Concordance Rate Between the Wada Test and fMRI for Language Lateralization in Patients with Medically Intractable Epilepsy. (P6.293)
Bibliographic record
Abstract
OBJECTIVE: To determine concordance rate between functional MRI (fMRI) and Wada test for language lateralization in our cohort of patients with medically intractable epilepsy. BACKGROUND: Preoperative fMRI is a non-invasive test that has been used increasingly in the epilepsy surgery centers to lateralize language. However, concordance rate between fMRI and Wada test has been variable in different studies. We report our local experience. DESIGN/METHODS: Patients with intractable focal epilepsy were studied for language lateralization using fMRI and Wada testing between 2007 and 2014. Three language paradigm tasks were used for fMRI studies: verb generation, sentence completion and naming. fMRI laterality indices were defined as a ratio (L-R)/(L+R) between the number of activated voxels in the left and right ROIs for Brodmann areas 44+45+46+8+9 (Anterior Language Area, ALA) and 22+39+40 (Posterior Language Area, PLA). fMRI and Wada results were divided into the right, left or bilateral hemispheric language dominance. RESULTS: 28 patients (15 men) were studied. Mean age at seizure onset was 19.3±14.57 years, and the mean age at fMRI was 34.8±12.48 years. 17 patients had left temporal epilepsy (TLE), 6 right TLE, 3 bilateral TLE, 1 left frontal and 1 multifocal epilepsy. The concordance rate between Wada and fMRI tests for the ALA and PLA was 68.2[percnt] and 52.2[percnt] for sentence completion; 56[percnt] and 52[percnt] for verb generation and 25[percnt] and 35[percnt] for naming paradigm, respectively. The concordance rate did not improve by combining the activation results of the 3 fMRI paradigms. Bilateral representation in Wada test or fMRI accounted for 68[percnt] of the discordant cases. CONCLUSIONS: Sentence completion and verb generation fMRI paradigms showed greater concordance with Wada test than naming paradigm. The higher discordance between the Wada test and fMRI was related to bilateral results suggestive of less stringent thresholds used for either test.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".