title: Sensitive diffusion tensor imaging quantification method to identify language pathway abnormalities in children with developmental delay.
abstract: OBJECTIVE
  To investigate whether abnormal regional white matter architecture in the perisylvian region could be used as an easy and sensitive quantitative method to demonstrate language pathway abnormalities in children with developmental delay (DD).
  
  
  METHODS
  We performed diffusion tensor imaging in 15 DD subjects (age, 61.1 ± 20.9 months) and 15 age-matched typically developing (TD) children (age, 68.4 ± 19.2 months). With diffusion tensor imaging color-coded orientation maps, we quantified the fraction of fibers in the perisylvian region that are oriented in anteroposterior (AP) and mediolateral (ML) directions, and their ratio (AP/ML) was calculated.
  
  
  RESULTS
  The AP/ML ratio was more sensitive than tractography in characterizing perisylvian regional abnormalities in DD children. The AP/ML ratio of the left perisylvian region was significantly lower in DD children compared with TD children (P = .03). The ML component of bilateral perisylvian regions was significantly higher in DD children compared with TD children (P = .01 [left] and P = .004 [right]). No significant difference was found in the AP component in the two groups. A significant negative correlation of the left ML component with Vineland communication skills was observed (r = -0.657, P = .011).
  
  
  CONCLUSIONS
  The AP/ML ratio appears to be a sensitive indicator of regional white matter architectural abnormalities in the perisylvian region of DD children.
authors.affiliation: Department of Pediatrics and Neurology, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Sai Prasad
authors.initials: SP
authors.lastname: Gopal
authors.forename: Vijay Narayan
authors.initials: VN
authors.lastname: Tiwari
authors.forename: Amy L
authors.initials: AL
authors.lastname: Veenstra
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar
authors.forename: Michael
authors.initials: M
authors.lastname: Behen
authors.forename: Harry T
authors.initials: HT
authors.lastname: Chugani
authors.forename: Senthil K
authors.initials: SK
authors.lastname: Sundaram
mesh_terms: D001931:Brain Mapping / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007805:Language Development Disorders / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity