Dynamic Causal Tractography Analysis of Auditory Descriptive Naming: An Intracranial Study of 106 Patients.

Humans understand and respond to spoken questions through coordinated activity across distributed cortical networks. However, the causal roles of network engagements alternating across multiple white matter bundles remain understudied at the whole-brain scale. Using intracranial high-gamma activity recorded from 7,792 non-epileptic electrode sites in 106 epilepsy patients who underwent direct cortical stimulation mapping, we constructed an atlas visualizing the millisecond-scale dynamics of functional coactivation and co-inactivation networks during a naming task conducted in response to auditory questions. This atlas, termed the Dynamic Causal Tractography Atlas, identified functional coactivation patterns within specific time windows that were most strongly associated with stimulation-induced language and speech manifestations (p-value range: 2.5 × 10 to 6.6 × 10; rho range: +0.54 to +0.82). The atlas revealed that no single intra-hemispheric fasciculus was consistently engaged in all naming stages; instead, each fasciculus supported specific stages, with multiple distinct major fasciculi simultaneously contributing to each stage. Additionally, this atlas identified the specific linguistic stages and fasciculi where handedness effects became evident. Our findings clarify the dynamics and causal roles of alternating, coordinated neural activity through specific fasciculi during auditory descriptive naming, advancing current neurobiological models of speech network organization.