{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T02:40:40Z","timestamp":1784601640971,"version":"3.55.0"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The Wada test, an intracarotid amobarbital procedure, is the gold standard for the preoperative evaluation of postoperative memory decline in patients with drug-resistant epilepsy. However, because the anesthetic perfuses the language areas, infusion into the language-dominant hemisphere also causes aphasia. Although it has been noted that aphasia may affect verbal memory scores in the Wada test, the extent of the effects has not been verified. This study aimed to examine the extent to which verbal memory is affected by aphasia induced by selective anesthetization of the proximal middle cerebral artery (M1) area (which does not affect the hippocampus) in patients with drug-resistant epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This single-center retrospective analysis included patients with drug-resistant epilepsy who underwent the Selective Anesthesia for Functional Evaluation (SAFE) as a preoperative evaluation between May 2018 and December 2023. SAFE includes cognitive tasks of equal difficulty administered before and immediately after anesthetic infusion. The preinfusion assessments confirmed the baseline, whereas the postinfusion assessments evaluated brain function under selective anesthesia. The patients were required to memorize 8 words and 8 pictures. After the anesthetic effects subsided, recognition tasks were performed for both words and pictures. The number of words and pictures successfully recognized were counted as verbal and visual memory scores, respectively. Memory scores were compared between the left and right M1 infusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of the 180 SAFE trials conducted during the study period, 38 trials (25 left and 13 right M1 infusions) in 29 patients with confirmed left language dominance and propofol infusion into the M1 were included. All left M1 infusions induced aphasia without causing significant disturbances in consciousness that could have interfered with task completion. The results indicated significantly lower verbal memory scores during left M1 infusions than during right M1 infusions, whereas the visual memory scores were comparable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The verbal memory score was significantly lower after infusion into the M1 of the language-dominant hemisphere than into the nondominant hemisphere, suggesting that aphasia during stimulus encoding may impair verbal memory. Thus, the Wada test with intracarotid anesthetic infusion may not accurately assess memory function due to aphasia. This study highlights the utility of SAFE in reducing aphasic interference in verbal memory, leading to a more accurate evaluation of surgical candidacy in patients with epilepsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.2.jns242534","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T22:46:29Z","timestamp":1751064389000},"page":"1194-1201","source":"Crossref","is-referenced-by-count":1,"title":["Impact of aphasia on verbal memory: insights from the Selective Anesthesia for Functional Evaluation"],"prefix":"10.3171","volume":"143","author":[{"given":"Hana","family":"Kikuchi","sequence":"first","affiliation":[{"name":"Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-ichiro","family":"Osawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Kakinuma","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoko","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuto","family":"Katsuse","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai;"},{"name":"Department of Neurology, Graduate School of Medicine, The University of Tokyo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazushi","family":"Ukishiro","sequence":"additional","affiliation":[{"name":"Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobukazu","family":"Nakasato","sequence":"additional","affiliation":[{"name":"Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Cochrane Database Syst Rev","first-page":"CD010541","article-title":"Surgery for epilepsy","volume":"6","author":"West S","year":"2019","unstructured":"West S, Nevitt SJ, Cotton J,  Surgery for epilepsy. Cochrane Database Syst Rev. 2019;6(6):CD010541."