Effect of Wada methodology in predicting lateralized memory impairment in pediatric epilepsy surgery candidates

Lee, Gregory P.; Park, Yong D.; Westerveld, Michael; Hempel, Ann; Loring, David W.

doi:10.1016/s1525-5050(02)00514-0

Cited by 17 publications

(10 citation statements)

References 16 publications

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“…17 Other factors, including method of stimulation presentation and testing procedure, may have important impact on Wada performance, making generalizability of results across centers unreliable. 18,19 The variable that is currently under most scrutiny is the choice of stimuli. Results from centers using mixed stimuli may not be comparable with results from centers using real objects.…”

Section: Discussionmentioning

confidence: 99%

“…Results from centers using mixed stimuli may not be comparable with results from centers using real objects. 19 Verbal stimuli may introduce a major confound, as presentation of language-based items during dominant hemisphere cortical anesthesia could have significant impact on encoding of these items. Because of this, many centers (including our own, since the date that this series was completed) use stimuli whose registration is not dependent on intact language function.…”

Section: Discussionmentioning

confidence: 99%

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Limitations of Wada memory asymmetry as a predictor of outcomes after temporal lobectomy

Kirsch

Walker²,

Winstanley

et al. 2005

Neurology

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Unexpected asymmetry is uncommon in patients with right anterior temporal lobectomy (R-ATL) and may be a risk marker of poor surgical outcome. This relationship may be obscured by language confounds in patients with L-ATL. The results suggest that Wada asymmetry (using mixed stimuli) does not predict postoperative verbal memory; it is unclear whether this finding is generalizable to centers using only nonverbal stimuli.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Limitations of Wada memory asymmetry as a predictor of outcomes after temporal lobectomy

Kirsch

Walker²,

Winstanley

et al. 2005

Neurology

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“…Preoperative Wada Test memory asymmetry (impaired ipsilateral and intact contralateral memory) has been found to be associated with side of ictal EEG onset 44 , hippocampal atrophy on MRI 45, 46 , and neuronal loss in resected hippocampus 33 . However, there are factors that can affect this relationship including atypical language representation 474849 , the types of memory stimuli used 50 , and the type of neuropsychological memory outcome measure [better for predicting list learning than prose recall change 51 . The Wada Test has been less useful for predicting non-verbal memory outcome following right ATL 52 , in part a likely reflection of the difficulty finding memory measures linked to a consistent right hemisphere effect 5354 .…”

Section: A Paradigm Shiftmentioning

confidence: 99%

The neurobiology of cognitive disorders in temporal lobe epilepsy

et al. 2011

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Cognitive impairment and especially memory disruption is a major complicating feature of the epilepsies. In this review we begin with a focus on the problem of memory impairment in temporal lobe epilepsy. We start with a brief overview of the early development of knowledge regarding the anatomic substrates of memory disorder in temporal lobe epilepsy, followed by discussion of the refinement of that knowledge over time as informed by the outcomes of epilepsy surgery (anterior temporal lobectomy) and the clinical efforts to predict those patients at greatest risk of adverse cognitive outcomes following epilepsy surgery. These efforts also yielded new theoretical insights regarding the function of the human hippocampus and a few examples of these insights are touched on briefly. Finally, the vastly changing view of temporal lobe epilepsy is examined including findings demonstrating that anatomic abnormalities extend far outside the temporal lobe, cognitive impairments extend beyond memory function, with linkage of these distributed cognitive and anatomic abnormalities pointing to a new understanding of the anatomic architecture of cognitive impairment in epilepsy. Challenges remain in understanding the origin of these cognitive and anatomic abnormalities, their progression over time, and most importantly, how to intervene to protect cognitive and brain health in epilepsy.

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“…Although the type and number of memory stimuli varied somewhat across the institutions (see ref. 30 for the specific stimuli), all three surgery centers used a Montreal Wada protocol involving presentation of discrete stimuli during the period of drug effect followed by memory stimuli recognition after return to neurologic baseline when the drug effects had worn off. Discrete memory items were presented between ∼30 and 60 s after development of a contralateral hemiparesis.…”

Section: Wada Memory Assessmentmentioning

confidence: 99%

Prediction of Verbal Memory Decline after Epilepsy Surgery in Children: Effectiveness of Wada Memory Asymmetries

et al. 2005

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Summary:Purpose: Differences in Wada memory performance after left and right amobarbital injection are powerful predictors of pre-to postoperative memory change among adult epilepsy patients after anterior temporal lobectomy. It is unknown, however, whether these Wada memory asymmetries apply to children who undergo focal cortical resection or to epilepsy surgery patients who undergo resection outside the temporal lobes.Methods: To investigate these issues, Wada memory asymmetries and pre-to postoperative neuropsychological memory test performances were examined in 132 children who underwent some form of resective epilepsy surgery. Ninety-three (70%) children showed Wada memory asymmetries in the predicted direction (memory after injection ipsilateral to side of surgery better than memory after contralateral injection), and 39 (30%) did not. Results:Children with Wada memory asymmetries showed significant improvement in verbal memory after surgery as compared with children without Wada memory asymmetries who showed significant verbal memory decline. This result was also obtained when individual cases were examined: 77% of children with Wada memory asymmetries in predicted direction showed no verbal memory decline after surgery, whereas 80% of children without asymmetries had lower postoperative verbal memory (passage recall) test scores. Wada memory asymmetries had no value in predicting postoperative changes in visual-spatial memory.Conclusions: Wada memory asymmetries may be used as one of the factors to assess risk for verbal memory decline after epilepsy surgery in children.

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Effect of Wada methodology in predicting lateralized memory impairment in pediatric epilepsy surgery candidates

Cited by 17 publications

References 16 publications

Limitations of Wada memory asymmetry as a predictor of outcomes after temporal lobectomy

Limitations of Wada memory asymmetry as a predictor of outcomes after temporal lobectomy

The neurobiology of cognitive disorders in temporal lobe epilepsy

Prediction of Verbal Memory Decline after Epilepsy Surgery in Children: Effectiveness of Wada Memory Asymmetries

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