[Vaccination of newborns with high risk of tuberculosis in a French maternity hospital]. / Vaccination des nouveau-nés à risque élevé de tuberculose dans une maternité française.

BACKGROUND: The early vaccination with BCG of children with a high risk of tuberculosis straight from the maternity hospital has been recommended since October 2005. However, this recommendation has not often been followed. Practitioners feared that the suspension of the mandatory character of the BCG vaccine dating from July 2007 would result in a decrease in vaccine coverage. The goal of this study was to assess a program for early vaccination with BCG in the maternity hospital for high-risk children. METHODS: Intradermal vaccination with BCG-SSI of high-risk newborns, as defined by the Conseil Supérieur d'Hygiène Publique de France, at the maternity hospital of Versailles from May 2007 to May 2008. RESULTS: Six hundred and sixty children (35% of births with a sex ratio of 1.13) fulfilled criteria for vaccination in the maternity hospital. Among the high-risk newborns, 596 (89%), were vaccinated. The geographic origin of one or both parents was the main indication (98.6%) for the vaccination. Three main practitioners (two pediatricians and one nurse) performed 72.6% of the BCG intradermal injections. The other BCG vaccinations were given by occasional practitioners: pediatricians, a midwife, or medical students. A papule was subsequently observed more often when the practitioner was experienced: 96.8% for the main practitioners, 83.5% for the occasional practitioners. Fifty-six (8.3%) parents refused vaccination for their eligible newborn. CONCLUSION: From our experience, the early vaccination of the at-risk of tuberculosis newborn is well accepted in the maternity hospital and presents very few technical problems for an experienced team.

[Proprioception changes induced by prismatic glasses wear in children suffering from developmental dyslexia]. / Etude de l'impact du contrôle postural associé au port de verres prismatiques dans la réduction des troubles cognitifs chez le dyslexique de développement.

PURPOSE: To evaluate the consequences of proprioception changes induced by a postural treatment on cognitive disturbances in children suffering from developmental dyslexia. MATERIAL: and methods: Twenty male dyslexic children were treated with prisms within their spectacles and a postural treatment. A control group of dyslexics (n=13) only received spectacles without prisms. All participants were evaluated at the beginning of the study and 6 months later with reading impairment tests and postural examinations. RESULTS: Mean age was 11 years and 5 months in the treated group and 11 years and 7 months in the control group. Four children were excluded from the 6-month analysis because of poor compliance. All dyslexic children presented with a postural deficiency syndrome. In 13 out of 16 treated children, dyslexia was improved at 6 months, especially for the global leximetric test and the reading of regular and irregular words. However, the treatment did not allow a complete recovery of reading ability when compared with age-matched individuals. CONCLUSION: Our results show that postural modifications may favorably influence some clinical signs associated with developmental dyslexia. Further studies with a larger sample and with a longer follow-up period are required to better assess the role of postural treatment in developmental dyslexia.

[Ocular proprioception and developmental dyslexia. Sixty clinical observations]. / Proprioception oculaire et dyslexie de développement. A propos de 60 observations cliniques.

PURPOSE: The objective of this study is to assess proprioception anomalies in postural deficiency syndrome in a group of children suffering from reading impairment. MATERIAL AND METHODS: Sixty male patients with an average age of 11 years and 9 months were included in the study. Initially, they were given a standardized neuropsychological examination, which confirmed the diagnosis of reading impairment. Then after filling out a questionnaire seeking a proprioceptive anomaly, the patients were subjected to a clinical ocular and postural examination consisting of nine precisely described steps. RESULTS: All of the patients recruited for the study presented clinical signs confirming a proprioception disorder found as a part of postural deficiency syndrome. CONCLUSION: This study opens a new direction for research concerning the origin and treatment of at least some reading-impaired children.

Gray matter alteration in dyslexia: converging evidence from volumetric and voxel-by-voxel MRI analyses.

Affecting up to 4-10% of the population, dyslexia is a highly prevalent, childhood onset developmental disorder adversely influencing multiple domains of adaptive functioning throughout the lifespan. The present brain imaging study was conducted in order to investigate the neuroanatomical correlates of developmental dyslexia. The MRI brain scans of 10 males with dyslexia and 14 matched controls were analyzed with (1) a classical volumetric method measuring gray and white matter lobar volumes and (2) a voxel-by-voxel method. The voxel-by-voxel method identifies changes in tissue density and localizes morphologic alterations without limiting the analyses to predefined regions. Subsequent correlations between gray matter density and neuropsychological performance on specific phonological processing tasks (rhyme judgment) were conducted. Volumetric analyses revealed significantly reduced gray matter volumes in both temporal lobes in dyslexic individuals. The voxel-by-voxel analyses further localized changes to the left temporal lobe, revealing reduced gray matter density in the middle and inferior temporal gyri. Conversely, increased gray matter density was found in the precentral gyri bilaterally. As a combined group, the dyslexic and control subjects demonstrated positive correlations between performance on the rhyme judgment tasks and gray matter density in the middle and inferior frontal gyri, and the middle temporal gyri bilaterally. The current study indicates that dyslexia is associated with a structural gray matter deficit involving a complex fronto-temporal network implicated in phonological processing.

