ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2023
Evaluating the concordance of functional MRI-based language lateralization and Wada testing in epilepsy patients: A single-center analysis.
Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is functional MRI a reliable surrogate for the Wada test for preoperative assessment of hemispheric language laterality in pediatric patients? A systematic review and meta-analysis.Neuroradiology · 2025Pooled it
- Frontotemporal bursting supports human working memory.NeuroImage · 2026Article
- The reliability of bilateral cerebral laterality for word generation: Who is left in the middle?Imaging neuroscience (Cambridge, Mass.) · 2025Article
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8 authors.
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Abstract
backgroundFor patients with drug-resistant epilepsy, surgery may be effective in controlling their disease. Surgical evaluation may involve localization of the language areas using functional magnetic resonance imaging (fMRI) or Wada testing. We evaluated the accuracy of task-based fMRI versus Wada-based language lateralization in a cohort of our epilepsy patients.
methodsIn a single-center, retrospective analysis, we identified patients with medically intractable epilepsy who participated in presurgical language mapping (n = 35) with fMRI and Wada testing. Demographic variables and imaging metrics were obtained. We calculated the laterality index (LI) from task-evoked fMRI activation maps across language areas during auditory and reading tasks to determine lateralization. Possible scores for LI range from -1 (strongly left-hemisphere dominant) to 1 (strongly right-hemisphere dominant). Concordance between fMRI and Wada was estimated using Cohen's Kappa coefficient. Association between the LI scores from the auditory and reading tasks was tested using Spearman's rank correlation coefficient.
resultsThe fMRI-based laterality indices were concordant with results from Wada testing in 91.4% of patients during the reading task (
conclusionOur findings suggest that fMRI is generally an accurate, low-risk alternative to Wada testing for language lateralization. However, when fMRI indicates atypical language lateralization (e.g., bilateral dominance), patients may benefit from subsequent Wada testing or intraoperative language mapping.
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