Just pretty pictures? What diffusion tractography can add in clinical neuroscience

Purpose of review Diffusion tractography uses non-invasive brain imaging data to trace fibre bundles in the human brain in vivo. This raises immediate possibilities for clinical application but responsible use of this approach requires careful consideration of the scope and limitations of the technique. Recent findings To illustrate the potential for tractography to provide new information in clinical neuroscience we review recent studies in three broad areas: use of tractography for quantitative comparisons of specific white matter pathways in disease; evidence from tractography for the presence of qualitatively different pathways in congenital disorders or following recovery; use of tractography to gain insights into normal brain anatomy that can aid our understanding of the consequences of localised pathology, or guide interventions. Summary Diffusion tractography opens exciting new possibilities for exploring features of brain anatomy that previously were not visible to us in vivo.