The Arcuate Fasciculus and Language Development in a Cohort of Pediatric Patients with Malformations of Cortical Development
Autor: | Farahnaz Golriz, K. Hedges, Michael J. Paldino |
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Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences Epilepsy 0302 clinical medicine medicine Arcuate fasciculus Humans Radiology Nuclear Medicine and imaging In patient Language Development Disorders Diffusion Tractography Child Dominance Cerebral Retrospective Studies business.industry Brain Neoplasms Cortical malformations Arcuate Nucleus of Hypothalamus medicine.disease Malformations of Cortical Development Language development medicine.anatomical_structure Diffusion Tensor Imaging Child Preschool Cohort Female Neurology (clinical) business Neuroscience 030217 neurology & neurosurgery Tractography |
Zdroj: | AJNR Am J Neuroradiol |
Popis: | BACKGROUND AND PURPOSE: Patients with epilepsy and malformations of cortical development have a high prevalence of language deficits. The purpose of this study was to investigate whether the status of the arcuate fasciculus at diffusion tractography could provide a clinically meaningful marker of language function in patients with cortical malformations. MATERIALS AND METHODS: Thirty-seven patients 3–18 years of age who had DTI performed at 3T and language evaluation by a pediatric neurologist were retrospectively identified. Twenty-two age-matched children without any neurologic, language, or MR imaging abnormalities who had identical DTI performed for an indication of headache were selected as a control cohort. The arcuate fasciculi were constructed and segmented by deterministic tractography for all subjects. RESULTS: Twenty-one patients had intact language; 11 had mild-to-moderate and 5, profound language impairment. All patients with normal language and all control subjects had an identifiable left arcuate. The left arcuate was absent in 11 patients; all 11 were language-impaired. Failure to identify the left arcuate was strongly associated with some degree of language impairment (P < .001). Sensitivity, specificity, and positive predictive value for language dysfunction were 65%, 100%, and 100%, respectively. The absence of the arcuate bilaterally was associated with complete failure to develop oral language (P < .015). CONCLUSIONS: Failure to identify the left arcuate fasciculus at diffusion tractography was a highly specific marker of language dysfunction in a cohort of pediatric patients with malformations of cortical development. Failure to identify the arcuate fasciculus on either side was associated with failure to develop oral language. |
Databáze: | OpenAIRE |
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