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Diffusion tensor imaging and tractography of the human language pathways: Moving into the clinical realm
Author(s) -
Muthusami Prakash,
James Jija,
Thomas Bejoy,
Kapilamoorthy T.R.,
Kesavadas Chandrasekharan
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24782
Subject(s) - realm , diffusion mri , neuroimaging , neuroscience , white matter , computer science , tractography , cognitive science , psychology , medicine , magnetic resonance imaging , radiology , political science , law
The functional correlates of anatomical derangements are of interest to the neurological clinician. Diffusion tensor tractography (DTT) is a relatively new tool in the arsenal of functional neuroimaging, by which to assess white matter tracts in the brain. While much import has been given to tracking corticospinal tracts in neurological disease, studying language pathway interconnections using DTT has largely remained in the research realm. Hardware and software advances have allowed this tool to ease into clinical practice, with several radiologists, neurologists, and neurosurgeons now familiar with its applications. DTT images, although visually appealing, are founded in mathematical equations and assumptions, and require a more than basic understanding of principles and limitations before they can be integrated into routine clinical practice. Cognitive pathways like that of language, that are normally hard to assess and especially more so when pathologically affected, have been at the receiving end of several opposing and often controversial hypotheses, and the past decade has seen the clarification, validation or rejection of several of these by the in vivo charting of functional connectivity using DTT. The focus of this review is to illustrate DTT of the language pathways with emphasis on practical considerations, clinical applications, and limitations. J. Magn. Reson. Imaging 2014;40:1041–1053 . © 2013 Wiley Periodicals, Inc.