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Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping

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Relationships between essential cortical language sites and subcortical pathways.

Timothy M Ellmore¹, Michael S Beauchamp, Thomas J O'Neill

¹Department of Neurosurgery, The University of Texas Medical School at Houston, Texas 77030, USA. Timothy.Ellmore@uth.tmc.edu

Journal of Neurosurgery

|April 21, 2009

Summary

Diffusion tensor imaging tractography of the arcuate fasciculus (AF) closely relates to essential language sites. This technique may predict eloquent brain areas, aiding in language mapping and understanding the AF

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Area of Science:

Neuroimaging
Neuroanatomy
Cognitive Neuroscience

Background:

Cortical language networks are distributed and mapped by electrical stimulation or functional imaging.
Connectivity within these language networks is increasingly explored using diffusion tensor (DT) imaging.
Complete characterization of language network connectivity remains an ongoing research objective.

Purpose of the Study:

To utilize DT imaging-based tractography to investigate the relationship between cortical language areas and the arcuate fasciculus (AF).
To determine if AF tractography can predict the location of essential language sites (ELSs).

Main Methods:

Localized the arcuate fasciculus (AF) in 10 patients using DT imaging.
Performed intraoperative electrical stimulation for language mapping in 9 patients.
Assessed the spatial relationship between ELSs and AF pathways.

Main Results:

81% of essential language sites (ELSs) were found in close proximity to the AF.
59% of ELSs were within 7.5 mm of AF pathway terminations.
Direct subcortical stimulation of the AF caused transient language deficits, confirming its role.

Conclusions:

The close spatial relationship between ELSs and the AF supports the utility of tractography for language site localization.
DT imaging of the AF can predict the location of language-eloquent brain areas.
The AF is confirmed as a critical pathway for fluent language.