neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2021-2-3-146-158neurojour-49Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSДислексия — самая распространённая форма специфических расстройств обучаемостиDyslexia as the most prevalent form of specific learning disabilitieshttps://orcid.org/0000-0003-0103-7422ЗаваденкоНиколай НиколаевичZavadenkoNikolay N.

Д.м.н., профессор, заведующий кафедрой неврологии, нейрохирургии и медицинской генетики им. академика Л.О. Бадаляна педиатрического факультета ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России.

e-mail: zavadenko@mail.ru

MD, PhD, DSci, professor, Head of the Neurology, Neurosurgery and Medical Genetics Department named after academician L.O. Badalyan, Faculty of Pediatrics, Pirogov Russian National Research Medical University, Moscow, 125412, Russian Federation.

e-mail: zavadenko@mail.ru

zavadenko@mail.ruФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian Federation20212909202123146158Copyright © Заваденко Н.Н., 20212021Заваденко Н.Н.Zavadenko N.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/49

Дислексия представляет собой самую распространённую форму специфических расстройств обучаемости. Дислексия наблюдается у 5,0-17,5% школьников, а среди детей со специфическими расстройствами обучаемости на её долю приходится примерно 70-80%. Обычно дислексия у детей проявляется не только в неспособности достичь такого уровня развития навыков чтения, которые были бы пропорциональны их интеллектуальным возможностям, но также освоить письмо и орфографию. Вторичные последствия дислексии включают проблемы с пониманием прочитанного и ограничение объёма чтения, что может препятствовать росту словарного запаса и базового уровня знаний. В обзоре рассматривается неврологическая организация чтения и письма как сложных высших психических функций, включающих много компонентов, которые обеспечиваются различными областями мозга. Приводятся принципы классификации дислексии, основные характеристики её традиционно определяемых форм: фонематической, оптической, мнестической, семантической, аграмматической. Анализируются церебральные механизмы развития дислексии, результаты современных исследований с применением нейропсихологических методов, функциональной нейровизуализации, изучения мозгового коннектома. Обсуждается вклад в развитие дислексии нарушений фонологической осведомлённости, быстрого автоматизированного называния, объёма зрительного внимания, компонентов управляющих функций мозга. Рассмотрены генез эмоциональных нарушений у детей с дислексией, факторы риска дислексии (включая генетическую предрасположенность). Перечислены проявления дислексии у детей, по поводу которых их родители впервые обращаются за консультацией к специалисту. В процессе диагностики дислексии следует обращать внимание на отставание развития речи ребенка, случаи специфических расстройств обучаемости среди членов семьи. Следует учитывать возможную коморбидность дислексии у ребёнка с синдромом дефицита внимания с гиперактивностью, дискалькулией, диспраксией развития, нарушениями эмоционального контроля и управляющих функций мозга. Своевременная диагностика определяет эффективность программ раннего вмешательства, которые основываются на комплексном подходе.

Dyslexia is the most common form of specific learning disabilities. Dyslexia is observed in 5-17.5 % of schoolchildren, and among children with specific learning disabilities, it accounts for about 70-80 %. Usually, dyslexia manifests itself as the inability to achieve an appropriate level of reading skills development that would be proportional to their intellectual abilities and writing and spelling skills. Secondary consequences of dyslexia may include problems in reading comprehension and reduced reading experience that can impede the growth of vocabulary and background skills. The review discusses neurological management of reading and writing as complex higher mental functions, including many components that are provided by various brain areas. The principles of dyslexia classification, the main characteristics of its traditionally defined forms are given: phonemic, optical, mnestic, semantic, agrammatic. The article analyzes the cerebral mechanisms of dyslexia development, the results of studies using neuropsychological methods, functional neuroimaging, and the study of the brain connectome. The contribution to dyslexia development of disturbances in phonological awareness, rapid automated naming (RAN), the volume of visual attention (VAS), components of the brain executive functions is discussed. The origin of emotional disorders in children with dyslexia, risk factors for dyslexia development (including genetic predisposition) are considered. Dyslexia manifestations in children are listed, about which their parents seek the advice of a specialist for the first time. In the process of diagnosing dyslexia, attention should be paid to the delay in the child’s speech development, cases of speech and language development disorders and specific learning disabilities among family members. It is necessary to consider possible comorbidity of dyslexia in a child with attention deficit hyperactivity disorder, dyscalculia, developmental dyspraxia, disorders of emotional control and brain executive functions. Timely diagnosis determines the effectiveness of early intervention programs based on an integrated multimodal approach.

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The authors declare that there are no conflicts of interest present.