以本体感觉为中心的假说：将发展性阅读障碍中感觉运动功能、呼吸与睡眠跨昼夜周期的联系联系起来

文献信息

中文摘要

目的： 发展性阅读障碍是一种异质性神经发育状况，除阅读困难外，还报告有运动、知觉、注意、呼吸和睡眠相关差异。本视角提出一个以本体感觉为中心的感觉运动协调框架，以考虑这些领域在昼夜周期中的潜在相互作用。
方法： 这一产生假说的叙述性视角追溯了所提出框架从临床观察到实验研究，以及随后基于感觉调制功能反应对临床检查进行细化的渐进发展过程。未进行系统综述或新的队列分析。该检查探讨三个主要领域——紧张性运动调节、空间定位和多感官整合——以及呼吸和睡眠相关因素。感觉运动调制包括眼、口、足底、呼吸、手和人体工学方法，根据其在不同领域中观察到的功能效应进行选择。一个临床病例说明了该方法的应用。
结果： 近二十年来在我们INSERM实验室进行的实验研究客观地考察了发展性阅读障碍中的姿势调节、本体感觉敏锐度、空间定位、多感官加工和动作表征。更近期的探索性临床研究将调查扩展到呼吸和睡眠。综合来看，这些观察提示，以本体感觉为中心的感觉运动协调可能代表一个功能层面，运动、知觉、呼吸、注意和学习相关过程随着学习的发展和持续，在昼夜周期中通过该层面相互作用。
结论： 所提出的框架是一个工作假说，而非已确立的因果模型或经过验证的发展性阅读障碍治疗方法。它提供了一种互补的具身视角，并识别出值得进一步研究的临床可观察和实验可检验的关系，包括通过对照研究考察各个感觉和功能成分的贡献。

英文摘要

Objectives: Developmental dyslexia is a heterogeneous neurodevelopmental condition in which motor, perceptual, attentional, respiratory, and sleep-related differences have been reported alongside reading difficulties. This Perspective proposes a proprioception-centered sensorimotor coherence framework to consider potential interactions among these domains across the day-night cycle. Methods: This hypothesis-generating narrative Perspective traces the progressive development of the proposed framework from clinical observations to experimental investigations and subsequent refinement of a clinical examination based on functional responses to sensory modulation. No systematic review or new cohort analysis was undertaken. The examination explores three principal domains-tonic-motor regulation, spatial localization, and multisensory integration-together with respiratory and sleep-related factors. Sensorimotor modulation includes ocular, oral, plantar, respiratory, manual, and ergonomic approaches selected according to their observed functional effects across domains. A clinical case illustrates the application of this approach. Results: Experimental studies conducted over nearly two decades in our INSERM laboratory objectively investigated postural regulation, proprioceptive acuity, spatial localization, multisensory processing, and action representation in developmental dyslexia. More recent exploratory clinical studies extended the investigation to respiration and sleep. Taken together, these observations suggest that proprioception-centered sensorimotor coherence may represent one functional level through which motor, perceptual, respiratory, attentional, and learning-related processes interact across the day-night cycle as learning develops and continues. Conclusions: The proposed framework is a working hypothesis rather than an established causal model or a validated treatment for developmental dyslexia. It provides a complementary embodied perspective and identifies clinically observable and experimentally testable relationships that warrant further investigation, including through controlled studies examining the contributions of individual sensory and functional components.