Developmental dyslexia: re-evaluation of the corpus callosum in male adults.

Using a new method based upon the measurement of four angles, we analyzed the corpus callosum of 23 adult male dyslexics and 25 age-matched controls on MRI sagittal scans. Two out of the four angles measured showed significant differences between the groups that are consistent with previous findings concerning the size of the corpus callosum in dyslexics. In particular, posterior regions are concerned, displaying a lowered corpus callosum in dyslexics. These findings are discussed in relation to cortical parietal asymmetries and possible hormonal events, referring to the testosterone hypothesis, that could occur in utero or in the perinatal period in the dyslexic population.

Developmental dyslexia: atypical cortical asymmetries and functional significance.

Using brain magnetic resonance imaging, we measured in 16 young developmental dyslexic adults and 14 age-matched controls cortical asymmetries of posterior language-related areas, including Planum temporale and parietal operculum cortical ribbon, and of the inferior frontal region related in the left hemisphere to speech processing. In addition, we assessed the sulcal morphology of the inferior frontal gyrus in both groups according to a qualitative method. The dyslexic subjects also performed specific tasks exploring different aspects of phonological and lexical-semantic processes. Results showed that: (1) contrary to most results reported in the literature, there is a lack of any morphological difference relative to Planum temporale asymmetry between the two groups; (2) there are significant differences between dyslexic and control subjects relative to frontal areas; (3) concerning the parietal region, there is a more asymmetrical pattern towards the left side in dyslexic subjects than in controls; and (4) relations in dyslexic subjects between parietal asymmetry coefficient and the level of performance in a phonological task have a particular reliance on verbal short-term memory, frontal asymmetry and performance in a non-word reading task. Considering these results it is suggested that phonological segmentation skills may relate to frontal lobe morphology, while phonological memory-based impairment in people with dyslexia may rather relate to parietal lobe morphology.

Abnormal callosal morphology in male adult dyslexics: relationships to handedness and phonological abilities.

The classical notion that developmental dyslexia may somehow relate to impaired communication between hemispheres has not yet received convincing support. Sixteen dyslexic adults and 12 controls received a high resolution brain MRI scan for morphometric study of the corpus callosum. Automatized measurements of callosal area and calculation of indices defining the general morphology of the callosal mid-surface were performed. Each participant received global intelligence and reading achievement evaluation; dyslexics were further proposed specific neuropsychological tests specially designed to explore the mechanisms of reading impairment. It just appears from the group comparisons (1) that the dyslexics' corpus callosum displays a more circular and evenly thicker general shape, and (2) that the midsagittal surface is on the average larger than in controls, in particular in the isthmus. Moreover, the different morphometric characteristics of the dyslexic brain correlated with the degree of impairment on various tests exploring phonological abilities. In vivo morphometry of the corpus callosum may provide valuable hints for understanding developmental learning disorders and their consequences in adults.

The time-course of metaphor comprehension: an event-related potential study.

ERPs were recorded while subjects were reading short familiar metaphors (e.g., Those fighters are lions), unfamiliar metaphors (Those apprentices are lions), or literal control sentences (Those animals are lions) presented in isolation or preceded by either an irrelevant or relevant context (e.g., They are not idiotic: ...." vs. "They are not cowardly: Those fighters are lions"). The terminal word of metaphors elicited larger N400 components than did the terminal word of literal sentences (Experiment 1) suggesting that the (incongruous) literal meaning of metaphors was indeed accessed at some point during comprehension. The analysis of the 600-1000 and 1000-1400 latency bands (Late Positive Components) revealed no significant difference between metaphors and literal sentences. The manipulation of metaphor difficulty (Experiments 2 and 3) also failed to reveal any late effect specifically linked to metaphorical processing. Finally, an effect of the preceding sentence context was found in Experiments 3 and 4, as early as 300 ms following the terminal word onset. Overall, these results support a context-dependent account of metaphor comprehension stating that when contextually relevant, the metaphorical meaning is the only one accessed.

Diverging asymmetries of temporo-parietal cortical areas: a reappraisal of Geschwind/Galaburda theory.

The general theory on the biological foundations of cerebral dominance formulated in 1985 by Geschwind and Galaburda entirely relies on a postulated causal relationship between anatomical asymmetry of the planum temporale and functional lateralization of the human brain, but does not take into account asymmetry of another cortical region, the parietal operculum. In 40 normal volunteers whose handedness was specified by the Edinburgh Handedness Inventory, we assessed asymmetries of these two regions on MRI sagittal scans. For both measurements, a significantly larger leftward asymmetry was found in the 24 consistent right-handers compared to the 16 non-right-handers. Moreover, the combination, for each subject, of the two indices of asymmetry, yielded four different subtypes between which handedness distribution significantly differed. We conclude that planum temporale and parietal operculum asymmetries may be divergent and that their convergence is strongly associated with right-handedness. Functional and developmental implications of these findings are discussed by reference to the Geschwind/Galaburda theory.