},{"issue":"5","key":"b2","series-title":"N Engl J Med","first-page":"311","article-title":"A randomized, controlled trial of surgery for temporal-lobe epilepsy","volume":"345","author":"Wiebe S","year":"2001","unstructured":"Wiebe S, Blume WT, Girvin JP, Eliasziw M. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001;345(5):311\u2013318."},{"issue":"3","key":"b3","series-title":"Neuropsychologia","first-page":"175","article-title":"Disorders of memory after brain lesions in man","volume":"6","author":"Milner B","year":"1968","unstructured":"Milner B. Disorders of memory after brain lesions in man. Neuropsychologia. 1968;6(3):175\u2013179."},{"issue":"1","key":"b4","series-title":"J Neurosurg","first-page":"101","article-title":"Verbal memory deficits after left temporal lobectomy for epilepsy. Mechanism and intraoperative prediction","volume":"62","author":"Ojemann GA","year":"1985","unstructured":"Ojemann GA, Dodrill CB. Verbal memory deficits after left temporal lobectomy for epilepsy. Mechanism and intraoperative prediction. J Neurosurg. 1985;62(1):101\u2013107."},{"key":"b5","series-title":"J Neurosurg","first-page":"266","article-title":"Intracarotid injection of sodium amytal for the lateralization of cerebral speech dominance","volume":"17","author":"Wada J","year":"1960","unstructured":"Wada J, Rasmussen T. Intracarotid injection of sodium amytal for the lateralization of cerebral speech dominance. J Neurosurg. 1960;17:266\u2013282."},{"issue":"11","key":"b6","series-title":"Neurology","first-page":"1813","article-title":"Evaluation of adverse effects in intracarotid propofol injection for Wada test","volume":"65","author":"Mikuni N","year":"2005","unstructured":"Mikuni N, Takayama M, Satow T,  Evaluation of adverse effects in intracarotid propofol injection for Wada test. Neurology. 2005;65(11):1813\u20131816."},{"issue":"3","key":"b7","series-title":"Neurology","first-page":"510","article-title":"Intracarotid propofol test for speech and memory dominance in man","volume":"63","author":"Takayama M","year":"2004","unstructured":"Takayama M, Miyamoto S, Ikeda A,  Intracarotid propofol test for speech and memory dominance in man. Neurology. 2004;63(3):510\u2013515."},{"key":"b8","series-title":"Clin Neurol Neurosurg.","first-page":"107580","article-title":"WADA test for postoperative memory prediction in left TLE. Is it still useful in the 21st century?","volume":"225","author":"Bruzsa AK","year":"2023","unstructured":"Bruzsa AK, Walther K, Kasper BS, Gollwitzer S, Hamer H, Schwarz M. WADA test for postoperative memory prediction in left TLE. Is it still useful in the 21st century? Clin Neurol Neurosurg.2023;225:107580."},{"key":"b9","series-title":"Epilepsy Behav","first-page":"107065","article-title":"Concordance between fMRI and Wada test for memory lateralization in temporal lobe epilepsy: a meta-analysis and systematic review","volume":"107","author":"Massot-Tarr\u00fas A","year":"2020","unstructured":"Massot-Tarr\u00fas A, White KP, Mousavi SR, Hayman-Abello S, Hayman-Abello B, Mirsattari SM. Concordance between fMRI and Wada test for memory lateralization in temporal lobe epilepsy: a meta-analysis and systematic review. Epilepsy Behav. 2020;107:107065."},{"issue":"10","key":"b10","series-title":"Hum Brain Mapp","first-page":"959","article-title":"High-resolution fMRI investigation of the medial temporal lobe","volume":"28","author":"Kirwan CB","year":"2007","unstructured":"Kirwan CB, Jones CK, Miller MI, Stark CEL. High-resolution fMRI investigation of the medial temporal lobe. Hum Brain Mapp. 2007;28(10):959\u2013966."},{"issue":"1","key":"b11","series-title":"Sci Rep","first-page":"10979","article-title":"Wada test results contribute to the prediction of change in verbal learning and verbal memory function after temporal lobe epilepsy surgery","volume":"11","author":"Conradi N","year":"2021","unstructured":"Conradi N, Rosenberg F, Knake S,  Wada test results contribute to the prediction of change in verbal learning and verbal memory function after temporal lobe epilepsy surgery. Sci Rep. 2021;11(1):10979."