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Failure to Identify the Left Arcuate Fasciculus at Diffusion Tractography Is a Specific Marker of Language Dysfunction in Pediatric Patients with Polymicrogyria.

Paldino MJ, Hedges K, Gaab N, Galaburda AM, Grant PE - Behav Neurol (2015)

Bottom Line: Each arcuate fasciculus (AF) was categorized as present or absent.PMG patients without a left AF had a significantly greater frequency of language impairment compared to those PMG patients with a left AF (p < 0.003).In patients with PMG (1) the presence of dysplastic cortex within WA and/or BA is associated with absence of the left AF and (2) absence of the left AF is associated with language impairment.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.

ABSTRACT

Background: Polymicrogyric cortex demonstrates interindividual variation with regard to both extent of dyslamination and functional capacity. Given the relationship between laminar structure and white matter fibers, we sought to define the relationship between polymicrogyria (PMG), intrahemispheric association pathways, and network function.

Methods: Each arcuate fasciculus (AF) was categorized as present or absent. Language was characterized by a pediatric neurologist. The presence of dysplastic cortex in the expected anatomic locations of Broca's (BA) and Wernicke's areas (WA) was evaluated by two pediatric neuroradiologists blinded to DTI and language data.

Results: 16 PMG patients and 16 age/gender-matched controls were included. All normative controls had an identifiable left AF. 6/7 PMG patients with dysplastic cortex within BA and/or WA had no left AF; PMG patients without involvement of these regions had a lower frequency of absence of the left AF (p < 0.006). All patients without a left AF had some degree of language impairment. PMG patients without a left AF had a significantly greater frequency of language impairment compared to those PMG patients with a left AF (p < 0.003).

Conclusion: In patients with PMG (1) the presence of dysplastic cortex within WA and/or BA is associated with absence of the left AF and (2) absence of the left AF is associated with language impairment.

No MeSH data available.


Related in: MedlinePlus

Left lateral (a) and posterior (b) views of the arcuate fasciculus (AF) in a patient with polymicrogyria involving both Broca's and Wernicke's areas in the left hemisphere. This right-handed patient had an identifiable left AF and normal language development.
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fig3: Left lateral (a) and posterior (b) views of the arcuate fasciculus (AF) in a patient with polymicrogyria involving both Broca's and Wernicke's areas in the left hemisphere. This right-handed patient had an identifiable left AF and normal language development.

Mentions: Six (86%) PMG patients with dysplastic cortex within the left BA and/or WA had no left AF (see representative example, Figure 2); PMG patients with no involvement of these gyri had a significantly lower frequency of absence of the left AF (11%; p < 0.006). There was a single patient who had dysplastic involvement of BA and WA and an identifiable left AF (Figure 3); this patient had normal language development. Of the PMG patients with absent left AF, six (86%) had dysplastic cortex within BA and/or WA. A single patient had no identifiable left AF but no dysplastic involvement of the left BA or WA (Figure 4); this patient was impaired with respect to language.


Failure to Identify the Left Arcuate Fasciculus at Diffusion Tractography Is a Specific Marker of Language Dysfunction in Pediatric Patients with Polymicrogyria.

Paldino MJ, Hedges K, Gaab N, Galaburda AM, Grant PE - Behav Neurol (2015)

Left lateral (a) and posterior (b) views of the arcuate fasciculus (AF) in a patient with polymicrogyria involving both Broca's and Wernicke's areas in the left hemisphere. This right-handed patient had an identifiable left AF and normal language development.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4477425&req=5

fig3: Left lateral (a) and posterior (b) views of the arcuate fasciculus (AF) in a patient with polymicrogyria involving both Broca's and Wernicke's areas in the left hemisphere. This right-handed patient had an identifiable left AF and normal language development.
Mentions: Six (86%) PMG patients with dysplastic cortex within the left BA and/or WA had no left AF (see representative example, Figure 2); PMG patients with no involvement of these gyri had a significantly lower frequency of absence of the left AF (11%; p < 0.006). There was a single patient who had dysplastic involvement of BA and WA and an identifiable left AF (Figure 3); this patient had normal language development. Of the PMG patients with absent left AF, six (86%) had dysplastic cortex within BA and/or WA. A single patient had no identifiable left AF but no dysplastic involvement of the left BA or WA (Figure 4); this patient was impaired with respect to language.

Bottom Line: Each arcuate fasciculus (AF) was categorized as present or absent.PMG patients without a left AF had a significantly greater frequency of language impairment compared to those PMG patients with a left AF (p < 0.003).In patients with PMG (1) the presence of dysplastic cortex within WA and/or BA is associated with absence of the left AF and (2) absence of the left AF is associated with language impairment.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.

ABSTRACT

Background: Polymicrogyric cortex demonstrates interindividual variation with regard to both extent of dyslamination and functional capacity. Given the relationship between laminar structure and white matter fibers, we sought to define the relationship between polymicrogyria (PMG), intrahemispheric association pathways, and network function.

Methods: Each arcuate fasciculus (AF) was categorized as present or absent. Language was characterized by a pediatric neurologist. The presence of dysplastic cortex in the expected anatomic locations of Broca's (BA) and Wernicke's areas (WA) was evaluated by two pediatric neuroradiologists blinded to DTI and language data.

Results: 16 PMG patients and 16 age/gender-matched controls were included. All normative controls had an identifiable left AF. 6/7 PMG patients with dysplastic cortex within BA and/or WA had no left AF; PMG patients without involvement of these regions had a lower frequency of absence of the left AF (p < 0.006). All patients without a left AF had some degree of language impairment. PMG patients without a left AF had a significantly greater frequency of language impairment compared to those PMG patients with a left AF (p < 0.003).

Conclusion: In patients with PMG (1) the presence of dysplastic cortex within WA and/or BA is associated with absence of the left AF and (2) absence of the left AF is associated with language impairment.

No MeSH data available.


Related in: MedlinePlus