IMR Press / JIN / Volume 20 / Issue 3 / DOI: 10.31083/j.jin2003072
Open Access Brief Report
Relationships among language ability, the arcuate fasciculus and lesion volume in patients with putaminal hemorrhage: a diffusion tensor imaging study
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1 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 705-717 Namku, Taegu, Republic of Korea
J. Integr. Neurosci. 2021, 20(3), 677–685; https://doi.org/10.31083/j.jin2003072
Submitted: 29 April 2021 | Revised: 14 May 2021 | Accepted: 22 July 2021 | Published: 30 September 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Relationships among language ability, arcuate fasciculus and lesion volume were investigated by use of diffusion tensor tractography in patients with putaminal hemorrhage. Thirty-three right-handed patients within six weeks of hemorrhage onset were recruited. Correlation of the aphasia quotient with subset (fluency, comprehension, repetition, naming) scores, diffusion tensor tractography parameters and lesion volume of patients, aphasia quotient (r = 0.446) with subset (naming: r = 0.489) score had moderate positive correlations with fractional anisotropy of the left arcuate fasciculus. The aphasia quotient subset (repetition) score had a strong positive correlation with fractional anisotropy of the left arcuate fasciculus (r = 0.520), whereas, aphasia quotient subset (fluency and comprehension) scores had no significant correlations with fractional anisotropy of the left arcuate fasciculus after Benjamini–Hochberg correction. Aphasia quotient (r = 0.668) with subset (fluency: r = 0.736, comprehension: r = 0.739, repetition: r = 0.649, naming: r = 0.766) scores had strong positive correlations with the tract volume of the left arcuate fasciculus and strong negative correlations with lesion volume (r = –0.521, fluency: r = –0.520, comprehension: r = –0.513, repetition: r = –0.518, naming: r = –0.562). Fractional anisotropy of the left arcuate fasciculus had a moderate negative correlation with lesion volume (r = –0.462), whereas the tract volume of the left arcuate fasciculus had a strong negative correlation with lesion volume (r = –0.700). According to the result of mediation analysis, tract volume of the left arcuate fasciculus fully mediated the effect of lesion volume on the aphasia quotient. Regarding the receiver operating characteristic curve, the lesion volume cut-off value was 29.17 cm3 and the area under the curve (0.74), sensitivity (0.77) and specificity (0.80) were higher than those of fractional anisotropy, tract volume and aphasia quotient cut-off values. It was found that level of language disability was related to lesion volume as well as to injury severity of arcuate fasciculus in the dominant hemisphere of patients with putaminal hemorrhage. In particular, the tract volume of the arcuate fasciculus in the dominant hemisphere fully mediated the effect of lesion volume on language ability. Additionally, a lesion volume of approximately 30 cm3 was helpful in discriminating arcuate fasciculus discontinuation in the dominant hemisphere.

Keywords
Arcuate fasciculus
Lesion volume
Language ability
Diffusion tensor tractography
Diffusion tensor imaging
Figures
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