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Naming outcome prediction in patients with discordant Wada and fMRI language lateralization. Epilepsy Behav 2013 May;27(2):399-403

Date

04/02/2013

Pubmed ID

23541860

Pubmed Central ID

PMC3644871

DOI

10.1016/j.yebeh.2013.02.030

Scopus ID

2-s2.0-84876127499   36 Citations

Abstract

OBJECTIVE: Investigations of the validity of fMRI as an alternative to Wada language testing have yielded Wada/fMRI discordance rates of approximately 15%, but almost nothing is known regarding the relative accuracy of Wada and fMRI in discordant cases. The objective of this study was to determine which of the two (the Wada test or the language fMRI) is more predictive of postoperative naming outcome following left anterior temporal lobectomy in discordant cases.

METHODS: Among 229 patients with epilepsy who prospectively underwent Wada and fMRI language testing, ten had discordant language lateralization results, underwent left anterior temporal lobectomy, and returned for postoperative language testing. The relative accuracy of Wada and fMRI for predicting language outcome was examined in these cases.

RESULTS: Functional magnetic resonance imaging provided a more accurate prediction of language outcome in seven patients, Wada was more accurate in two patients, and the two tests were equally accurate in one patient.

CONCLUSIONS: In cases of discordance, fMRI predicted postsurgical naming outcome with relatively better accuracy compared to the Wada test.

Author List

Janecek JK, Swanson SJ, Sabsevitz DS, Hammeke TA, Raghavan M, Mueller W, Binder JR

Authors

Jeffrey R. Binder MD Professor in the Neurology department at Medical College of Wisconsin
Julie K. Janecek PhD Associate Professor in the Neurology department at Medical College of Wisconsin
Wade M. Mueller MD Professor in the Neurosurgery department at Medical College of Wisconsin
Manoj Raghavan MD, PhD Professor in the Neurology department at Medical College of Wisconsin
Sara 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

Adult
Amobarbital
Brain
Epilepsy
Female
Functional Laterality
Humans
Image Processing, Computer-Assisted
Language Tests
Magnetic Resonance Imaging
Male
Middle Aged
Names
Neuropsychological Tests
Neurosurgery
Oxygen
Predictive Value of Tests