The Wada test is the gold standard for language localization, although it is intrusive and demands a significant amount of human and material resources. Functional MRI and tractography with diffusion tensor imaging (DTI) have been shown to be beneficial in epilepsy surgery for detecting language. In language, however, there is no indication of a link between the Wada tests and DTI MRI. From 2012 to 2017, the authors conducted a retrospective assessment of patients who underwent a Wada test prior to epilepsy surgery at their hospital. The authors compared the dominant and nondominant hemispheres’ fractional anisotropy (FA), fibre number and length, and volume of the arcuate fasciculus and uncinate fasciculus.

The medical records of ten patients with temporal lobe epilepsy were examined. The dominant hemisphere’s mean FA of the arcuate fasciculus was higher than the nondominant hemisphere, according to statistical analysis. In the dominant hemisphere, the number of fibres in the arcuated fasciculum was higher (881.5 vs 305.4, p = 0.003). There were no variations in the length of fibres in the uncinate fasciculum or the nucleus. DTI examination of the arcuate fasciculus and other tract bundles could be effective for language location tests in individuals with refractory epilepsy before surgery.

Reference Link – https://thejns.org/view/journals/j-neurosurg/134/6/article-p1703.xml

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