TY - JOUR
T1 - The Single Word Auditory Comprehension (SWAC) test
T2 - A simple method to identify receptive language areas with electrical stimulation
AU - Alarcón, Gonzalo
AU - Bird Pedersen, Marie
AU - Juárez-Torrejón, Noelia
AU - Martín-López, David
AU - Ughratdar, Ismail
AU - Selway, Richard P.
AU - Valentín, Antonio
PY - 2018/11/13
Y1 - 2018/11/13
N2 - Objectives Resective surgery for medically refractory epilepsy in proximity to speech receptive areas requires balancing adequate resection of the epileptogenic zone for optimal seizure control with preservation of function. We develop a simple test (Single Word Auditory Comprehension or SWAC) to localize speech receptive areas by evaluating patients' ability to comprehend a single word. Methods Patients were studied during presurgical or intraoperative assessment for epilepsy with intracranial electrodes. They were asked to listen to a common word (target word) and to describe what it meant without saying the target word. Electrical stimulation (trains of biphasic 2-ms pulses, 50 Hz for 3 s) was delivered while the patient listened to the target word, not while the patient explained the meaning of the word. In six patients, SWAC test was carried out during extraoperative chronic recordings, and in one patient in the operating theater under local anesthesia. Results Among the 7 patients where the test identified deficits, 6 underwent resection (4 temporal, 1 supramarginal, and 1 occipital). Two patients showed temporary minor speech deficits after resection. No patient showed permanent speech deficits after resection. Conclusion/significance The SWAC test is reliable, simple and fast to implement, and suitable for intraoperating mapping. It could be used as a simple initial test to identify receptive language areas where more complex additional tests can be performed.
AB - Objectives Resective surgery for medically refractory epilepsy in proximity to speech receptive areas requires balancing adequate resection of the epileptogenic zone for optimal seizure control with preservation of function. We develop a simple test (Single Word Auditory Comprehension or SWAC) to localize speech receptive areas by evaluating patients' ability to comprehend a single word. Methods Patients were studied during presurgical or intraoperative assessment for epilepsy with intracranial electrodes. They were asked to listen to a common word (target word) and to describe what it meant without saying the target word. Electrical stimulation (trains of biphasic 2-ms pulses, 50 Hz for 3 s) was delivered while the patient listened to the target word, not while the patient explained the meaning of the word. In six patients, SWAC test was carried out during extraoperative chronic recordings, and in one patient in the operating theater under local anesthesia. Results Among the 7 patients where the test identified deficits, 6 underwent resection (4 temporal, 1 supramarginal, and 1 occipital). Two patients showed temporary minor speech deficits after resection. No patient showed permanent speech deficits after resection. Conclusion/significance The SWAC test is reliable, simple and fast to implement, and suitable for intraoperating mapping. It could be used as a simple initial test to identify receptive language areas where more complex additional tests can be performed.
KW - Language
KW - Wernicke
KW - Electrical stimulation
KW - Functional mapping
KW - Auditory comprehension
KW - Epilepsy surgery
U2 - 10.1016/j.yebeh.2018.10.022
DO - 10.1016/j.yebeh.2018.10.022
M3 - Article
SN - 1525-5050
JO - Epilepsy & Behavior
JF - Epilepsy & Behavior
ER -