Language Outcome After Left Temporal Lobectomy in Patients with Discordant fMRI and Sodium Amobarbital Testing Results

The rationale for this study was to examine 1) language lateralization discordance rates between fMRI and the IAT in pre- surgical epilepsy patients and 2) naming outcome after left ATL in a group of patients for whom IAT and fMRI language LIs were discordant. Participants were 229 consecutive pre-surgical epilepsy patients who underwent the IAT and fMRI. IAT LIs (% correct inject right -% correct inject left condition) were calculated based on performance on comprehension, naming, repetition and reading language tasks. The fMRI LIs [(L-R)/(L+R) where L = number of activated left hemisphere voxels and R = number of activated right hemisphere voxels) were calculated for lateral, angular gyrus, temporal, and frontal regions of interest (ROIs) using a published semantic decision task. Discordance was determined using cut scores and difference scores for each method. Regression analyses were performed to investigate predictors of discordance. Additionally, regression formulas developed from a separate sample for predicting language outcome using fMRI and IAT LIs were applied to the discordant cases so that observed and predicted outcome scores could be compared with each method. Discordance rates ranged from 14-17%, depending on ROI. Atypical language dominance on fMRI was most predictive of discordance. Of discordant cases who underwent left ATL, language outcome was more accurately predicted by each method in approximately half the cases. When fMRI indicates left language dominance, IAT LI concordance is high. However, when fMRI indicates atypical language dominance, concordance rates with the IAT decrease. Post-operative language outcome data suggests that the IAT and fMRI each predict outcome in certain cases, suggesting some error variance with each mapping method

Language Outcome after Left Anterior Temporal Lobectomy in Patients with Discordant Functional Magnetic Resonance Imaging and Intracarotid Sodium Amobarbital Testing Results

Language Outcome after Left Temporal Anterior Lobectomy in Patients with Discordant Functional Magnetic Resonance Imaging and Intracarotid Sodium Amobarbital Testing Results Rationale: Previous research has examined concordance rates between Wada and fMRI language lateralization indices (LIs) and has yielded variable results with limited post-surgical language outcome data. Therefore, additional evidence of the concurrent and predictive validity of fMRI LIs is needed. We will calculate Wada/fMRI LI concordance rates in the largest sample to date, investigate predictors of discordance and examine the ability of each procedure to predict language outcome in discordant cases. Methods: A consecutive series of 229 presurgical epilepsy patients who underwent Wada testing and fMRI will be included in the study. Wada LIs (% correct inject right –% correct inject left condition) were calculated based on performance on comprehension, naming, repetition and reading language tasks. fMRI LIs ((L-R)/(L+R) where L = number of activated left hemisphere voxels and R = number of activated right hemisphere voxels) were calculated for four ROIs using a published semantic decision/tone decision task. Discordance will be determined using a difference score of .50. Regression analyses will be performed to investigate factors that are predictive of discordance and the predictive value of Wada and fMRI in discordant cases. Results: Available by conference date. Conclusions: We hypothesize a discordance rate of approximately 1 in 10. We hypothesize predictors of discordance may be posterior cerebral artery filling, crossflow ratings, abnormal vasculature, duration of drug effect, fMRI behavioral performance and activation threshold, motion artifacts, MTS, and IQ

Positive and problematic dissertation experiences: The faculty perspective

We interviewed 14 clinical and counseling psychology faculty regarding their experiences chairing positive and problematic dissertations. Data were analyzed using consensual qualitative research (CQR). Participants reported that advisors’ roles involved guiding/facilitating dissertations and helping students shape research ideas; students’ roles included taking responsibility, working independently, and maintaining good relationships with the chair/committee. With positive dissertation experiences, chairs and students collaborated before the dissertation, worked together well during the dissertation, and students began the dissertation feeling competent and motivated; such dissertations positively affected participants. Problematic dissertation experiences evinced difficult relationships between chair and student, and students’ low research capability; such dissertations negatively affected participants