Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt and Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany.
Sci Rep. 2021 May 26;11(1):10979. doi: 10.1038/s41598-021-90376-3.
In recent years, the clinical usefulness of the Wada test (WT) has been debated among researchers in the field. Therefore, we aimed to assess its contribution to the prediction of change in verbal learning and verbal memory function after epilepsy surgery. Data from 56 patients with temporal lobe epilepsy who underwent WT and subsequent surgery were analyzed retrospectively. Additionally, a standard neuropsychological assessment evaluating attentional, learning and memory, visuospatial, language, and executive function was performed both before and 12 months after surgery. Hierarchical linear regression analyses were used to determine the incremental value of WT results over socio-demographic, clinical, and neuropsychological characteristics in predicting postsurgical change in patients' verbal learning and verbal memory function. The incorporation of WT results significantly improved the prediction models of postsurgical change in verbal learning (∆R = 0.233, p = .032) and verbal memory function (∆R = 0.386, p = .005). Presurgical performance and WT scores accounted for 41.8% of the variance in postsurgical change in verbal learning function, and 51.1% of the variance in postsurgical change in verbal memory function. Our findings confirm that WT results are of significant incremental value for the prediction of postsurgical change in verbal learning and verbal memory function. Thus, the WT contributes to determining the risks of epilepsy surgery and, therefore, remains an important part of the presurgical work-up of selected patients with clear clinical indications.
近年来,Wada 测试(WT)的临床实用性在该领域的研究人员中引起了争议。因此,我们旨在评估其对预测癫痫手术后言语学习和言语记忆功能变化的贡献。对 56 例接受 WT 及随后手术的颞叶癫痫患者的数据进行回顾性分析。此外,对 56 例患者进行了标准的神经心理学评估,评估注意力、学习和记忆、视空间、语言和执行功能,评估在手术前和手术后 12 个月进行。使用层次线性回归分析来确定 WT 结果在预测患者言语学习和言语记忆功能手术后变化方面,在社会人口统计学、临床和神经心理学特征方面的增量价值。WT 结果的纳入显著改善了言语学习(∆R=0.233,p=0.032)和言语记忆功能(∆R=0.386,p=0.005)的术后变化预测模型。术前表现和 WT 评分占言语学习功能术后变化的 41.8%,言语记忆功能术后变化的 51.1%。我们的发现证实,WT 结果对预测言语学习和言语记忆功能的术后变化具有显著的增量价值。因此,WT 有助于确定癫痫手术的风险,因此仍然是具有明确临床适应症的选定患者术前评估的重要组成部分。