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AJNR - American Journal of Neuroradiology

Publication Preview: Published November 26, 2007

American Journal of Neuroradiology 2008;29:483.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A0846

BRAIN

Language Dysfunction After Stroke and Damage to White Matter Tracts Evaluated Using Diffusion Tensor Imaging

J.I. Breier, K.M. Hasan, W. Zhang, D. Men and A.C. Papanicolaou

From the Division of Clinical Neurosciences, Department of Pediatrics (J.I.B., D.M., A.C.P.), and Department of Diagnostic and Interventional Imaging (K.M.H.), University of Texas Health Science Center at Houston, Houston, Tex; and Minnesota Epilepsy Group and United Hospital (W.Z.), St Paul, Minn.

Please address correspondence to Joshua I. Breier, Division of Clinical Neurosciences, Department of Neurosurgery, University of Texas Medical School at Houston, 1333 Moursund St, Suite H114, Houston, TX 77098; e-mail: joshua.i.breier{at}uth.tmc.edu

BACKGROUND AND PURPOSE: Knowledge of the anatomic basis of aphasia after stroke has both theoretic and clinical implications by informing models of cortical connectivity and providing data for diagnosis and prognosis. In this study we use diffusion tensor imaging to address the relationship between damage to specific white matter tracts and linguistic deficits after left hemisphere stroke.

Materials and METHODS: Twenty patients aged 38–77 years with a history of stroke in the left hemisphere underwent diffusion tensor imaging, structural MR imaging, and language testing. All of the patients were premorbidly right handed and underwent imaging and language testing at least 1 month after stroke.

RESULTS: Lower fractional anisotropy (FA) values in the superior longitudinal and arcuate fasciculi of the left hemisphere, an indication of greater damage to these tracts, were correlated with decreased ability to repeat spoken language. Comprehension deficits after stroke were associated with lower FA values in the arcuate fasciculus of the left hemisphere. The findings for repetition were independent of MR imaging ratings of the degree of damage to cortical areas of the left hemisphere involved in language function. There were no findings for homotopic tracts in the right hemisphere.

CONCLUSION: This study provides support for a specific role for damage to the superior longitudinal and arcuate fasciculi in the left hemisphere in patients with deficits in repetition of speech in aphasia after stroke.