},{"issue":"12","key":"b12","series-title":"Epilepsia","first-page":"2305","article-title":"Diagnostic accuracy of functional magnetic resonance imaging, Wada test, magnetoencephalography, and functional transcranial Doppler sonography for memory and language outcome after epilepsy surgery: a systematic review","volume":"59","author":"Schmid E","year":"2018","unstructured":"Schmid E, Thomschewski A, Taylor A,  Diagnostic accuracy of functional magnetic resonance imaging, Wada test, magnetoencephalography, and functional transcranial Doppler sonography for memory and language outcome after epilepsy surgery: a systematic review. Epilepsia. 2018;59(12):2305\u20132317."},{"issue":"2","key":"b13","series-title":"Brain Cogn","first-page":"210","article-title":"An exploratory comparison of three methods of memory assessment with the intracarotid amobarbital procedure","volume":"33","author":"Dodrill CB","year":"1997","unstructured":"Dodrill CB, Ojemann GA. An exploratory comparison of three methods of memory assessment with the intracarotid amobarbital procedure. Brain Cogn. 1997;33(2):210\u2013223."},{"issue":"2","key":"b14","series-title":"Brain Cogn","first-page":"178","article-title":"Level of consciousness and memory during the intracarotid sodium amobarbital procedure","volume":"33","author":"Meador KJ","year":"1997","unstructured":"Meador KJ, Loring DW, Lee GP, Nichols ME, Moore EE, Figueroa RE. Level of consciousness and memory during the intracarotid sodium amobarbital procedure. Brain Cogn. 1997;33(2):178\u2013188."},{"issue":"2","key":"b15","series-title":"Seizure","first-page":"122","article-title":"Bilateral Wada test: amobarbital or propofol?","volume":"23","author":"Curot J","year":"2014","unstructured":"Curot J, Denuelle M, Busigny T,  Bilateral Wada test: amobarbital or propofol? Seizure. 2014;23(2):122\u2013128."},{"issue":"11","key":"b16","series-title":"Neurol Med Chir (Tokyo)","first-page":"661","article-title":"A super-selective Wada test successfully detected an artery that supplied Broca\u2019s area in a case of left frontal lobe glioblastoma: technical case report","volume":"61","author":"Yamashita S","year":"2021","unstructured":"Yamashita S, Saito R, Osawa SI,  A super-selective Wada test successfully detected an artery that supplied Broca\u2019s area in a case of left frontal lobe glioblastoma: technical case report. Neurol Med Chir (Tokyo). 2021;61(11):661\u2013666."},{"key":"b17","series-title":"IBRO Neurosci Rep","first-page":"156","article-title":"Determination of language areas in patients with epilepsy using the super-selective Wada test","volume":"13","author":"Kakinuma K","year":"2022","unstructured":"Kakinuma K, Osawa SI, Hosokawa H,  Determination of language areas in patients with epilepsy using the super-selective Wada test. 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Neurology. 2005;65(5):676\u2013680."},{"issue":"8","key":"b25","series-title":"Mayo Clin Proc","first-page":"965","article-title":"Selective posterior cerebral artery injection of amytal: new method of preoperative memory testing","volume":"64","author":"Jack CR Jr","year":"1989","unstructured":"Jack CR Jr, Nichols DA, Sharbrough FW,  Selective posterior cerebral artery injection of amytal: new method of preoperative memory testing. Mayo Clin Proc. 1989;64(8):965\u2013975."},{"issue":"4","key":"b26","series-title":"Neuroradiology","first-page":"290","article-title":"Posterior cerebral artery Wada test: sodium amytal distribution and functional deficits","volume":"43","author":"Urbach H","year":"2001","unstructured":"Urbach H, Klemm E, Linke DB,  Posterior cerebral artery Wada test: sodium amytal distribution and functional deficits. Neuroradiology. 2001;43(4):290\u2013294."},{"issue":"2","key":"b27","series-title":"J Neurointerv Surg","first-page":"165","article-title":"Selective posterior cerebral artery amobarbital test: a predictor of memory following subtemporal selective amygdalohippocampectomy","volume":"12","author":"Catapano JS","year":"2020","unstructured":"Catapano JS, Whiting AC, Wang DJ,  Selective posterior cerebral artery amobarbital test: a predictor of memory following subtemporal selective amygdalohippocampectomy. J Neurointerv Surg. 2020;12(2):165\u2013169."