Validation of a Neuropsychological Wada Procedure

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Title: Validation of a Neuropsychological Wada Procedure
Author: Eisenman, Daniel David
Abstract: The Intracarotid amobarbital procedure (IAP ) is considered an essential part of the presurgical neurodiagnostic evaluation in most epilepsy centers throughout the country . Despite the IAP's mainstream use , there is great variability in how the test is being performed across centers . The main purpose of this study was to validate a standardized IAP memory measure and explore its value in predicting lateralization as well as treatment outcome . The IAP memory measure had good overall reliability for all three Forms (Cronbach's Alpha = .85 for Form I , .83 for Form II , and .69 for Form III ) . The majority of items on Form I and II had acceptable item difficulty values , item discrimination values , and item -total correlations . There were a few items on Forms I and II that may be candidates for revision , but most items were only slightly below predicted ranges for what defines a "good" measure , and the majority of items contributed to the reliability of the test . In terms of construct validity , correlations with other memory tests provided some evidence of convergent validity for the IAP memory measure , but were generally low . In terms of divergent validity , both Forms I and II had low or no correlations with the executive functioning measures , providing preliminary support for the construct validity of the measure . When utilizing a discrepancy score to predict lateralization in subjects with temporal lobe epilepsy , asymmetry scores from the IAP memory measure were able to classify 92 % of subjects with either left or right TLE after applying a correction factor for left injection scores . There was limited data regarding post -operative seizure outcome . However , seizure -free subjects had a higher percentage of DS greater than 20 % than those subjects who reported at least one seizure postoperatively . In addition , there was a significant difference on Form I of the IAP memory measure between subjects who reported they were seizure free following temporal resection as compared to subjects who continued to report symptoms . Overall , the IAP memory measure demonstrated good psychometric properties and this study represents one of the most thorough analyses of the IAP memory test to date .
URI: http : / /hdl .handle .net /2152 .5 /229
Date: 2005-08-11

Citation

Validation of a Neuropsychological Wada Procedure. Graduate School of Biomedical Sciences. Available electronically from http : / /hdl .handle .net /2152 .5 /229 .

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