Benbadis S R, Binder J R, Swanson S J, Fischer M, Hammeke T A, Morris G L, Frost J A, Springer J A
Department of Neurology, Cleveland Clinic Florida, Ft. Lauderdale, USA.
Brain Lang. 1998 Dec;65(3):441-6. doi: 10.1006/brln.1998.2018.
The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, but others base language lateralization solely on speech arrest. This study sought to determine whether speech arrest alone during Wada testing provides valid data regarding language lateralization.
The subjects (previously reported) were 21 patients evaluated for intractable epilepsy, who underwent language lateralization by Wada testing and functional MRI (FMRI). For each patient, language representation was determined by calculating: (1) a Wada laterality index based exclusively on speech arrest; (2) a Wada laterality index based on comprehensive language assessment; and (3) an FMRI laterality quotient. Correlation coefficients and categorical classifications were analyzed.
There was no significant correlation between the Wada laterality quotient derived from duration of speech arrest and either the comprehensive Wada language laterality score (r =.35, p =.12) or FMRI language laterality score (r =.32, p =.16). Categorical classification as left, right or bilateral language also showed marked discordance between speech arrest and the other two methods.
Duration of speech arrest during Wada testing is not a valid measure of language dominance.
颈内动脉注射异戊巴比妥试验，即Wada试验，是确定语言半球表征的首选方法，常用于顽固性癫痫的术前评估。一些研究人员进行全面的语言评估，但另一些人仅根据言语停止来确定语言优势半球。本研究旨在确定Wada试验期间仅言语停止是否能提供有关语言优势半球的有效数据。
研究对象（先前已报道）为21例接受顽固性癫痫评估的患者，他们接受了Wada试验和功能磁共振成像（FMRI）以确定语言优势半球。对于每位患者，通过计算来确定语言表征：（1）仅基于言语停止的Wada优势指数；（2）基于全面语言评估的Wada优势指数；（3）FMRI优势商数。分析相关系数和分类。
由言语停止持续时间得出的Wada优势商数与全面的Wada语言优势评分（r = 0.35，p = 0.12）或FMRI语言优势评分（r = 0.32，p = 0.16）之间均无显著相关性。言语停止与其他两种方法在语言为左、右或双侧优势的分类上也存在明显差异。
Wada试验期间言语停止的持续时间不是语言优势的有效衡量指标。
