Application of fMRI in combination with Wada test in preoperative assessment of speech function in medically refractory epilepsy_Journal of Epilepsy

Authors：

 YAN Hongjun ¹ , ZHANG Hanqing ² , LI Kaihui ¹ , ZHUANG Jun ¹ ,  HU Xiangshu ³ , TAN Qinghua ¹

1. Epilepsy Center, Guangdong 999 Brain Hospital, Guangzhou 510510, China;
2. South China Normal University, Guangzhou 510510, China;
3. Department of Neurosurgery, Guangdong Second Provincial General Hospital ,Guangzhou 510317, China;

Corresponding author：

YAN Hongjun, Email: yhj8441285@qq.com; HU Xiangshu, Email: hxs75@126.com

Keywords：

Preoperative fMRI; Wada test; Medically refractory epilepsy

DOI：

10.7507/2096-0247.202303012

Video：

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Objective To investigate the task group’s effectiveness in language evaluation based on the task group's functional Magnetic resonance (fMRI) results’ agreement with the fixation side of the Wada language area. Methods We collected 90 patients with intractable epilepsy of 90 patients from December 13, 2018 to January 3, 2020 from the Epilepsy Center of Guangdong 999 Brain Hospital. We used two simple fMRI tasks. Among them, 25 patients completed the Wada experimental examination, and 8 patients completed the electrode implantation and subsequent preoperative language area mapping. Adopt block experimental design, ABBA style presentation, and use AFNI software to process fMRI data, lateralization index calculation, and multiple regression analysis. Results fMRI results from 90 patients showed that the results from both the sentence-completion task and the image-naming task were more stable than those from either task. The results were then compared with the results of the “gold standard” Wada test in 25 patients with fMRI-located language dominance in the hemisphere. The results showed that the accuracy of the single task was between 70% and 80%, but the accuracy of the combined results of the two tasks was 93.3%. Conclusions Compared with the results of a single task, the results of multiple fMRI tasks are more stable in the judgment of activation range and language dominance hemisphere. fMRI and Wada language area siding accuracy 93.3%, fMRI task siding valid and replicable.

Citation： YAN Hongjun, ZHANG Hanqing, LI Kaihui, ZHUANG Jun, HU Xiangshu, TAN Qinghua. Application of fMRI in combination with Wada test in preoperative assessment of speech function in medically refractory epilepsy. Journal of Epilepsy, 2023, 9(3): 200-204. doi: 10.7507/2096-0247.202303012 Copy

1.	Rutten GJM, Ramsey NF, Van Rijen PC, et al. Development of a functional magnetic resonance imaging protocol for intraoperative localization of critical temporoparietal language areas. Annals of Neurology, 2002, 51(3): 350-360.
2.	Meier M P, Ilmberger J, Fesl G, et al. Validation of functional motor and language MRI with direct cortical stimulation. Acta Neurochirurgica, 2013, 155(4): 675-683.
3.	Babajaniferemi A, Narayana S, Rezaie R, et al. Language mapping using high gamma electrocorticography, fMRI, and TMS versus electrocortical stimulation. Clinical Neurophysiology, 2016, 127(3): 1822-1836.
4.	Black DF, Vachha B, Mian A, et al. American society of functional neuroradiology–recommended fmri paradigm algorithms for presurgical language assessment. American Journal of Neuroradiology, 2017, 38(10): E65-E73.
5.	Binder JR. Functional MRI is a valid noninvasive alternative to Wada testing. Epilepsy & behavior, 2011, 20(2): 214-222.
6.	Szaflarski JP, Gloss D, Binder JR, et al. Practice guideline summary: use of fMRI in the presurgical evaluation of patients with epilepsy. Neurology, 2017, 88(4): 395-402.
7.	Wada J, Rasmussen T. Intracarotid injection of sodium amytal for the lateralization of cerebral speech dominance: experimental and clinical observations. Journal of Neurosurgery, 1960, 17(2): 266-282.
8.	Janecek JK, Swanson SJ, Sabsevitz DS, et al. Language lateralization by f MRI and Wada testing in 229 patients with epilepsy: rates and predictors of discordance. Epilepsia, 2013, 54(2): 314-322.
9.	Arora J, Pugh K, Westerveld M, et al. Language lateralization in epilepsy patients: fMRI validated with the Wada procedure. Epilepsia, 2009, 50(10): 2225-2241.

1. Rutten GJM, Ramsey NF, Van Rijen PC, et al. Development of a functional magnetic resonance imaging protocol for intraoperative localization of critical temporoparietal language areas. Annals of Neurology, 2002, 51(3): 350-360.
2. Meier M P, Ilmberger J, Fesl G, et al. Validation of functional motor and language MRI with direct cortical stimulation. Acta Neurochirurgica, 2013, 155(4): 675-683.
3. Babajaniferemi A, Narayana S, Rezaie R, et al. Language mapping using high gamma electrocorticography, fMRI, and TMS versus electrocortical stimulation. Clinical Neurophysiology, 2016, 127(3): 1822-1836.
4. Black DF, Vachha B, Mian A, et al. American society of functional neuroradiology–recommended fmri paradigm algorithms for presurgical language assessment. American Journal of Neuroradiology, 2017, 38(10): E65-E73.
5. Binder JR. Functional MRI is a valid noninvasive alternative to Wada testing. Epilepsy & behavior, 2011, 20(2): 214-222.
6. Szaflarski JP, Gloss D, Binder JR, et al. Practice guideline summary: use of fMRI in the presurgical evaluation of patients with epilepsy. Neurology, 2017, 88(4): 395-402.
7. Wada J, Rasmussen T. Intracarotid injection of sodium amytal for the lateralization of cerebral speech dominance: experimental and clinical observations. Journal of Neurosurgery, 1960, 17(2): 266-282.
8. Janecek JK, Swanson SJ, Sabsevitz DS, et al. Language lateralization by f MRI and Wada testing in 229 patients with epilepsy: rates and predictors of discordance. Epilepsia, 2013, 54(2): 314-322.
9. Arora J, Pugh K, Westerveld M, et al. Language lateralization in epilepsy patients: fMRI validated with the Wada procedure. Epilepsia, 2009, 50(10): 2225-2241.

Journal of Epilepsy

Application of fMRI in combination with Wada test in preoperative assessment of speech function in medically refractory epilepsy

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