Diffusion tensor tractography in children with developmental language delay

Abstract

Objective: Diffusion tensor tractography (DTT) is valuable for confirming the connectivity between functional cortical regions by a noninvasive method. This object is to evaluate language pathway in Korean speaking children for delayed language development by means of DTT. Methods: Patients were identified retrospectively with the chief complaint of delayed speech and diagnosis of developmental language delay established by sequenced language scale for infant (SELSI) or preschool receptive-expressive language scale (PRES). MR imaging of the brain performed at 3T, including 30 direction diffusion tensor imaging (DTI) with win 1 month of the above speech evaluation. Results: This study included 16 children with developmental language delay. The mean age was 43 months (standard deviation: 21 months; range: 21–96 months) with 6 born prematurely, 10 males, and 6 females. On brain imaging, 10 (63%) demonstrated normal structure but all of them showed decreased volume in bilateral hemisphere or hemispheric asymmetry of ILF and 9 (90%) showed those findings of IFOF. Inappropriate AF was shown in 6 (60%) children. Five (50%) demonstrated focal deficit of CC on midbody or splenium area. The speech ability of ten who showed normal structure on brain imaging was estimated under 1%ile. Conclusion: The current study examined the WM microstructure changes in children with delayed language development. Based on DTT data, non-conventional language area connections such as IFOF, ILF which represents components of ventral language pathway showed strong relationship to speech disability in children including the cases under normal brain structure.