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fMRI Wada Test: Prospects for Presurgical Mapping of Language and Memory

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Functional Neuroradiology

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Abstract

Since the inception of functional magnetic resonance imaging (fMRI) in the early 1990s, clinicians and researchers have been interested in the potential utility of this technology for replacement of the intracarotid amobarbital test (IAT or Wada test). The IAT is an invasive angiographic procedure that has traditionally been considered the conventional procedure for preoperative lateralization of language and memory in neurosurgical populations with lesions affecting brain regions critical for these functions. As fMRI is a repeatable, noninvasive procedure with no significant known health risks for most individuals, it would be advantageous to create validated paradigms to allow its use in place of the IAT. To date, the available literature strongly suggests that fMRI paradigms can be successfully used to replace the IAT in terms of language lateralization. While the status of appropriately reliable and valid memory assessment paradigms is not as advanced, significant progress has been made in this area as well. Despite the apparent advantages of fMRI in presurgical assessment, including more specific localization of task-related brain regions, which is not possible with IAT, there remain methodological challenges and issues of interpretation that have thus far prevented widespread use of fMRI in place of the IAT. This chapter discusses the background of the IAT and its risks and benefits compared to fMRI and reviews the body of literature examining the capacity of fMRI to lateralize and localize expressive and receptive language functions effectively, as well as more recent advances in utilizing fMRI findings to predict postsurgical outcome.

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Acknowledgments

This work was supported in part by members of the Partnership for Pediatric Epilepsy Research, which includes the American Epilepsy Society, the Epilepsy Foundation, the Epilepsy Project, Fight Against Childhood Epilepsy and Seizures (f.a.c.e.s.), and Parents Against Childhood Epilepsy (P.A.C.E.). Aspects of this work were also supported by the Indiana Economic Development Corporation (grant #87884), the National Alliance for Medical Image Computing (NAMIC; NIH grant U54 EB005149), and the Hitchcock Foundation. The authors thank their colleagues in the Surgical Epilepsy Programs at Indiana University Medical Center and Dartmouth-Hitchcock Medical Center for their contributions to the data presented in this chapter.

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Authors and Affiliations

  1. Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 950 West Walnut Street, R2 E124, Indianapolis, IN, 46202, USA

    Brenna C. McDonald PsyD, MBA (Assistant Professor of Radiology and Imaging Sciences)

  2. Department of Physical Medicine and Rehabilitation, Indiana University Center for Neuroimaging, Rehabilitation Hospital of Indiana, Indiana University School of Medicine, 4141 Shore Drive, Indianapolis, IN, 46254, USA

    Jacob Kean PhD (Visiting Assistant Professor)

  3. Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 950 West Walnut Street, R2 E124, Indianapolis, IN, 46202, USA

    Andrew J. Saykin PsyD, ABPP/CN

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Correspondence to Brenna C. McDonald PsyD, MBA .

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  1. Temple University School of Medicine, 3401 Broad Street, Philadelphia, 19140-5189, Pennsylvania, USA

    Scott H. Faro

  2. Dept. of Radiology, Temple University Hospital, 3401 Broad Street, Philadelphia, 19140-5189, Pennsylvania, USA

    Feroze B. Mohamed

  3. , Radiology, University of Southern California School, Zonal Avenue 1975, Los Angeles, 90033, California, USA

    Meng Law

  4. , Department of Radiology, Medical College of Wisconsin, Watertown Plank Road 8701, Milwaukee, 53226, USA

    John T. Ulmer

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McDonald, B.C., Kean, J., Saykin, A.J. (2011). fMRI Wada Test: Prospects for Presurgical Mapping of Language and Memory. In: Faro, S., Mohamed, F., Law, M., Ulmer, J. (eds) Functional Neuroradiology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-0345-7_25

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