Cognitive tutoring induces widespread neuroplasticity and remediates brain function in children with mathematical learning disabilities.

Teresa Iuculano,Vinod Menon,Kaustubh Supekar,Miriam Rosenberg-Lee,Jennifer Richardson,Caitlin Tenison,Lynn Fuchs

doi:10.1038/ncomms9453

Abstract

Competency with numbers is essential in today's society; yet, up to 20% of children exhibit moderate to severe mathematical learning disabilities (MLD). Behavioural intervention can be effective, but the neurobiological mechanisms underlying successful intervention are unknown. Here we demonstrate that eight weeks of 1:1 cognitive tutoring not only remediates poor performance in children with MLD, but also induces widespread changes in brain activity. Neuroplasticity manifests as normalization of aberrant functional responses in a distributed network of parietal, prefrontal and ventral temporal–occipital areas that support successful numerical problem solving, and is correlated with performance gains. Remarkably, machine learning algorithms show that brain activity patterns in children with MLD are significantly discriminable from neurotypical peers before, but not after, tutoring, suggesting that behavioural gains are not due to compensatory mechanisms. Our study identifies functional brain mechanisms underlying effective intervention in children with MLD and provides novel metrics for assessing response to intervention.

Highlights

The extent to which effective behavioral intervention can alter aberrant activations in distributed brain systems is currently unknown. It is not known whether successful behavioural interventions can effectively normalize activity in the same systems that show aberrant functional responses in mathematical learning disabilities (MLD), or whether children with MLD recruit atypical neural resources to achieve the same level of performance as typically developing (TD) children
Prominent differences in brain activation between MLD and TD groups in prefrontal, parietal, ventral temporal–occipital cortices that were evident before tutoring, were entirely absent after tutoring (Fig. 2)
Tutoring resulted in significant reductions of widespread overactivation in multiple neurocognitive systems important for numerical problem solving (Fig. 3)[6,22,23,24,42], and machine-learning algorithms revealed that brain activity patterns in MLD learners were no longer discriminable from those of their peers after tutoring (Fig. 4b)

Summary

Introduction

Competency with numbers is essential in today’s society; yet, up to 20% of children exhibit moderate to severe mathematical learning disabilities (MLD). Lesion studies of individuals with math impairments have primarily focused on the specific role of the parietal cortex, recent neuroimaging research has begun to suggest that MLD involves aberrations in multiple functional systems[1,6,22,23,24] These include brain systems implicated in visual form judgement and symbol recognition, anchored in the ventral temporal–occipital cortex; quantity and magnitude processing, anchored in the intraparietal sulcus region of the parietal cortex; as well as attention and working memory functions, supported by a frontoparietal control network[1,6,22,23,24]. We investigate the possibility that poor response to intervention may be associated with weak functional neuroplasticity in children with MLD38

Methods

Results

Conclusion