Is speech arrest during wada testing a valid method for determining hemispheric representation of language? Brain Lang 1998 Dec;65(3):441-6
Date
12/09/1998Pubmed ID
9843613DOI
10.1006/brln.1998.2018Scopus ID
2-s2.0-0032403860 (requires institutional sign-in at Scopus site) 64 CitationsAbstract
BACKGROUND AND OBJECTIVE: The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, but others base language lateralization solely on speech arrest. This study sought to determine whether speech arrest alone during Wada testing provides valid data regarding language lateralization.
METHODS: The subjects (previously reported) were 21 patients evaluated for intractable epilepsy, who underwent language lateralization by Wada testing and functional MRI (FMRI). For each patient, language representation was determined by calculating: (1) a Wada laterality index based exclusively on speech arrest; (2) a Wada laterality index based on comprehensive language assessment; and (3) an FMRI laterality quotient. Correlation coefficients and categorical classifications were analyzed.
RESULTS: There was no significant correlation between the Wada laterality quotient derived from duration of speech arrest and either the comprehensive Wada language laterality score (r =.35, p =.12) or FMRI language laterality score (r =.32, p =.16). Categorical classification as left, right or bilateral language also showed marked discordance between speech arrest and the other two methods.
CONCLUSION: Duration of speech arrest during Wada testing is not a valid measure of language dominance.
Author List
Benbadis SR, Binder JR, Swanson SJ, Fischer M, Hammeke TA, Morris GL, Frost JA, Springer JAAuthors
Jeffrey R. Binder MD Professor in the Neurology department at Medical College of WisconsinSara J. Swanson PhD Chief, Professor in the Neurology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AmobarbitalBrain
Epilepsy
Functional Laterality
GABA Modulators
Humans
Speech