fMRI wada test: Prospects for presurgical mapping of language and memory

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). The IAT, or Wada test, is an invasive angiographic procedure, with some potential risks, that currently serves as the conventional standard for lateralization of language, memory, and other functions. The IAT is used primarily in patients under consideration for neurosurgery to treat epilepsy, but also in other neurosurgical populations (e.g., motor cortex tumor, arteriovenous malformation in language association cortex, etc.). If a valid assessment paradigm could be created, the advantages of fMRI assessment of memory and language functions over the IAT would be obvious. Functional MRI is a repeatable, noninvasive procedure with no significant known health risks for most individuals. It is also very flexible and can be readily modified to assess the clinical questions at issue for a particular patient. In addition, a recent cost analysis demonstrated considerable savings of total direct costs for fMRI over IAT.1 © 2010 Springer Science+Business Media, LLC.