Clinical Evidence of the Role of the Cerebellum in the Suppression of Overt Articulatory Movements During Reading. A Study of Reading in Children and Adolescents Treated for Cerebellar Pilocytic Astrocytoma

Abstract

It has been suggested that the cerebellum is involved in reading acquisition and in particular in the progression from automatic grapheme-phoneme conversion to the internalization of speech required for silent reading. This idea is in line with clinical and neuroimaging data showing a cerebellar role in subvocal rehearsal for printed verbalizable material and with computational "internal models" of the cerebellum suggesting its role in inner speech (i.e. covert speech without mouthing the words). However, studies examining a possible cerebellar role in the suppression of articulatory movements during silent reading acquisition in children are lacking. Here, we report clinical evidence that the cerebellum plays a part in this transition. Reading performances were compared between a group of 17 paediatric patients treated for benign cerebellar tumours and a group of controls matched for age, gender, and parental socio-educational level. The patients scored significantly lower on all reading, but the most striking difference concerned silent reading, perfectly acquired by almost all controls, contrasting with 41 % of the patients who were unable to read any item silently. Silent reading was correlated with the Working Memory Index. The present findings converge with previous reports on an implication of the cerebellum in inner speech and in the automatization of reading. This cerebellar implication is probably not specific to reading, as it also seems to affect non-reading tasks such as counting.

Adaptive behavior impaired in children with low‐grade glioma

“…More specifically, the results indicate trends toward less adequate receptive and writing skills. These impairments have been described earlier in children with LGG after surgery, with an important role of the cerebellum involving inner speech and automatization of reading . School‐based interventions considering language comprehension and writing may be most appropriate.…”

Patients with focal cerebellar lesions show reduced auditory cortex activation during silent reading

“…Notably, a recent study employing formalized reading tests in a larger group of patients with cerebellar tumor resections (N = 21) observed significantly reduced reading accuracy, reading speed, reading comprehension and silent reading in patients relative to controls (Ait Khelifa-Gallois et al, 2015). In line with these findings, the individual scores on the CWIT-reading subtest showed slowed reading in four of the patients in the current sample (reading latencies > 2 SD slower than the control group mean).…”

“…A second hypothesis, one that is not incompatible with the mapping hypothesis, is that the cerebellum is involved in the generation and modulation of inner speech (Ait Khelifa-Gallois et al, 2015). Activations of auditory cortex during silent reading are often interpreted as reflecting inner speech (Perrone-Bertolotti et al, 2014).…”

“…These deficits could arise from disruption of inner speech (Ackermann, Mathiak, & Ivry, 2004); for example, it may make it be difficult to maintain the contents of working memory. Clinical evidence has supported a relationship between inner speech impairments and reduced working memory capacity in patients with cerebellar tumor resections (Ait Khelifa-Gallois et al, 2015). It should be noted that inner speech typically also activates an inferior frontal region associated with subarticulation and supramarginal gyri (Perrone-Bertolotti et al, 2014; Price, 2012), and is negatively affected by lesions to these areas (Geva et al, 2011).…”

Communication and swallowing outcomes of children diagnosed with childhood brain tumor or leukemia: A systematic review

“…22,36 Language difficulties ranging in severity and impact were reported in children with CBTL, including problems with general language (eg, vocabulary, syntax), [22][23][24][25][26][34][35][36][54][55][56][57]62,65,68,[73][74][75][76][77] . 23,25,26,76,77,79,80 Literacy skills including preliteracy, reading, writing, and spelling were also identified as areas of weakness in several studies, 23,27,29,35,65,79,81 although one study showed intact reading decoding for children receiving treatment for brain tumor. 82 A number of studies on language outcomes included betweengroup comparisons with a typically developing control group and found no statistically significant differences between groups on some or all measures.…”