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@ARTICLE{Bisten:279356,
      author       = {Bisten, Justus and Grün, Johannes and Hoppe, Christian and
                      Bauer, Tobias and Held, Nina Rebecca and Rose, Renata and
                      Althausen, Anita and Witt, Juri-Alexander and Borger, Valeri
                      and Schneider, Matthias and Vatter, Hartmut and
                      Helmstaedter, Christoph and Radbruch, Alexander and Surges,
                      Rainer and Schultz, Thomas and Rüber, Theodor},
      title        = {{S}tructural {W}hite {M}atter {C}orrelates of the
                      {C}rowding {E}ffect: {I}nsights {F}rom a {T}ractography
                      {S}tudy of the {A}rcuate {F}asciculus
                      {P}ost-{H}emispherotomy.},
      journal      = {Human brain mapping},
      volume       = {46},
      number       = {9},
      issn         = {1065-9471},
      address      = {New York, NY},
      publisher    = {Wiley-Liss},
      reportid     = {DZNE-2025-00733},
      pages        = {e70258},
      year         = {2025},
      abstract     = {The neuropsychological crowding effect denotes the
                      reallocation of cognitive functions within the
                      contralesional hemisphere following unilateral brain damage,
                      prioritizing language at the expense of nonverbal abilities.
                      This study investigates structural white matter correlates
                      of crowding in the arcuate fasciculus (AF), a key language
                      tract, using hemispherotomy as a unique setting to explore
                      structural reorganization supporting language preservation.
                      We explore two main hypotheses. First, the contralesional
                      right AF undergoes white matter reorganization correlated
                      with preserved language function at the expense of nonverbal
                      abilities following left-hemispheric damage. Second, this
                      reorganization varies with epilepsy etiology, influencing
                      different stages of developmental language lateralization.
                      This retrospective study included individuals
                      post-hemispherotomy and healthy controls. Inclusion criteria
                      were; (1) being a native German speaker, (2) having no MRI
                      contraindication, (3) the ability to undergo approximately 2
                      h of MRI scans, and (4) the ability to participate in
                      neuropsychological assessments over two consecutive days.
                      Neuroimaging included T1-, T2-, and diffusion-weighted
                      imaging, alongside postoperative neuropsychological
                      assessments, where it was taken as evidence for crowding if
                      verbal IQ exceeded performance IQ by at least 10 points. The
                      AF was reconstructed using advanced tractography, and
                      CoBundleMAP was used to compare morphologically
                      corresponding AF subsections. Statistical significance was
                      set at $ p<0.05 $ , with correction for multiple comparisons
                      applied across contiguous tract sections using
                      Threshold-Free Cluster Enhancement. The final cohort
                      comprised 22 individuals post-hemispherotomy (median age: $
                      20.4 $ years, range: $ 12.3-43.9 $ ; 55\% female; 55\% with
                      left-sided surgeries) and 20 healthy controls (median age: $
                      23.8 $ years, range: $ 15.5-54.0 $ ; 55\% female). Crowding
                      was associated with significantly higher fractional
                      anisotropy (FA) in the AF ( $ p=0.015 $ , Cohen's $ d=1.69 $
                      ), but only observed in individuals with left-sided
                      hemispherotomy, localized to a subsection between
                      Geschwind's territory and Wernicke's area ( $
                      {p}_{\mathrm{corrected}}=0.02 $ ). This region also
                      displayed significantly higher normalized FA in AF of
                      individuals with congenital etiology and crowding compared
                      to acquired etiology and no crowding ($
                      {p}_{\mathrm{corrected}}=0.0189 $ ). This study identifies
                      previously unreported neural correlates of crowding in right
                      contralesional AF of individuals post-hemispherotomy and
                      highlights specific AF subsections involved in preserving
                      language functions at the cost of nonverbal abilities. The
                      findings suggest a link between crowding and epilepsy
                      etiology, particularly in the region spanning Geschwind's
                      territory and Wernicke's area.},
      keywords     = {Humans / Female / White Matter: diagnostic imaging / White
                      Matter: pathology / Male / Diffusion Tensor Imaging / Adult
                      / Retrospective Studies / Hemispherectomy / Young Adult /
                      Functional Laterality: physiology / Middle Aged / Adolescent
                      / Language / Neural Pathways: diagnostic imaging},
      cin          = {AG Stöcker / AG Radbruch},
      ddc          = {610},
      cid          = {I:(DE-2719)1013026 / I:(DE-2719)5000075},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40536189},
      pmc          = {pmc:PMC12177811},
      doi          = {10.1002/hbm.70258},
      url          = {https://pub.dzne.de/record/279356},
}