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Diffusion Tensor Imaging and Advanced Diffusion Imaging in Post-Stroke Aphasia Recovery
Irem Yesiloglu1, Melissa Stockbridge2, Zafer Keser1
1Department of Neurology, Mayo Clinic, Rochester, MN 55902, USA.
Summary
Advanced diffusion imaging techniques, like CSD, DSI, and DKI, offer superior insights into white matter integrity for post-stroke aphasia (PSA) recovery compared to conventional diffusion tensor imaging (DTI). These methods aid in personalized rehabilitation.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- Stroke is a primary cause of death and disability, with aphasia being a frequent and severe consequence.
- Diffusion imaging techniques assess white matter integrity and offer relevant measures for post-stroke aphasia (PSA).
Purpose of the Study:
- To review and synthesize studies using diffusion tensor imaging (DTI) or advanced diffusion imaging to explore structural connectivity in adults with PSA.
- To categorize studies based on their diagnostic, prognostic, or therapeutic applications in PSA.
Main Methods:
- A comprehensive literature search was performed across PubMed, CENTRAL, Ovid MEDLINE, and Embase.
- Ninety-five studies investigating structural connectivity in PSA using DTI or advanced diffusion models were included and synthesized.
Main Results:
- Most studies (n=77) used conventional DTI, while a smaller but growing number (n=18) employed advanced models like CSD, DSI, and DKI.
- Diagnostic, prognostic, and therapeutic applications were identified in 59, 17, and 19 studies, respectively.
- Diffusion-derived markers of language pathways and preserved global network architecture correlated with language performance and recovery.
Conclusions:
- Advanced diffusion imaging methods provide superior characterization of white matter architecture and clinical-anatomical correlations in PSA compared to conventional DTI.
- Markers from language pathways and network analyses are linked to language function and recovery.
- Translating diffusion imaging findings into clinical biomarkers for personalized aphasia rehabilitation requires further research, emphasizing advanced methods.

