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Abstract：
Determination of language hemispheric dominance (HD) in patients undergoing evaluation for epilepsy surgery has traditionally relied on the sodium amobarbital (Wada) test. The emergence of non-invasive methods for determining language laterality has increasingly shown to be a viable alternative. In this study, we assessed the efficacy of transcranial magnetic stimulation (TMS) and magnetoencephalography (MEG), compared to the Wada test, in determining language HD in a sample of 12 patients. TMS-induced speech errors were classified as speech arrest, semantic, or performance errors, and the HD was based on the total number of errors in each hemisphere with equal weighting of all errors (classic) and with a higher weighting of speech arrests and semantic errors (weighted). Using MEG, HD for language was based on the spatial extent of long-latency activity sources localized to receptive language regions. Based on the classic and weighted language laterality index (LI) in 12 patients, TMS was concordant with the Wada in 58.33% and 66.67% of patients, respectively. In eight patients, MEG language mapping was deemed conclusive, with a concordance rate of 75% with the Wada test. Our results indicate that TMS and MEG have moderate and strong agreement, respectively, with the Wada test, suggesting they could be used as non-invasive substitutes.
摘要：
传统上，在接受癫痫手术评估的患者中，语言半球优势度（HD）的测定通常依赖于苯巴比妥钠（Wada）测试。用于确定语言侧向性的非侵入性方法的出现越来越被证明是可行的替代方案。在这项研究中,我们评估了经颅磁刺激（TMS）和脑磁图（MEG）的疗效，与Wada测试相比，在确定12例患者样本中的语言HD。TMS引起的言语错误被归类为言语停滞，语义，或性能错误，HD基于每个半球的错误总数，所有错误的权重相等（经典），语音逮捕和语义错误的权重更高（加权）。使用MEG，语言的HD基于位于接受语言区域的长延迟活动源的空间范围。根据12例患者的经典和加权语言偏侧指数(LI)，58.33%和66.67%的患者TMS与Wada一致，分别。在八个病人中，MEG语言映射被认为是决定性的，与Wada测试的一致率为75％。我们的结果表明，TMS和MEG具有中等和强的一致性，分别,Wada测试,表明它们可以用作非侵入性替代品。
