title: Roles of the Wada Test and Functional Magnetic Resonance Imaging in Identifying the Language-dominant Hemisphere among Patients with Gliomas Located near Speech Areas.
abstract: This study examined the accuracy of functional magnetic resonance imaging (fMRI) in identifying the language-dominant hemisphere and the situations in which the Wada test can be skipped among patients with gliomas located near speech areas. We examined 74 patients [48 men (64.9%); mean ± standard deviation age of 42.7 ± 13.6 years (range: 13 to 70 years); 71 right-handed, 2 left-handed, and 1 ambidextrous] with gliomas located near speech areas. All patients underwent the Wada test and fMRI, and 34 patients underwent awake surgery. The "last-and-first" task was administered during fMRI. The Wada test was successful in determining the language-dominant hemisphere in 73 patients (98.6%): left hemisphere in 68 patients (91.9%), right hemisphere in 4 patients (5.4%), and bilateral in 1 patient (1.4%). The dominant hemisphere for right-handed patients (n = 71) was the left hemisphere in 67 patients (94.3%), right hemisphere in 3 patients (4.2%), and undetectable in 1 patient (1.4%). The fMRI was successful in determining the language-dominant hemisphere in 53 patients (71.6%). The results of the Wada test and fMRI were inconsistent in 5 patients (8.6%), of which 3 (5.2%) exhibited dominance in opposite hemispheres. Furthermore, 2 of these 3 cases (2.7%) were contralateral false positive cases, whereby fMRI identified the right-hemisphere as language dominant for right-handed individuals with tumors in the left hemisphere. Based on these findings, we concluded that the Wada test can be skipped if language dominancy can be detected by fMRI.
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muragaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.forename: Kayoko
authors.initials: K
authors.lastname: Abe
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D005910:Glioma / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology; D055815:Young Adult