Is Speech Arrest during Wada Testing a Valid Method for Determining Hemispheric Representation of Language?

Background and objective: The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, bu...

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Bibliographic Details
Published in:Brain and language 1998-12, Vol.65 (3), p.441-446
Main Authors: Benbadis, Selim R., Binder, Jeffrey R., Swanson, Sara J., Fischer, Mariellen, Hammeke, Thomas A., Morris, George L., Frost, Julie A., Springer, Jane A.
Format: Article
Language:English
Subjects:
Amobarbital
Anatomical correlates of behavior
Behavioral psychophysiology
Biological and medical sciences
Brain - drug effects
Epilepsy
epilepsy surgery
Functional Laterality
Fundamental and applied biological sciences. Psychology
GABA Modulators
Humans
Key Words: Language
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Speech - physiology
Wada test
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Summary:Background and objective: The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, but others base language lateralization solely on speech arrest. This study sought to determine whether speech arrest alone during Wada testing provides valid data regarding language lateralization. Methods: The subjects (previously reported) were 21 patients evaluated for intractable epilepsy, who underwent language lateralization by Wada testing and functional MRI (FMRI). For each patient, language representation was determined by calculating: (1) a Wada laterality index based exclusively on speech arrest; (2) a Wada laterality index based on comprehensive language assessment; and (3) an FMRI laterality quotient. Correlation coefficients and categorical classifications were analyzed. Results: There was no significant correlation between the Wada laterality quotient derived from duration of speech arrest and either the comprehensive Wada language laterality score (r= .35,p= .12) or FMRI language laterality score (r= .32,p= .16). Categorical classification as left, right or bilateral language also showed marked discordance between speech arrest and the other two methods. Conclusion: Duration of speech arrest during Wada testing is not a valid measure of language dominance.
ISSN:0093-934X
1090-2155
DOI:10.1006/brln.1998.2018