Predictive value of fractional anisotropy of the arcuate fasciculus for the functional recovery of language after brain tumor resection: A preliminary study

Objective: The arcuate fasciculus has been recognized as an important pathway for language processing. Brain tumors located in proximity to the fasciculus frequently cause preoperative language impairment, and in some cases, no language recovery occurs after tumor resection. No predictive value has been presented for possible postoperative language recovery after tumor resection. The aim of this study is to analyze the preoperative state of the arcuate fasciculus in the patients with brain tumor from the perspective of its usefulness as a predictive factor for postoperative recovery of language functions. Methods: For 12 right-handed patients with brain tumors in the left hemisphere, preoperative arcuate fasciculi were analyzed with fractional anisotropy (FA) of the diffusion tensor imaging (DTI) tractography. Language functions were evaluated pre- and postoperatively by using the Western Aphasia Battery (WAB). The preoperative value of the FA of the arcuate fasciculus on the lesion side was examined in relation with the language recovery. Results: There was a positive relationship between preoperative increasing values of the FA of the left arcuate fasciculus and improvement of the postoperative total WAB score (p = 0.0056), and the scores of the naming (p = 0.018), reading (p = 0.029), and writing subcategories (p = 0.012) Conclusion: The preoperative increasing value of the FA of the arcuate fasciculus in the dominant hemisphere could be a predictor for postoperative language recovery following tumor resection. Meticulous procedure should be performed especially in the cases with higher FA of the arcuate fasciculus harboring high possibility of language recovery. (C) 2013 Elsevier B.V. All rights reserved.