Motor recovery by the aberrant pyramidal pathway in a patient with cerebral infarct

Diffusion Tensor Tractography Studies on Recovery Mechanisms of Aphasia in Stroke Patients: A Narrative Mini-Review

Aphasia is a common and serious clinical feature of stroke. Various neural tracts are known to be involved in language processing. Diffusion tensor tractography (DTT) appears to be an appropriate imaging technique for the elucidation of the recovery mechanisms of aphasia in the language-related neural tracts in stroke patients. In this article, twelve previous DTT-based studies on the recovery mechanisms of aphasia in stroke were reviewed. We classified the twelve studies into the following three categories according to the recovery mechanisms: recovery via the neural tracts in the dominant hemisphere (eight studies), via transcallosal fibers (two studies), and via the neural tracts in the non-dominant hemisphere (two studies). Although there are various neural tracts for language processing, eight of the ten studies focused only on the role of the arcuate fasciculus (AF) in the recovery process. Consequently, it appears from the studies that only one recovery mechanism of aphasia via the restoration of the integrity of the injured AF in the dominant hemisphere was clearly demonstrated. However, because various neural tracts are involved in language processing, there could be other mechanisms that have not yet been elucidated. Therefore, further original studies involving a larger number of patients with aphasia in stroke should be encouraged forthwith. Further studies involving various lesion locations and severity levels of injuries to the language-related neural tracts are also necessary because the recovery mechanisms of aphasia in stroke could be dependent on these factors.