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Fixel-based evidence of microstructural damage in crossing pathways improves language mapping in Post-stroke aphasia.

Authors
  • Zhang, Jie1
  • Zheng, Weihao2
  • Shang, Desheng3
  • Chen, Yating4
  • Zhong, Shuchang4
  • Ye, Jing4
  • Li, Lingling5
  • Yu, Yamei6
  • Zhang, Li4
  • Cheng, Ruidong4
  • He, Fangping5
  • Wu, Dan7
  • Ye, Xiangming4
  • Luo, Benyan8
  • 1 Department of Neurology & Brain Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China. , (China)
  • 2 School of Information Science and Engineering, Lanzhou University, Lanzhou, China. , (China)
  • 3 Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. , (China)
  • 4 Rehabilitation Medicine Center & Rehabilitation Research Institute of Zhejiang Province, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China. , (China)
  • 5 Department of Neurology & Brain Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. , (China)
  • 6 Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China. , (China)
  • 7 Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China. , (China)
  • 8 Department of Neurology & Brain Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Collaborative Innovation Center for Brain Science, Zhejiang University School of Medicine, China. Electronic address: [email protected] , (China)
Type
Published Article
Journal
NeuroImage Clinical
Publisher
Elsevier
Publication Date
Jul 25, 2021
Volume
31
Pages
102774–102774
Identifiers
DOI: 10.1016/j.nicl.2021.102774
PMID: 34371239
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The complex crossing-fiber characteristics in the dual-stream system have been ignored by traditional diffusion tensor models regarding disconnections in post-stroke aphasia. It is valuable to identify microstructural damage of crossing-fiber pathways and reveal accurate fiber-specific language mapping in patients with aphasia. This cross-sectional study collected magnetic resonance imaging data from 29 participants with post-stroke aphasia in the subacute stage and from 33 age- and sex-matched healthy controls. Fixel-based analysis was performed to examine microstructural fiber density (FD) and bundle cross-section alterations of specific fiber populations in crossing-fiber regions. Group comparisons were performed, and relationships with language scores were assessed. The aphasic group exhibited significant fixel-wise FD reductions in the dual-stream tracts, including the left inferior fronto-occipital fasciculus (IFOF), arcuate fasciculus, and superior longitudinal fasciculus (SLF) III (family-wise-error-corrected p < 0.05). Voxel- and fixel-wise comparisons revealed mismatched distributions in regions with crossing-fiber nexuses. Fixel-wise correlation analyses revealed significant associations between comprehension impairment and reduced FD in the temporal and frontal segments of the left IFOF, and also mapped naming ability to the IFOF. Average features along the whole course of dominant tracts assessed with tract-wise analyses attributed word-level comprehension to the IFOF (r = 0.723, p < 0.001) and revealed a trend-level correlation between sentence-level comprehension and FD of the SLF III (r = 0.451, p = 0.021). The mean FD of the uncinate fasciculus (UF) and IFOF correlated with total and picture naming scores, and the IFOF also correlated with responsive naming subdomains (Bonferroni corrected p < 0.05). FD reductions of dual streams suggest that intra-axonal volume reduction constitutes the microstructural damage of white matter integrity in post-stroke aphasia. Fixel-based analysis provides a complementary method of language mapping that identifies fiber-specific tracts in the left hemisphere language network with greater specificity than voxel-based analysis. It precisely locates the precise segments of the IFOF for comprehension, yields fiber-specific evidence for the debated UF-naming association, and reveals dissociative subdomain associations with distinct tracts. Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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