title: Correlation between language function and the left arcuate fasciculus detected by diffusion tensor imaging tractography after brain tumor surgery.
abstract: OBJECTIVE
  Disturbance of the arcuate fasciculus in the dominant hemisphere is thought to be associated with language-processing disorders, including conduction aphasia. Although the arcuate fasciculus can be visualized in vivo with diffusion tensor imaging (DTI) tractography, its involvement in functional processes associated with language has not been shown dynamically using DTI tractography. In the present study, to clarify the participation of the arcuate fasciculus in language functions, postoperative changes in the arcuate fasciculus detected by DTI tractography were evaluated chronologically in relation to postoperative changes in language function after brain tumor surgery.
  
  
  METHODS
  Preoperative and postoperative arcuate fasciculus area and language function were examined in 7 right-handed patients with a brain tumor in the left hemisphere located in proximity to part of the arcuate fasciculus. The arcuate fasciculus was depicted, and its area was calculated using DTI tractography. Language functions were measured using the Western Aphasia Battery (WAB).
  
  
  RESULTS
  After tumor resection, visualization of the arcuate fasciculus was increased in 5 of the 7 patients, and the total WAB score improved in 6 of the 7 patients. The relative ratio of postoperative visualized area of the arcuate fasciculus to preoperative visualized area of the arcuate fasciculus was increased in association with an improvement in postoperative language function (p = 0.0039).
  
  
  CONCLUSIONS
  The role of the left arcuate fasciculus in language functions can be evaluated chronologically in vivo by DTI tractography after brain tumor surgery. Because increased postoperative visualization of the fasciculus was significantly associated with postoperative improvement in language functions, the arcuate fasciculus may play an important role in language function, as previously thought. In addition, postoperative changes in the arcuate fasciculus detected by DTI tractography could represent a predicting factor for postoperative language-dependent functional outcomes in patients with brain tumor.
authors.affiliation: Department of Neurosurgery, Kanazawa University, Kanazawa, Japan. yuh@ns.m.kanazawa-u.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Masashi
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Nakada
authors.forename: Jun-ichiro
authors.initials: J
authors.lastname: Hamada
mesh_terms: D000328:Adult; D000368:Aged; D001111:Arcuate Nucleus of Hypothalamus / Q000473:pathology* / Q000601:surgery; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D003627:Data Interpretation, Statistical; D056324:Diffusion Tensor Imaging; D005260:Female; D007839:Functional Laterality; D038421:Hemispherectomy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007802:Language; D007807:Language Tests; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures