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Learning Disability

Learning Disability: Pathogenesis and clinical findings Authors: Erin Brintnell Reviewers: Annie Pham Michelle Chen Dr. Jean Mah* * MD at time of publication Genetics (largest impact) E.g. Changes to neuronal migration genes (DCDC2 & ROBO1) in dyslexia Co-morbid neurodevelopmental disorder, especially ADHD Difficulty concentrating impedes learning Home environment ↓ Reading at home, ↓ parental education, socio-economic status Acquired (brain injury) Learning Disability Persistent impairment in reading (dyslexia), writing (dysgraphia) and/or arithmetic (dyscalculia) beyond what is expected for age Differences in brain activation during learning Dyslexia Dysgraphia Dyscalculia ↓ Activation of left temporal parietal cortex (sounding words out) ↓ White matter connections between brain regions important for reading ↓ Activation of visual-word form area (representing sounds as symbols) ↑ Activation of Broca’s area (spoken word) ↓ Letter & sound recall Difficulty sounding out words Poor spelling Difficulty naming objects Difficulty identifying words ↑ Sounding-out in later reading Cerebellar activation differences Cortical & subcortical damage to functional language regions Anterior thalamic radiation differences (executive functioning) Cingulum differences (cognitive control) Illegible & very slow writing Poor spelling & writing fatigue ↓ White matter in inferior longitudinal fasciculus (object recognition) ↓ Gray matter in inferior parietal lobe (understanding numbers & quantities) ↓ Gray matter in bilateral supramarginal gyri (retrieving arithmetic facts) ↓ White matter in fronto- occipital fasciculus & anterior thalamic radiation (goal-oriented behavior & executive functioning) Difficulty recognizing patterns & numbers Difficulty with basic arithmetic Difficulty with mathematic operations Difficulty with number processing Work-avoidance ↓ Self-esteem Difficulty forming relationships Depression Impulsivity Opposition to authority Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Nov 11, 2024 on www.thecalgaryguide.com