From the Department of Neurology, University of Münster (S.K., M.D.,
H.H., T.H., E.-B.R.), and Epilepsie-Zentrum Bethel (A.E., H.J.), Münster,
Germany.
Correspondence to Stefan Knecht, MD, Department of Neurology, University of Münster, Albert-Schweitzer-Straße 33, D-48129 Münster, Germany. E-mail knecht{at}uni-muenster.de
Background and Purpose—Functional
transcranial Doppler ultrasonography (fTCD) can assess
event-related changes in cerebral blood flow velocities and, by
comparison between sides, can provide a measure of hemispheric
perfusional lateralization. It is easily applicable, insensitive to
movement artifacts, and can be used in patients with less than perfect
cooperation. In the present study we investigated the validity of
fTCD in determining the hemispheric dominance for language by direct
comparison of fTCD with intracarotid amobarbital anesthesia
(Wada test).
Methods—fTCD and the Wada test were performed in 19 patients
evaluated for epilepsy surgery. By the Wada test, 13 patients were
classified as left-hemisphere dominant and 6 as right-hemisphere
dominant for language. fTCD was based on the continuous bilateral
measurements of blood flow velocities in the middle cerebral arteries
and event-related averaging during a cued word generation task
previously shown to activate lateralized language areas in
normal adults.
Results—In 4 patients fTCD assessment was not possible because of
lack of an acoustic temporal bone window. In the remaining 15
candidates, determination of language dominance was concordant with the
Wada test in every case. Moreover, the correlation of the
lateralization measures from both procedures was highly significant
(r=.92, P<.0001).
Conclusions—This strong correlation validates fTCD as a
noninvasive and practical tool for the determination of language
lateralization that can be applied for clinical and investigative
purposes.
© 1998 American Heart Association, Inc.
Original Contributions
Noninvasive Determination of Language Lateralization by Functional Transcranial Doppler Sonography
A Comparison With the Wada Test
Key Words: cerebral dominance • laterality • ultrasonography, Doppler • Wada test
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