Moscow Wada protocol: an optimised protocol for language and memory lateralization

Area of Science:

• Neuroscience
• Neurology
• Epileptology

Background:

• The Wada test is crucial for assessing language and memory lateralization in epilepsy patients.
• Existing Wada test protocols have methodological differences and do not fully address language comprehension.
• Accurate lateralization assessment is vital for presurgical planning in epilepsy.

Purpose of the Study:

• To introduce a novel, optimized Wada test protocol for assessing language and memory lateralization.
• To evaluate the protocol's efficacy in a cohort of epilepsy patients undergoing presurgical evaluation.
• To provide a cross-linguistic adaptation for broader application.

Main Methods:

• Development and testing of an optimized Wada test protocol using Russian and English language stimuli.
• Application of the protocol to eight epilepsy patients during presurgical evaluation.
• Analysis of language comprehension, production, and memory lateralization patterns.

Main Results:

• The optimized protocol demonstrated consistent lateralization patterns: bilateral language comprehension, unilateral language production, and bilateral/right-hemisphere memory organization.
• Postoperative outcomes confirmed the protocol's ability to identify eloquent hemispheres.
• Intraoperative mapping results corroborated the findings.

Conclusions:

• The novel Wada test protocol enhances the determination of individual language and memory lateralization patterns.
• This optimized protocol offers valuable insights for improving presurgical planning and treatment strategies in epilepsy.
• The protocol's cross-linguistic adaptation supports wider clinical application.