The intracarotid amobarbital procedure as a predictor of memory failure following unilateral temporal lobectomy

Loring, David W.; Lee, G. P.; Meador, Kimford J.; Flanigin, Herman F.; Smith, Joseph R.; Damián, Ricardo Figueroa; Martin, Roy C.

doi:10.1212/wnl.40.4.605

Cited by 106 publications

(54 citation statements)

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“…In contrast to our findings, Loring et al (31), who describe an IAP procedure similar to ours, found no difference between seizure onset groups following injection contralateral to the side of seizure onset. However, the Loring et al (31) study included a separate group of items presented sometime after the initial 8 objects.…”

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…However, the Loring et al (31) study included a separate group of items presented sometime after the initial 8 objects. In addition, reported mean amobarbital dosages were higher in the Loring et al (31) study than in ours. They report a mean left amobarbital dosage of 130 mg and a mean right amobarbital dosage of 128 mg, as compared with values of 102 and 103 mg for analogous injections in our study.…”

Section: Discussionmentioning

confidence: 99%

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Asymmetries in the Effect of Side of Seizure Onset on Recognition Memory Following Intracarotid Amobarbital Injection

et al. 1997

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Summary:Purpose: To assess interhemispheric differences in recognition memory for objects during the intracarotid amobarbital sodium procedure (IAP).Methods: The recognition memory for real objects of patients with either right (RTLE, n = 28) or left (LTLE; n = 22) temporal lobe epilepsy was assessed at baseline, and after left and right intracarotid amobarbital sodium injection.Results: There were no differences between groups on baseline performance. Performance following injection ipsilateral to the side of seizure focus was relatively lower for the LTLE as compared with the RTLE group, but this difference did not reach statistical significance. However, performance following injection contralateral to the side of seizure focus was significantly lower for the RTLE as compared with the LTLE group. Within-group differences in performance after ipsilateral as compared with contralateral injection were significant for the RTLE but not the LTLE group. The difference in interhemispheric asymmetry in IAP memory performance between RTLE and LTLE groups was reflected in decreased ability to classify LTLE patients as compared with RTLE patients about side of seizure onset, using a clinically applicable decision rule. Conclusions:Recognition memory during the IAP for real objects, simultaneously named and presented visually during encoding, is mediated effectively by both the left and right hemisphere when there is no seizure focus present. However, memory appears to be more vulnerable to the presence of a seizure focus in the right as compared with the left hemisphere.

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confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Asymmetries in the Effect of Side of Seizure Onset on Recognition Memory Following Intracarotid Amobarbital Injection

et al. 1997

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“…However, its ability to predict memory function following unilateral medial temporal lobe resection has been highly variable (Loring, Meador, Lee, Martin, & Huh, 1998;Jack, Nichols, Sharbrough, Marsh, & Petersen, 1988;Jack et al, 1989). This may be related, in part, to the inconsistent delivery of sodium amytal to medial temporal lobe structures during Wada testing.…”

Section: Angiography Resultsmentioning

confidence: 99%

Wada Testing Reveals Frontal Lateralization for the Memorization of Words and Faces

Kelley

Ojemann

Wetzel

et al. 2002

Journal of Cognitive Neuroscience

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Abstract& Neuroimaging studies have suggested that specific regions of the frontal and medial temporal cortex are engaged during memory formation. Further, there is specialization across these regions such that verbal materials appear to preferentially engage the left regions while nonverbal materials primarily engage the right regions. An open question, however, has been to what extent frontal regions contribute to successful memory formation. The present study investigates this question using a reversible lesion technique known as the Wada test. Patients memorized words and unfamiliar faces while portions of their left and right hemispheres were temporarily anesthetized with sodium amytal. Subsequent memory tests revealed that faces were remembered better than words following left-hemisphere anesthesia, whereas words were remembered better than faces following right-hemisphere anesthesia. Importantly, inspection of the circulation affected by the amytal further suggests that these memory impairments did not result from direct anesthetization of the medial temporal regions. Taken in the context of the imaging findings, these results suggest that frontal regions may also contribute to memory formation in normal performance. &

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“…Unexpectedly, 12 of 13 severely amnesic persons obtained nearperfect memory scores. Amnesia had no impact on the speech protocol.…”

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confidence: 89%

Criterion‐Based Validity of an Intracarotid Amobarbital Recognition‐Memory Protocol

McGlone

Black

Evans³

et al. 1999

Epilepsia

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Summary: Purpose: We tested whether the behavioral components of an Intracarotid Amobarbital Protocol (IAP) had criterion validity. It was hypothesized that a recognition-memory test designed for intracarotid injections and used to predict the risk of global amnesia before an elective temporal lobectomy should also identify persons who are severely amnesic due to other neurologic causes. Divergent validity predicts that speech tasks would be unaffected by amnesia. Test-retest reliability also was measured.Methods: Fifteen persons with severe amnesia were administered four alternate forms of a yesho recognition-memory protocol and a speech protocol. No drug injection occurred. Standardized neuropsychological tests were used to divide the amnesic group into those with Global Amnesia (i.e., retain no ongoing memories), Severe Amnesia (i.e., memory impaired), and Amnesia Plus (severe amnesia plus other neuropsychologic deficits).Results: Two persons with Global Amnesia obtained scores at or below chance (i.e., failed) on the memory protocol. Unexpectedly, 12 of 13 severely amnesic persons obtained nearperfect memory scores. Amnesia had no impact on the speech protocol. PassFail outcomes were highly correlated across all four sets.Conclusions: A four-item IAP memory protocol showed good reliability and criterion validity in identifying the rare condition of Global Amnesia, but it was insensitive to other disabling, severe amnesic disorders. This IAP memory protocol might have validity in predicting a postsurgical Global Amnesic disorder, but it did not identify and therefore could not predict other more common severe amnesic disorders. Key Words: IAP-Memory-Validity.The Wada test or intracarotid amobarbital protocol (IAP) has been used clinically for almost 40 years to measure cerebral lateralization of speech (l), and predict severe amnesic syndromes (2-4). More recently clinicians use IAP results to confirm lateralization of a temporal lobe seizure focus ( 5 ) and predict verbal memory loss (6,7). For a more thorough review of how this procedure has evolved, see Rausch and Langfitt (7), Acharya and Dinner (S), and a special issue of Bruin and Cognition (9,lO). The purpose of this article is to review empirically based evidence that IAP memory protocols can reliably and validly measure very severe memory disorders, including global amnesia.Base rates of global amnesia after temporal lobectomy

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The intracarotid amobarbital procedure as a predictor of memory failure following unilateral temporal lobectomy

Cited by 106 publications

References 0 publications

Asymmetries in the Effect of Side of Seizure Onset on Recognition Memory Following Intracarotid Amobarbital Injection

Asymmetries in the Effect of Side of Seizure Onset on Recognition Memory Following Intracarotid Amobarbital Injection

Wada Testing Reveals Frontal Lateralization for the Memorization of Words and Faces

Criterion‐Based Validity of an Intracarotid Amobarbital Recognition‐Memory Protocol

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