Determination of language areas in patients with epilepsy using the super-selective Wada test

Kakinuma, Kazuo; Osawa, Shin-ichiro; Hosokawa, Hiroaki; Oyafuso, Marie; Ota, Shoko; Kobayashi, Erena; Kawakami, Nobuko; Ukishiro, Kazushi; Jin, Kazutaka; Ishida, M.; Sato, Takafumi; Sakamoto, Mika; Niizuma, Kuniyasu; Tominaga, Teiji; Nakasato, Nobukazu; Suzuki, Kyoko

doi:10.1016/j.ibneur.2022.08.002

Cited by 4 publications

(7 citation statements)

References 26 publications

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“…The results for the individual cases are summarized in Table 1 . The case numbers were the same as those in the supplementary table of Kakinuma et al [ 3 ]; Cases S-23, S-24, and S-25 have been added to this study.…”

Section: Resultsmentioning

confidence: 99%

“…All neurological symptoms generally resolved within 10 min, and we assessed language within 5 min. The exact duration of neurological symptoms in each case is given in the supplementary table appended to our previous paper [ 3 ]. Language assessment included sequential speech, reading aloud (both words and sentences), repetition (both words and sentences), listening comprehension, reading comprehension, naming, and writing.…”

Section: Methodsmentioning

confidence: 99%

“…In this study, we classified the induced language states into three groups: “global aphasia,” characterized by impairments in speech, comprehension, and repetition; “other aphasia,” involving significant language impairments in some areas but not all; and “no language deficits,” indicating the absence of language deficits in any of these tasks. More detailed procedures and assessments of the ssWada are described in our previous papers [ 3 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…Fujii et al [ 1 ] suggested that selective anesthetic infusion into the middle cerebral artery (MCA) reduces adverse effects in the Wada test. We established a modified version of the Wada test using super-selective catheterization that involves injecting anesthetics selectively into the target arteries corresponding to the planned resection area [ 3 , 16 ], named the “super-selective Wada test” (ssWada). As most of the brain areas responsible for language are perfused by the MCA, we believe that the ssWada in the MCA region will help adequately anesthetize language-related areas with minimal effect in adjacent regions, compared with the cWada.…”

Section: Introductionmentioning

confidence: 99%

“…As most of the brain areas responsible for language are perfused by the MCA, we believe that the ssWada in the MCA region will help adequately anesthetize language-related areas with minimal effect in adjacent regions, compared with the cWada. The ssWada not only helps reduce discomfort and disturbance of consciousness but also enables a more detailed assessment of cognitive impairments during anesthetization [ 3 ]. This study aimed to investigate the effectiveness and accuracy of the ssWada in determining language dominance.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of language lateralization in epilepsy patients using the super-selective Wada test

Kakinuma,

Osawa,

Katsuse

et al. 2024

Acta Neurochir

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Background The classical Wada test (cWada), performed by injecting a short-acting anesthetic through the intracarotid route, helps determine language dominance. In the cWada, adverse effects are observed in 10–30% of trials, hindering accurate assessments. In this study, we assessed the effectiveness of the super-selective Wada test (ssWada), a more selective approach for anesthetic infusion into the middle cerebral artery (MCA). Methods We retrospectively examined the data of 17 patients with epilepsy who underwent ssWada via anesthetic injection into one M1 segment of the MCA and at least one contralateral trial. Results The ssWada identified 12 patients with left language dominance, 3 with right language dominance, and 2 with bilateral language distribution. Nine trials on the language dominant side resulted in global aphasia for patients with left- or right language dominance. Of the 13 trials conducted on the non-dominant language side, 12 revealed intact language function and one resulted in confusion. Among these, the outcomes of global aphasia or no language impairment were confirmed in the contralateral trials. Among the 22 trials of unilateral M1 injections in patients with unilateral language dominance, 21 (95.5%) showed either global aphasia or no language impairment, indicating language dominance. Conclusions The ssWada yields clear results, with a high rate of over 90% in determining the language dominant hemisphere with few side effects.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%