thirty-eight severely dyslexic boys and 38 good readers were evaluated with neurometrics, a diagnostic prowdurr after their original testing, based on the application of numerical taxonomy to EEG spectra obtained during resting conditions, supplemented by selected e\<rhrd 69% of the original group, r€ potential features. This procedure generates deviance scores for the EEG spectra by comparing each individual’s values to :hose study. obtained from a normative population and has been reported to discriminate learning disabled children from normal controls (.Aim ei All subjects were Cauc al. 1980). boys. An extensive history In the present study, all subjects, dyslexic and control, passed stringent screening to assure normal intellectual, neurolrycnl. pregnancy and perinatal c sensory and emotional status. The false positive rate obtained in our control group was comparable to that reported earlier. Hotuaer. academic problems. Childrc none of the deviance scores significantly discriminated dyslexics from controls; most subjects from both groups were classified 3s [ems, hyperactivity, or birth normal. Severe dyslexia per se is thus not associated with the specific neurometric abnormalities reported previously in :iiore 5creening was carried out bi heterogeneous learning disabled populations. Touwen and Prechtl (1970 inuscle strength and symt Keywords: dyslexia - EEG - neurometrics cia1 reflexes, 5 categories of Jssociated movements, abn perceptual-motor perform: touch, two-point localizat In 1977. John et al. described the neurometrics procedure. U.S., and 2% in normals from Barbados. The neuroh.gical imitation of gestures. EXC~ an application of principles of numerical taxonomy to the group showed a 48% rate of abnormalities (‘true posiri\cs’). ties in three or more motc analysis of electroencephalogram (EEG) and evoked potential while the two LD groups produced positive rates of 46. dnd of disability in the senst (EP) data. The essential features of this method are: (I) a 47%. respectively. Although lower than the original est) nilteh major neurologic signs, SL standardized protocol for data collection: (2) objective extrac- (John et al. 1977). these detection rates, combined with thr. IOU dination or seizures, was in tion of quantitative features; (3) a large normative data base false positive rate. still suggested that quantitative EEG acuity, refraction, accomi against which individual cases can be compared: (4) computa- abnormalities might be associated with both neuro1ogic.J dis- function examinations we: tion of a deviance measure for each feature based upon the orders and learning disabilities in a substantial proport,\m of cally normal hearing and ’ degree to which that feature differs from age-adjusted norms; cases. However, the clinical significance of such findingy dr- All subjects had WI! and (5) computation of an overall deviance measure based on pends on whether neurometric abnormalities can be sh, to mn differences between verba the number of deviant features exhibited for each individual. be associated with learning disabilities per se, or whethcr the! points. Groups were def The underlying assumption is that, provided appropriate ana- are secondary to other, coexisting neurological deficii\ We reading age)/(chronolo@ lytical methods were employed. disorders of brain function have addressed this issue by using the same procedurz, em- were based on the total S( which presumably underlie cognitive deficits can be detected in ployed by John et al. to evaluate a highly screened gr<.up of test and on the Gray Oral the EEG and EPs. In the initial report John et al. (1977) stated dyslexic boys, and a carefully matched control group. 111 of on the WISC-R. All dysll that ‘neurometric EEG measures . .. discriminated between whom were free of overt neurological dysfunction. Q.2 now both oral and silent read normal and LD children better ... than psychometric mea- report that this method does not detect significant abnmnali- were over 0.93, and thei sures.’ and were in addition culture-free and thus less biased. In ties in severely dyslexic boys who have no other clinicd find- actual grade level, or hi1 contrast to traditional visual inspection of clinical EEGs or ings. simple spectral analysis, this numerical taxonomy approach although having equivalc might provide more sensitive, objective indicators of subtle widely divergent in readi brain dysfunctions such as learning disabilities (LD) or de- screening, when the suk mentia. and thus extend the utility of clinical neurophysiology Methods control subjects averagec in diagnosis of disorders with primarily cognitive symptoms. and oral reading; dyslexi reading and at the 2.0 Subsequent reports (Ahn et al. 1980; John et al. 