title: Is it time to replace the Wada test and put awake craniotomy to sleep?
abstract: The question we address here is whether the invasive presurgical brain mapping approaches of direct cortical stimulation and of the Wada procedure can be replaced by noninvasive functional neuroimaging methods (functional magnetic resonance imaging [fMRI], magnetoencephalography [MEG], transcranial magnetic stimulation and [TMS]). First, we outline the reasons for contemplating such a replacement. Second, we present evidence to the effect that the efficacy of the invasive and noninvasive methods, while suboptimal, is comparable. Third, we discuss additional advantages of noninvasive presurgical brain mapping and conclude that there are no longer compelling reasons for opting for invasive mapping in many if not most cases provided that the non-invasive methods are available.
authors.affiliation: Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.|Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, U.S.A.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Papanicolaou
authors.affiliation: Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.|Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, U.S.A.
authors.forename: Roozbeh
authors.initials: R
authors.lastname: Rezaie
authors.affiliation: Department of Pediatrics, Division of Clinical Neurosciences, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.|Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, U.S.A.
authors.forename: Shalini
authors.initials: S
authors.lastname: Narayana
authors.affiliation: Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, U.S.A.|Department of Radiology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.|Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.
authors.forename: Asim F
authors.initials: AF
authors.lastname: Choudhri
authors.affiliation: Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, U.S.A.|Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.
authors.forename: James W
authors.initials: JW
authors.lastname: Wheless
authors.affiliation: Magnetoencephalography Laboratory, Florida Hospital for Children, Orlando, Florida, U.S.A.
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Castillo
authors.affiliation: Comprehensive Epilepsy Center at Florida Hospital for Children, Orlando, Florida, U.S.A.
authors.forename: James E
authors.initials: JE
authors.lastname: Baumgartner
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.|Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Boop
mesh_terms: D000654:Amobarbital / Q000008:administration & dosage; D001931:Brain Mapping / Q000379:methods*; D002339:Carotid Arteries; D002540:Cerebral Cortex / Q000503:physiopathology* / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007269:Injections, Intra-Arterial; D007802:Language; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008568:Memory / Q000502:physiology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D050781:Transcranial Magnetic Stimulation; D014851:Wakefulness / Q000502:physiology
chemical_list: D000654:Amobarbital
keywords: Awake craniotomy; Cortical stimulation mapping; Functional magnetic resonance imaging; Magnetoencephalography; Transcranial magnetic stimulation; Wada test