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Conradi N, Rosenberg F, Knake S, Biermann L, Haag A, Gorny I, Hermsen A, von Podewils V, Behrens M, Gurschi M, du Mesnil de Rochemont R, Menzler K, Bauer S, Schubert-Bast S, Nimsky C, Konczalla J, Rosenow F, Strzelczyk A. Wada test results contribute to the prediction of change in verbal learning and verbal memory function after temporal lobe epilepsy surgery. Sci Rep 2021; 11:10979. [PMID: 34040075 PMCID: PMC8154896 DOI: 10.1038/s41598-021-90376-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/07/2021] [Indexed: 02/04/2023] Open
Abstract
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 (∆R2 = 0.233, p = .032) and verbal memory function (∆R2 = 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.
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Affiliation(s)
- Nadine Conradi
- 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.
| | - Friederike Rosenberg
- Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt and Goethe University, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Susanne Knake
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt am Main, Germany
- Department of Neurology, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Louise Biermann
- Department of Neurology, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Anja Haag
- Department of Neurology, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Iris Gorny
- Department of Neurology, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Anke Hermsen
- 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
| | - Viola von Podewils
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Marion Behrens
- Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt am Main, Germany
| | - Marianna Gurschi
- Department of Neuroradiology, Philipps-University Marburg, Marburg, Germany
| | | | - Katja Menzler
- Department of Neurology, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Sebastian Bauer
- 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
| | - Susanne Schubert-Bast
- 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
- Department of Neuropediatrics, University Hospital Frankfurt and Goethe University, Frankfurt am Main, Germany
| | - Christopher Nimsky
- Department of Neurosurgery, Philipps-University Marburg, Marburg, Germany
| | - Jürgen Konczalla
- Department of Neurosurgery, University Hospital Frankfurt and Goethe University, Frankfurt am Main, Germany
| | - Felix Rosenow
- 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
| | - Adam Strzelczyk
- 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
- Department of Neurology, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
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Piber D, Hinkelmann K, Gold SM, Heesen C, Spitzer C, Endres M, Otte C. [Depression and neurological diseases]. DER NERVENARZT 2013; 83:1423-33. [PMID: 23095843 DOI: 10.1007/s00115-012-3674-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In many neurological diseases a depressive syndrome is a characteristic sign of the primary disease or is an important comorbidity. Post-stroke depression, for example, is a common and relevant complication following ischemic brain infarction. Approximately 4 out of every 10 stroke patients develop depressive disorders in the course of the disease which have a disadvantageous effect on the course and the prognosis. On the other hand depression is also a risk factor for certain neurological diseases as was recently demonstrated in a meta-analysis of prospective cohort studies which revealed a much higher stroke risk for depressive patients. Furthermore, depression plays an important role in other neurological diseases with respect to the course and quality of life, such as Parkinson's disease, multiple sclerosis and epilepsy. This article gives a review of the most important epidemiological, pathophysiological and therapeutic aspects of depressive disorders as a comorbidity of neurological diseases and as a risk factor for neurological diseases.
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Affiliation(s)
- D Piber
- Klinik für Psychiatrie und Psychotherapie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Deutschland.
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Findlay AM, Ambrose JB, Cahn-Weiner DA, Houde JF, Honma S, Hinkley LBN, Berger MS, Nagarajan SS, Kirsch HE. Dynamics of hemispheric dominance for language assessed by magnetoencephalographic imaging. Ann Neurol 2012; 71:668-86. [PMID: 22522481 DOI: 10.1002/ana.23530] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The goal of the current study was to examine the dynamics of language lateralization using magnetoencephalographic (MEG) imaging, to determine the sensitivity and specificity of MEG imaging, and to determine whether MEG imaging can become a viable alternative to the intracarotid amobarbital procedure (IAP), the current gold standard for preoperative language lateralization in neurosurgical candidates. METHODS MEG was recorded during an auditory verb generation task and imaging analysis of oscillatory activity was initially performed in 21 subjects with epilepsy, brain tumor, or arteriovenous malformation who had undergone IAP and MEG. Time windows and brain regions of interest that best discriminated between IAP-determined left or right dominance for language were identified. Parameters derived in the retrospective analysis were applied to a prospective cohort of 14 patients and healthy controls. RESULTS Power decreases in the beta frequency band were consistently observed following auditory stimulation in inferior frontal, superior temporal, and parietal cortices; similar power decreases were also seen in inferior frontal cortex prior to and during overt verb generation. Language lateralization was clearly observed to be a dynamic process that is bilateral for several hundred milliseconds during periods of auditory perception and overt speech production. Correlation with the IAP was seen in 13 of 14 (93%) prospective patients, with the test demonstrating a sensitivity of 100% and specificity of 92%. INTERPRETATION Our results demonstrate excellent correlation between MEG imaging findings and the IAP for language lateralization, and provide new insights into the spatiotemporal dynamics of cortical speech processing.
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Affiliation(s)
- Anne M Findlay
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, USA
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Loddenkemper T, Möddel G, Dinner DS, Kim H, Schuele SU, Alexopoulos AV, Kotagal P, Lüders HO. Language assessment in Wada test: comparison of methohexital and amobarbital. Seizure 2009; 18:656-9. [PMID: 19800265 DOI: 10.1016/j.seizure.2009.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2008] [Revised: 08/07/2009] [Accepted: 08/28/2009] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Methohexital has replaced amobarbital during Wada testing at many centers. The objective of our study was to compare the use of methohexital and amobarbital during Wada testing regarding language and memory lateralization quotients as well as speech arrest times. METHODS A chart review of 582 consecutive patients undergoing 1041 Wada-procedures was performed (left=60, right=63, bilateral=459). Language lateralization was calculated based on duration of speech arrest using a laterality index, defined as (L-R)/(L+R). Memory lateralization was expressed as percentage of retained objects and laterality quotient. RESULTS Language and memory lateralization revealed a similar distribution with amobarbital and methohexital. Speech arrest after left and right-sided injection was significantly longer in the amobarbital group as compared to the methohexital group. Language lateralization did not differ in the two groups. Percentage of retained memory items was higher in the methohexital group and there were fewer presented test items in the methohexital group. DISCUSSION Language and memory testing during the Wada test can successfully be performed with methohexital instead of amobarbital. The shorter half-life of methohexital allows repeated injections and shorter interhemispheric testing intervals, but also shortens the testing window.
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