Abstract
BackgroundThe role of the arcuate fasciculus (AF) in the dominant hemisphere in stroke patients with aphasia has not been clearly elucidated. We investigated the relation between language function and diffusion tensor tractography (DTT) findings for the left AF in chronic stroke patients with aphasia.MethodTwenty five consecutive right-handed stroke patients with aphasia following lesions in the left hemisphere were recruited for this study. The aphasia quotient (AQ) of Korean-Western Aphasia Battery was used for assessment of language function. We measured values of fractional anisotropy (FA), apparent diffusion coefficient (ADC), voxel number of the left AF. We classified patients into three groups: type A - the left AF was not reconstructed, type B - the left AF was discontinued between Wernicke’s and Broca’s areas, and type C – the left AF was preserved around the stroke lesion.ResultsModerate positive correlation was observed between AQ and voxel number of the left AF (r = 0.471, p < 0.05). However, no correlation was observed between AQ and FA (r = 0.275, p > 0.05) and ADC values (r = -0.286, p > 0.05). Significant differences in AQ scores were observed between the three types (p < 0.05); the AQ score of type C was higher than those of type A and B, and that of type B was also higher than that of type A (p < 0.05).ConclusionAccording to our findings, the remaining volume of the left AF, irrespective of directionality and diffusivity, showed moderate positive correlation with language function in chronic stroke patients with aphasia. Discontinuation or non-construction of the left AF was also an important factor for language function.
Highlights
The role of the arcuate fasciculus (AF) in the dominant hemisphere in stroke patients with aphasia has not been clearly elucidated
Moderate positive correlation was observed between aphasia quotient (AQ) and voxel number of the left AF (r = 0.471, p < 0.05)
Subjects Twenty five consecutive right-handed patients were recruited according to following inclusion criteria: (1) first-ever stroke, (2) age range: 20 ~ 69 years, (3) stroke lesion was located in the left hemisphere, (4) aphasia: aphasia quotient (AQ) scores on Korean-Western Aphasia Battery (K-WAB) below 92.8, (5) diffusion tensor imaging (DTI) scanning and K-WAB were performed after three months from stroke onset, (6) no history of stroke, head trauma, or psychiatric disorder, and (7) no previous stroke lesion on the brain MRI which was taken at stroke onset [24]
Summary
The role of the arcuate fasciculus (AF) in the dominant hemisphere in stroke patients with aphasia has not been clearly elucidated. We investigated the relation between language function and diffusion tensor tractography (DTT) findings for the left AF in chronic stroke patients with aphasia. Aphasia is one of the most common sequelae of stroke. 24%-38% of stroke patients have been reported to suffer from aphasia during acute stage [1,2,3,4]. Patients with aphasia can show some degree of spontaneous recovery, this improvement of aphasia is observed mainly during the first three months after stroke onset [2,3,5,6,7]. Approximately 10-18% of stroke patients are known to suffer from aphasia during chronic stage [1,6,7,8]. Previous studies of the AF using intra-operative mapping techniques, brain CT, conventional brain MRI, or functional neuroimaging
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