Temporal lobe white matter asymmetry and language laterality in epilepsy patients

Timothy M. Ellmore, Michael S. Beauchamp, Joshua I. Breier, Jeremy D. Slater, Giridhar P. Kalamangalam, Thomas J. O'Neill, Michael A. Disano, Nitin Tandon

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Recent studies using diffusion tensor imaging (DTI) have advanced our knowledge of the organization of white matter subserving language function. It remains unclear, however, how DTI may be used to predict accurately a key feature of language organization: its asymmetric representation in one cerebral hemisphere. In this study of epilepsy patients with unambiguous lateralization on Wada testing (19 left and 4 right lateralized subjects; no bilateral subjects), the predictive value of DTI for classifying the dominant hemisphere for language was assessed relative to the existing standard-the intra-carotid Amytal (Wada) procedure. Our specific hypothesis is that language laterality in both unilateral left- and right-hemisphere language dominant subjects may be predicted by hemispheric asymmetry in the relative density of three white matter pathways terminating in the temporal lobe implicated in different aspects of language function: the arcuate (AF), uncinate (UF), and inferior longitudinal fasciculi (ILF). Laterality indices computed from asymmetry of high anisotropy AF pathways, but not the other pathways, classified the majority (19 of 23) of patients using the Wada results as the standard. A logistic regression model incorporating information from DTI of the AF, fMRI activity in Broca's area, and handedness was able to classify 22 of 23 (95.6%) patients correctly according to their Wada score. We conclude that evaluation of highly anisotropic components of the AF alone has significant predictive power for determining language laterality, and that this markedly asymmetric distribution in the dominant hemisphere may reflect enhanced connectivity between frontal and temporal sites to support fluent language processes. Given the small sample reported in this preliminary study, future research should assess this method on a larger group of patients, including subjects with bi-hemispheric dominance.

Original languageEnglish (US)
Pages (from-to)2033-2044
Number of pages12
Issue number3
StatePublished - Feb 1 2010


  • Arcuate fasciculus
  • Broca's area
  • Diffusion tensor imaging
  • Functional magnetic resonance imaging
  • Handedness
  • Inferior longitudinal fasciculus
  • Inferior occipitofrontal fasciculus
  • Language
  • Laterality
  • Uncinate fasciculus
  • Wada (sodium Amytal) test

ASJC Scopus subject areas

  • Neurology
  • Cognitive Neuroscience


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