| 제목 |
Language assessment according to arcuate fasciculus among developmental delayed children |
| 소속 |
Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Department of Rehabilitation Medicine1, Eunpyeong St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Department of Rehabilitation Medicine2 |
| 저자 |
Sehee Kim1*, Hae yeon Park1, Kyung Eun Nam1, Ah-Ra Cho2, Joo Hyun Park1† |
Introduction:
In adults, the arcuate fasciculus(AF) is known to play an important role in speech production. However, the role of AF in language development of toddlers is not clear yet. AF has been proposed to play a role in language development and cognitive function. In adults, language is lateralized to the left hemisphere of the cerebrum but the timing of lateralization is not known precisely.
Objective:
To investigate the role of AF in clinical development aspect, especially in language status, we elucidate the difference of development and language assessment results according to presence of AF in diffusion tensor tractography (DTT). We also assessed the relationship between the absence of AF and development status depending on hemisphere.
Method:
A retrospective chart review was done in 131 developmental delayed children who underwent brain MR imaging and DTT. Among them, 31 patients showed the absence of AF. Patients were divided into 2 groups based on the presence of AF. A Mann-whitney test was done to determine statistical differences of language profile between two groups. A student’s t-test was performed to elucidate the difference of Developmental Quotient (DQ) between two groups.
Patients with absence of AF then were divided again into 3 groups based on hemisphere. A Kruskal wallis test was conducted to determine statistical differences of Developmental Quotient (DQ) and language profile using Sequenced Language Scale for Infants (SELSI) or Preschool Receptive Expressive Language Scale (PRES) between three groups. DQ was calculated based on the results of the Denver Developmental Screening Test.
Results:
Of the total patients, 23.66% showed no AF in DTT. There was no statistically significant difference between the two groups on general demographic data and the DQ (Table1). No statistically significant difference was observed between the two groups on language assessment including SELSI and PRES(Table2). There was no statistically significant difference between the three groups based on side of absent AF on DQ and language assessment in all domains (Table 3).
Conclusion:
A few studies suggested the role of AF in cognitive development in children. In this study, there was no significant difference in developmental assessment according to presence or absence of AF among children with developmental and language delay. And also no difference was observed in the language domain according to the side of absent AF. It seems that the unilateral hemisphere of children does not dominate in language function, unlike adults. The limitations of this study is that there was no normal control group and the sample size was small. Further cumulative and prospective data are needed to understand the role and correlation between language development and AF at DTT.
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table1.General demographics and Developmental Quotient (DQ) between two groups according to presence of arcuate fasciculus.
table2.Comparison between the groups classified by arcuate fasciculus in language assessment. * SELSI : Sequenced Language Scale for Infants, PRES : Preschool Receptive Expressive Language Scale, AE : Age Equivalent
table3.Comparison between tree groups classified by side of absent arcuate fasciculus in development and language assessment.
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