title: Naming outcome prediction in patients with discordant Wada and fMRI language lateralization.
abstract: OBJECTIVE
  Investigations of the validity of fMRI as an alternative to Wada language testing have yielded Wada/fMRI discordance rates of approximately 15%, but almost nothing is known regarding the relative accuracy of Wada and fMRI in discordant cases. The objective of this study was to determine which of the two (the Wada test or the language fMRI) is more predictive of postoperative naming outcome following left anterior temporal lobectomy in discordant cases.
  
  
  METHODS
  Among 229 patients with epilepsy who prospectively underwent Wada and fMRI language testing, ten had discordant language lateralization results, underwent left anterior temporal lobectomy, and returned for postoperative language testing. The relative accuracy of Wada and fMRI for predicting language outcome was examined in these cases.
  
  
  RESULTS
  Functional magnetic resonance imaging provided a more accurate prediction of language outcome in seven patients, Wada was more accurate in two patients, and the two tests were equally accurate in one patient.
  
  
  CONCLUSIONS
  In cases of discordance, fMRI predicted postsurgical naming outcome with relatively better accuracy compared to the Wada test.
authors.affiliation: Department of Neurology and the Comprehensive Epilepsy Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA. jjanecek@mcw.edu
authors.forename: Julie K
authors.initials: JK
authors.lastname: Janecek
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Swanson
authors.forename: David S
authors.initials: DS
authors.lastname: Sabsevitz
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Hammeke
authors.forename: Manoj
authors.initials: M
authors.lastname: Raghavan
authors.forename: Wade
authors.initials: W
authors.lastname: Mueller
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Binder
mesh_terms: D000328:Adult; D000654:Amobarbital; D001921:Brain / Q000098:blood supply*; D004827:Epilepsy / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007807:Language Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009275:Names; D009483:Neuropsychological Tests; D009493:Neurosurgery; D017063:Outcome Assessment, Health Care; D010100:Oxygen / Q000097:blood; D011237:Predictive Value of Tests
chemical_list: D000654:Amobarbital; D010100:Oxygen
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