},{"issue":"2","key":"b28","series-title":"Seizure","first-page":"117","article-title":"Selective posterior cerebral artery amobarbital test in patients with temporal lobe epilepsy for surgical treatment","volume":"15","author":"Yen DJ","year":"2006","unstructured":"Yen DJ, Lirng JF, Shih YH,  Selective posterior cerebral artery amobarbital test in patients with temporal lobe epilepsy for surgical treatment. 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Cochrane Database Syst Rev. 2019;6(6):CD010541."},{"issue":"5","key":"b2","series-title":"N Engl J Med","first-page":"311","article-title":"A randomized, controlled trial of surgery for temporal-lobe epilepsy","volume":"345","author":"Wiebe S","year":"2001","unstructured":"Wiebe S, Blume WT, Girvin JP, Eliasziw M. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001;345(5):311\u2013318."},{"issue":"3","key":"b3","series-title":"Neuropsychologia","first-page":"175","article-title":"Disorders of memory after brain lesions in man","volume":"6","author":"Milner B","year":"1968","unstructured":"Milner B. Disorders of memory after brain lesions in man. Neuropsychologia. 1968;6(3):175\u2013179."},{"issue":"1","key":"b4","series-title":"J Neurosurg","first-page":"101","article-title":"Verbal memory deficits after left temporal lobectomy for epilepsy. 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Epilepsy Behav. 2020;107:107065."},{"issue":"10","key":"b10","series-title":"Hum Brain Mapp","first-page":"959","article-title":"High-resolution fMRI investigation of the medial temporal lobe","volume":"28","author":"Kirwan CB","year":"2007","unstructured":"Kirwan CB, Jones CK, Miller MI, Stark CEL. High-resolution fMRI investigation of the medial temporal lobe. Hum Brain Mapp. 2007;28(10):959\u2013966."},{"issue":"1","key":"b11","series-title":"Sci Rep","first-page":"10979","article-title":"Wada test results contribute to the prediction of change in verbal learning and verbal memory function after temporal lobe epilepsy surgery","volume":"11","author":"Conradi N","year":"2021","unstructured":"Conradi N, Rosenberg F, Knake S,  Wada test results contribute to the prediction of change in verbal learning and verbal memory function after temporal lobe epilepsy surgery. Sci Rep. 2021;11(1):10979."},{"issue":"12","key":"b12","series-title":"Epilepsia","first-page":"2305","article-title":"Diagnostic accuracy of functional magnetic resonance imaging, Wada test, magnetoencephalography, and functional transcranial Doppler sonography for memory and language outcome after epilepsy surgery: a systematic review","volume":"59","author":"Schmid E","year":"2018","unstructured":"Schmid E, Thomschewski A, Taylor A,  Diagnostic accuracy of functional magnetic resonance imaging, Wada test, magnetoencephalography, and functional transcranial Doppler sonography for memory and language outcome after epilepsy surgery: a systematic review. Epilepsia. 2018;59(12):2305\u20132317."},{"issue":"2","key":"b13","series-title":"Brain Cogn","first-page":"210","article-title":"An exploratory comparison of three methods of memory assessment with the intracarotid amobarbital procedure","volume":"33","author":"Dodrill CB","year":"1997","unstructured":"Dodrill CB, Ojemann GA. 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Seizure. 2014;23(2):122\u2013128."},{"issue":"11","key":"b16","series-title":"Neurol Med Chir (Tokyo)","first-page":"661","article-title":"A super-selective Wada test successfully detected an artery that supplied Broca\u2019s area in a case of left frontal lobe glioblastoma: technical case report","volume":"61","author":"Yamashita S","year":"2021","unstructured":"Yamashita S, Saito R, Osawa SI,  A super-selective Wada test successfully detected an artery that supplied Broca\u2019s area in a case of left frontal lobe glioblastoma: technical case report. Neurol Med Chir (Tokyo). 2021;61(11):661\u2013666."},{"key":"b17","series-title":"IBRO Neurosci Rep","first-page":"156","article-title":"Determination of language areas in patients with epilepsy using the super-selective Wada test","volume":"13","author":"Kakinuma K","year":"2022","unstructured":"Kakinuma K, Osawa SI, Hosokawa H,  Determination of language areas in patients with epilepsy using the super-selective Wada test. 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