MURAGAKI Yoshihiro    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Visiting Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Rolesof the Wada Test and Functional Magnetic Resonance Imaging in Identifying the Language-dominant Hemisphere among Patients with Gliomas Located near Speech Areas
Journal	Formal name：Neurologia medico-chirurgica Abbreviation：Neurol Med Chir (Tokyo) ISSN code：04708105
Domestic / Foregin	Foregin
Volume, Issue, Page	57(1),pp.28-34
Author and coauthor	ISHIKAWA Tatsuya†, MURAGAKI Yoshihiro, MARUYAMA Takashi, ABE Kayoko, KAWAMATA Takakazu
Publication date	2017/01
Summary	This study examined the accuracy of functional magnetic resonance imaging (fMRI) in identifying the language-dominant hemisphere and the situations in which the Wada test can be skipped among patients with gliomas located near speech areas. We examined 74 patients [48 men (64.9%); mean +/- standard deviation age of 42.7 +/- 13.6 years (range: 13 to 70 years); 71 right-handed, 2 left-handed, and 1 ambidextrous]with gliomas located near speech areas. All patients underwent the Wada test and fMRI, and 34 patients underwent awake surgery. The"last-and-first"task was administered during fMRI. The Wada test was successful in determining the language-dominant hemisphere in 73 patients (98.6%): left hemisphere in 68 patients (91.9%), right hemisphere in 4 patients (5.4%), and bilateral in 1 patient (1.4%). The dominant hemisphere for right-handed patients (n = 71) was the left hemisphere in 67 patients (94.3%), right hemisphere in 3 patients (4.2%), and undetectable in 1 patient (1.4%). The fMRI was successful in determining the language-dominant hemisphere in 53 patients (71.6%). The results of the Wada test and fMRI were inconsistent in 5 patients (8.6%), of which 3 (5.2%) exhibited dominance in opposite hemispheres. Furthermore, 2 of these 3 cases (2.7%) were contralateral false positive cases, whereby fMRI identified the right-hemisphere as language dominant for right-handed individuals with tumors in the left hemisphere. Based on these findings, we concluded that the Wada test can be skipped if language dominancy can be detected by fMRI.
DOI	10.2176/nmc.oa.2016-0042
Document No.	27980284