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Is speech arrest during wada testing a valid method for determining hemispheric representation of language?
S R Benbadis1, J R Binder, S J Swanson
1Department of Neurology, Cleveland Clinic Florida, Ft. Lauderdale, USA. benbads@cesmtp.ccf.org
Brain and Language
|December 9, 1998
Summary
Speech arrest duration during the Wada test is not a valid measure for determining language dominance. Comprehensive assessments and fMRI are more reliable for language lateralization in epilepsy patients.
Area of Science:
- Neuroscience
- Neurology
- Epilepsy Research
Background:
- The intracarotid amobarbital procedure (Wada test) is standard for assessing language representation before epilepsy surgery.
- Practices vary, with some relying solely on speech arrest, while others use comprehensive language evaluations.
Purpose of the Study:
- To evaluate the validity of using speech arrest alone during Wada testing for language lateralization.
- To compare speech arrest data with comprehensive Wada testing and fMRI results.
Main Methods:
- 21 epilepsy patients underwent Wada testing and functional MRI (fMRI) for language lateralization.
- Calculated Wada laterality indices based on speech arrest and comprehensive assessment.
- Compared these with fMRI laterality quotients.
Main Results:
- No significant correlation was found between speech arrest duration and comprehensive Wada scores (r=.35, p=.12).
- Speech arrest data also showed no significant correlation with fMRI lateralization (r=.32, p=.16).
- Categorical language lateralization differed significantly between speech arrest and other methods.
Conclusions:
- Speech arrest duration during Wada testing is an unreliable indicator of language dominance.
- Comprehensive language assessment and fMRI are recommended for accurate language lateralization.