1980) Subjects retested 1-3 years later 1 described in more detail the application of the procedure to (a) Specific developmental dyslexia is a learning disabil,tk t\.Pl- of 13.3 years. Control I two groups of normal children, (b) one group considered to be cally defined as failure to acquire normal reading slulk JrspJe dent and 10.6 for oral at risk for neurological disorders, and (c) two groups with average or hgher IQ. intact sensory function. and con\~nrional learning disabilities. Very low false positive rates of neuromet- instruction (Cntchley 1970). Our sample, under stud\ since and 3.3 (oral). Differenc cant at iO.OOO1. ric abnormalities were found: 4% in normal children from the 1979. consists of a group of 56 severely dyslexlc bob. and a P 0013-4649/86/%03.50 6 1986 Elsevier Scientific Publishers Ireland, Ltd. vEUROMETRICS AND DYSLEXIA 421 mntrol group of 57 normal readers, all between 10 and 16 years Procedures dd at the time of this study. All subjects met rigorous screen- All data were acquired with a Model NM-1OlA data ing criteria designed to ensure no overlap in reading abilities acquisition unit made available to the project by Neurometrics, hetween the two groups, and no coexisting neurological or Inc., New York, who further agreed to analyze the records psychological conditions which might cause physiological find- blind. The data acquisition unit conntrolled delivery of stimuli ,figs unrelated to dyslexia per se. Academic screening criteria and digitized 20 channels of data, which were stored on floppy for our control group were roughly equivalent to those de- disks. The bandpass of the amplifiers was 1.9-29.0 c/sec at 3 gibed by John et al. (1980). while our dyslexic group was dB down with a 60 c/sm 45 dB notch filter. Standard EEG more severely disabled than those in the Ahn et al. (1980) study electrodes were attached at all 19 locations of the International below). Our sample is thus an ideal test set with which to 10-20 system referenced to linked ears, and the 20th channel assess the validity of the neurometrics procedure in detecting was used to record EOG. brain dysfunctions specifically associated with learning disabili- A standardized protocol developed by Neurometrics. Inc. lies. VI e were able to recontact most of the subjects, 1-3 years was followed throughout. The system was first calibrated for . a diagnostic procedurr after their original testing, and 40 controls and 38 dyslexics, artifact rejection based on each subject's characteristic EEG. ented by selected e\,,k& 69% of the original group, returned to participate in the present An artifact-free segment of eyes closed EEG was defined for ividual's values to tho% stud! each subject on the basis of predetermined criteria, such as normal controls (Ahn et Ail subjects were Caucasian, right-handed. middle class peak EOG values of less than SO pV and greater alpha power in boys An extensive history was taken from parents, including posterior than anterior leads. Subsequently, epochs in which ntellectual, neurological. pregnancy and perinatal complications, medical, social and the values exceeded those in the calibration segment by a ported earlier. Honcicr, academic problems. Children with histories of emotional prob- predetermined amount were automatically excluded. All experi- pups were classifled ar lems. hyperactivity, or birth stress were excluded. Neurological mental runs continued until 60 sec of artifact-free EEG (or 50 rted previously in niore screcning was carried out based on the examination methods of single trials for evoked potentials) had'been obtained; thus. the Touwen and Prechtl (1970) including cranial nerve functions, runs were of varying length depending on the amount of rnusde strength and symmetry, muscle stretch reflexes, superfi- artifact. Further artifact rejection was carried out by off-line cial reflexes, 5 categories of motor functioning (balance, tremor, programs. associated movements, abnormal movements, sequencing), and After artifact calibration, data were collected in a number perLeptual-motor performance including double simultaneous of standard conditions. always in the same order: eyes closed bados. The neurologicai tow h. two-point localization on fingers, graphesthesia, and EEG, 3 visual evoked potential conditions. and 2 auditory EP alities ('true positive.'), imilation of gestures. Exclusion criteria were moderate disabili- conditions. The 3 visual EP conditions were blank flash, coarse xitive rates of 46% and tie. in three or more-motor categories, or a consistent pattern checkerboard pattern onset, and fine checkerboard pattern n the original estirnare, 01 disability in the sensory-perceptual area.
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