title: Intracarotid Etomidate Decreases the Interhemispheric Synchronization in Electroencephalogram (EEG) During the Wada Test.
abstract: BACKGROUND
  The Wada test is a diagnostic method to anesthetize 1 cerebral hemisphere and assess the language and memory functions of awake contralateral hemisphere before temporal lobectomy in patients with epilepsy. The effects of an ipsilateral injection of etomidate on the functional properties of contralateral hemisphere are not known. Our aim was to characterize the electroencephalographic (EEG) effects after intracarotid injection of etomidate and to determine the changes in synchronization between the ipsilateral and contralateral hemispheres.
  
  
  METHODS
  We retrospectively analyzed EEG data from 15 patients who underwent Wada test with etomidate. Continuous EEG data from 4 electrodes (2 anterior [F3, F4] and 2 posterior [P3, P4]) were analyzed. After artifact rejection, we measured the amplitudes of delta (1 to 4 Hz) and alpha (7 to 13 Hz) waves and the changes in the interhemispheric synchronization before, during, and after etomidate injection.
  
  
  RESULTS
  Ipsilateral injection of etomidate causes EEG changes in both hemispheres with increased amplitude of delta waves anteriorly and the alpha waves posteriorly. However this effect of etomidate is not uniform. Although there was a decrease in the interhemispheric synchronization of delta waves, there was no change in the synchronization of the alpha waves.
  
  
  CONCLUSIONS
  Our study showed that the EEG effects of intracarotid ipsilateral injection of etomidate is not uniform in both hemispheres. Decrease in the interhemispheric synchronization of delta waves might serve as an indicator of ipsilateral effect of etomidate on the brain. Additional studies are needed to confirm our findings.
authors.affiliation: *Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada †BrainMARC Ltd, Beit Hermon, Yokneam, Israel.
authors.forename: Dana B
authors.initials: DB
authors.lastname: Shahaf
authors.forename: Goded
authors.initials: G
authors.lastname: Shahaf
authors.forename: Jigesh
authors.initials: J
authors.lastname: Mehta
authors.forename: Lashmi
authors.initials: L
authors.lastname: Venkatraghavan
mesh_terms: D000328:Adult; D001921:Brain / Q000187:drug effects*; D004569:Electroencephalography / Q000187:drug effects*; D005045:Etomidate / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D008297:Male; D012189:Retrospective Studies
chemical_list: D006993:Hypnotics and Sedatives; D005045:Etomidate