Abstracts

Rationale: Naming decline in left anterior temporal lobectomy patients can be predicted by extent of Wada language lateralization (LI) toward the left hemisphere. Few studies have examined naming outcome in R-ATL patients whose language representation varies across the continuum of cerebral dominance. We hypothesized that, similar to the L-ATL patients, Wada LI would be related to naming outcome in R-ATL patients. Methods: 86 R-ATL patients in a consecutive series who had valid Wada testing and pre and postoperative neuropsychological testing including the Boston Naming Test (BNT) were included in this study. Quantitative Wada LI scores (% correct in the inject right - % correct in the inject left condition) were calculated based on performance on comprehension, naming, repetition and reading language tasks. Of these 86 patients, only three had greater language representation in the right, surgical hemisphere (Wada LIs= -3, -11, and -78) and another 10 patients had bilateral language representation. Results: Of the three R-ATL patients with right language, only one showed significant (based on reliable change index normative data) decline on the BNT. See Table 1. Two other patients in the sample declined on BNT (change scores of -8 and -5) and were left hemisphere dominant (Wada LIs= +73, + 96, respectively). There was no difference in the mean BNT change scores for the three language-dominance groups (left, right or bilateral). See Table 2. The overall correlation between Wada LI and BNT change was not significant (r = .053, p= .631). Conclusions: There was no correlation between Wada language representation and naming decline after R-ATL in this sample, which included patients with right and bilateral language. While the number of patients with atypical language in the sample is small, there appears to be little risk for language decline after R-ATL even in those with atypical language.