Neural plasticity after pre-linguistic injury to the arcuate and superior longitudinal fasciculi.

We describe the case of girl who was born prematurely and diagnosed periventricular leukomalacia, a condition characterized by severe injury to the white matter tracts primarily surrounding the ventricles. At 12 years of age, we obtained diffusion tensor imaging (DTI) data on this child as part of a research protocol. Multiple analyses of DTI data, including tractography, showed that the left and right arcuate and superior longitudinal fasciculi were missing in the child though all other major white matter tracts were present. Standardized psychometric tests at age 12 years revealed that despite early language delays, she had average scores on expressive language, sentence repetition, and reading, functions that have been hypothesized to depend on signals carried by the arcuate fasciculus. We identified intact ventral connections between the temporal and frontal lobes through the extreme capsule fiber system and uncinate fasciculus. Preserved language and reading function after serious injury to the arcuate fasciculus highlights the plasticity of the developing brain after severe white matter injury early in life.