Objective: To investigate the myelination progression course in language-correlated regions of children with normal brain development by quantitative magnetic resonance imaging (MRI) analysis compared with histological studies.
Methods: The subjects were 241 neurologically intact neonates, infants and young children (128 boys and 113 girls) who underwent MRI between 2001 and 2007 at the University of Tokyo Hospital, ranging in age from 0 to 429 weeks corrected by postnatal age. To compare their data with adult values, 25 adolescents and adults (14 men and 11 women, aged from 14 to 83 years) were examined as controls. Axial T2-weighted images were obtained using spin-echo sequences at 1.5 T. Subjects with a history of prematurity, birth asphyxia, low Apgar score, seizures, active systemic disease, congenital anomaly, delayed development, infarcts, hemorrhages, brain lesions, or central nervous system malformation were excluded from the analysis. Seven regions of interest in language-correlated areas, namely Broca's area, Wernicke's area, the arcuate fasciculus, and the angular gyrus, as well as their right hemisphere homologous regions, and the auditory cortex, the motor cortex, and the visual cortex were examined. Signal intensity obtained by a region-of-interest methodology progresses from hyper- to hypointensity during myelination. We chose the inferior cerebellar peduncle as the internal standard of maturation.
Results: Myelination in all these seven language-correlated regions examined in this study shared the same curve pattern: no myelination was observed at birth, it reached maturation at about 1.5 years of age, and it continued to progress slowly thereafter into adult life. On the basis of scatter plot results, we put these areas into three groups: Group A, which included the motor cortex, the auditory cortex, and the visual cortex, myelinated faster than Group B, which included Broca's area, Wernicke's area, and the angular gyrus before 1.5 years old; Group C, consisting of the arcuate fasciculus, has similar degree of myelination as Group B before 1.5 years but then myelinated more slowly after 3 years of age. No gender or left-right differences between homologous regions were found.
Conclusions: In this study, we determined the sequence of myelination of language-correlated regions in infants and children by quantitative MRI assessment. The higher cortical areas matured later than the primary cortical areas, and the arcuate fasciculus matured last. The observation that myelination reaches maturity after 18 months suggests that myelination may be a reason for the acceleration in vocabulary acquisition observed in children from that age. The slow pace of myelination also suggested the possibility of language development's continuation into early adult life. Myelination assessed by MRI was at least 1 month behind that assessed by histological staining. No gender or left-right hemisphere differences in myelination were noted.