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Related Experiment Video

Updated: Apr 27, 2026

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
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Tractography-based Predictors of Post-Stroke Aphasia: A Systematic Review.

Mahshad Narimani1, Iman Kiani1, Hamed Ghorani1

  • 1From the Student Research Committee (M.N.), Tabriz University of Medical Sciences, Tabriz, Iran; Students' Scientific Research Center (I.K.), Advanced Diagnostic and Interventional Radiology Research Center (ADIR) (H.G.), Department of Radiology (H.G.), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Medical student, Department of Medicine (P.S.), Tehran Medical Branch, Islamic Azad University, Tehran, Iran; Department of Radiology and Radiological Sciences (A.C.), Radiology (K.L., A.H.), Division of Neuroradiology, Division of Neuroradiology (V.Y.), Department of Radiology and Radiological Sciences, Johns Hopkins Medical Center, Baltimore, MD, USA; Department of Neuroradiology (D.A.L.), Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA; Neurointerventional & Neuroanalytics Consortium (NAN-C) (A.D.), School of Medicine, Toronto Metropolitan University, Toronto, ON; Institute of Therapeutic Neuroradiology (A.D.), Nuffield Department of Surgical Sciences, Faculty of Clinical Medicine, University of Oxford, Oxford, UK and Division of Neurointerventional Surgery (F.H.), The Neuroscience Institute, The Queen's Medical Center, Honolulu, HI, USA.

AJNR. American Journal of Neuroradiology
|April 25, 2026
PubMed
Summary

Diffusion tensor imaging reveals the arcuate fasciculus as a key predictor of post-stroke aphasia. This neuroimaging technique offers valuable insights for assessing language recovery after stroke.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Speech and Language Pathology

Background:

  • Post-stroke aphasia significantly impacts communication and quality of life.
  • Early risk identification is crucial for effective stroke rehabilitation planning.
  • Diffusion tractography is emerging as a tool to map language pathways and predict aphasia.

Purpose of the Study:

  • To evaluate the prognostic value of diffusion tensor imaging (DTI) characteristics of white matter tracts.
  • To assess the predictive capability of DTI metrics for post-stroke aphasia.

Main Methods:

  • Systematic literature search of PubMed, Embase, and Scopus databases.
  • Inclusion of studies using diffusion MRI tractography to analyze language pathways in stroke patients.
  • Qualitative synthesis of extracted data due to insufficient quantitative data for pooling.

Main Results:

  • Twenty-one studies with 550 patients were included, predominantly older adults.
  • Left arcuate fasciculus (AF) integrity, assessed by fractional anisotropy (FA) and reconstruction status, was the strongest predictor of aphasia severity and recovery.
  • Tract-specific microstructure improved prognostic models beyond lesion volume or NIHSS, explaining an additional 12-29% of outcome variance.

Conclusions:

  • Diffusion tractography provides valuable insights into the structural basis of post-stroke aphasia.
  • The arcuate fasciculus (AF) is the most robust predictor identified.
  • Standardization of tractography protocols and multicenter validation are necessary for clinical application.