Role of the Wada test and functional magnetic resonance imaging in preoperative mapping of language and memory: two atypical cases

Połczyńska, Monika; Benjamin, Christopher; Moseley, Brian D.; Walshaw, Patricia D.; Eliashiv, Dawn; Vigil, Celia; Jones, Michael R.; Bookheimer, Susan Y.

doi:10.1080/13554794.2014.977300

Cited by 14 publications

(9 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We present these findings as a caution to viewing functional imaging as a replacement for Wada testing and in the context of a relatively small literature that has yet to establish consensus on, which imaging technique, which activation paradigms and, which method of analysis to best apply clinically. These data support the position taken by Limotai and Mirsattari [14] that imaging technology is yet to attain its full potential and the position taken by Połczyńska et al [33] that imaging and the Wada test may turn out to be complementary and not competing techniques to counsel and safeguard patients from adverse neuropsychological outcomes following epilepsy surgery.…”

Section: Discussionsupporting

confidence: 81%

Concordance between the Wada test and neuroimaging lateralization: Influence of imaging modality (fMRI and MEG) and patient experience

Kemp

Prendergast

Karapanagiotidis

et al. 2018

Epilepsy & Behavior

View full text Add to dashboard Cite

The Wada test remains the traditional test for lateralizing language and memory function prior to epilepsy surgery. Functional imaging, particularly functional MRI (fMRI), has made progress in the language domain, but less so in the memory domain. Magnetoencephalography (MEG) has received less research attention, but shows promise, particularly for language lateralization. We recruited a consecutive sample of 19 patients with epilepsy who had completed presurgical work-up, including the Wada test, and compared fMRI (memory) and MEG (language and memory) with Wada test results. The main research question was the concordance between Wada and these two imaging techniques as preepilepsy surgery investigations. We were also interested in the acceptability of the three techniques to patients. Concordance rates (N=16) were nonsignificant (Cohen's Kappa) between fMRI and Wada test (memory) and between MEG and Wada test (memory and language). The Wada test was a well-established protocol used at several epilepsy surgery centers in the UK. Patients generally found the Wada test an odd, but not aversive procedure. Sixteen (84%) patients who were scanned reported some level of obtundation in MEG. We present these discordant findings in support of the position that functional imaging and the Wada test are distinctive procedures, with little in the way of overlapping mechanisms, and that patient's experience should be taken into account when procedures are selected and offered to them.

show abstract

Section: Discussionsupporting

confidence: 81%

Concordance between the Wada test and neuroimaging lateralization: Influence of imaging modality (fMRI and MEG) and patient experience

Kemp

Prendergast

Karapanagiotidis

et al. 2018

Epilepsy & Behavior

View full text Add to dashboard Cite

show abstract

“…Less is also currently known about the ability to predict deficits in some higher‐order aspects of language function, such as grammar, postsurgically. There is evidence that non lexico‐semantic aspects of language such as grammar may have a partially distinct neuroarchitecture in epilepsy and tumor patients [Ojemann and Mateer, ] and preliminary evidence that considering grammar as part of evaluation may improve the utility of clinical mapping paradigms [Połczyńska et al, ; Rofes and Miceli, ]. More broadly, this fMRI‐based approach focuses on cortical structures and does not explicitly consider the connections between these regions, or subcortical involvement, and it is imperative that these be considered in planning.…”

Section: Discussionmentioning

confidence: 99%

“…A modified Montreal protocol was used [e.g., Połczyńska et al, ]. A catheter was placed within the carotid artery (transfemorally; radiologist).…”

Section: Methodsmentioning

confidence: 99%

Presurgical language fMRI: Mapping of six critical regions

Benjamin

Walshaw

Hale

et al. 2017

Human Brain Mapping

Self Cite

118

View full text Add to dashboard Cite

Language mapping is a key goal in neurosurgical planning. fMRI mapping typically proceeds with a focus on Broca's and Wernicke's areas, although multiple other language‐critical areas are now well‐known. We evaluated whether clinicians could use a novel approach, including clinician‐driven individualized thresholding, to reliably identify six language regions, including Broca's Area, Wernicke's Area (inferior, superior), Exner's Area, Supplementary Speech Area, Angular Gyrus, and Basal Temporal Language Area. We studied 22 epilepsy and tumor patients who received Wada and fMRI (age 36.4[12.5]; Wada language left/right/mixed in 18/3/1). fMRI tasks (two × three tasks) were analyzed by two clinical neuropsychologists who flexibly thresholded and combined these to identify the six regions. The resulting maps were compared to fixed threshold maps. Clinicians generated maps that overlapped significantly, and were highly consistent, when at least one task came from the same set. Cases diverged when clinicians prioritized different language regions or addressed noise differently. Language laterality closely mirrored Wada data (85% accuracy). Activation consistent with all six language regions was consistently identified. In blind review, three external, independent clinicians rated the individualized fMRI language maps as superior to fixed threshold maps; identified the majority of regions significantly more frequently; and judged language laterality to mirror Wada lateralization more often. These data provide initial validation of a novel, clinician‐based approach to localizing language cortex. They also demonstrate clinical fMRI is superior when analyzed by an experienced clinician and that when fMRI data is of low quality judgments of laterality are unreliable and should be withheld. Hum Brain Mapp 38:4239–4255, 2017. © 2017 Wiley Periodicals, Inc.

show abstract

“…Language dominance testing was carried out when deemed clinically necessary. Language dominance was determined either through a standard Wada protocol or through fMRI language testing ( Połczyńska et al, 2015 ). All research was carried out at the UCLA Medical Center and the UCLA Institutional Review Board approved the study protocol.…”

Section: Methodsmentioning

confidence: 99%

Theta-burst microstimulation in the human entorhinal area improves memory specificity

Titiz

Hill

Mankin

et al. 2017

eLife

Self Cite

112

View full text Add to dashboard Cite

The hippocampus is critical for episodic memory, and synaptic changes induced by long-term potentiation (LTP) are thought to underlie memory formation. In rodents, hippocampal LTP may be induced through electrical stimulation of the perforant path. To test whether similar techniques could improve episodic memory in humans, we implemented a microstimulation technique that allowed delivery of low-current electrical stimulation via 100 μm-diameter microelectrodes. As thirteen neurosurgical patients performed a person recognition task, microstimulation was applied in a theta-burst pattern, shown to optimally induce LTP. Microstimulation in the right entorhinal area during learning significantly improved subsequent memory specificity for novel portraits; participants were able both to recognize previously-viewed photos and reject similar lures. These results suggest that microstimulation with physiologic level currents—a radical departure from commonly used deep brain stimulation protocols—is sufficient to modulate human behavior and provides an avenue for refined interrogation of the circuits involved in human memory.

show abstract

Role of the Wada test and functional magnetic resonance imaging in preoperative mapping of language and memory: two atypical cases

Cited by 14 publications

References 44 publications

Concordance between the Wada test and neuroimaging lateralization: Influence of imaging modality (fMRI and MEG) and patient experience

Concordance between the Wada test and neuroimaging lateralization: Influence of imaging modality (fMRI and MEG) and patient experience

Presurgical language fMRI: Mapping of six critical regions

Theta-burst microstimulation in the human entorhinal area improves memory specificity

Contact Info

Product

Resources

About