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Objective: The WADA test is used to determine cerebral language dominance and assess the risk of postoperative amnesia following mesial temporal lobe resection. This study aims to explore the correlation between automated measures of hippocampal volume and WADA memory scores and to evaluate whether these volumetric measurements can reliably predict WADA memory scores. Methods: This study included patients who underwent a comprehensive presurgical assessment along with bilateral WADA testing. Hippocampal volumes were measured from high-resolution brain MRIs using automated software (volBrain), which were harmonized and normalized to whole brain volume. These harmonized and normalized volumes were then correlated with ipsilateral WADA memory scores and stratified according to brain MRI findings. A similar analysis was conducted between hippocampal volume asymmetry and WADA memory score asymmetry (WMA). A Receiver Operating Characteristic (ROC) curve was generated to compare the sensitivity and specificity in predicting successful WADA outcomes based on ipsilateral harmonized normalized hippocampal volumes. Results: In patients with mesial temporal sclerosis (MTS), significant positive correlations were found between harmonized normalized hippocampal volumes and ipsilateral WADA memory scores, as well as between harmonized hippocampal volume asymmetries and WMA. However, no significant correlations were found in patients with epileptogenic lesions other than MTS or those with normal brain MRIs. A harmonized normalized hippocampal volume threshold of ≥ 28.94 units was identified as a predictor of a WADA memory score exceeding 50% following contralateral carotid artery injection, with a sensitivity of 62.1% and a specificity of 100%. Significance: This study indicates that hippocampal volumetry could potentially serve as an alternative to the WADA test in patients with MTS. Conversely, in individuals with normal MRI results or other types of epileptogenic lesions, hippocampal volumetry does not reliably predict memory deficits, necessitating the use of the WADA test or functional MRI for planning resections of mesial temporal structures in the dominant hemisphere.

Multiple sclerosis (MS) is an autoimmune, inflammatory, and degenerative disease of the central nervous system. Axonal degeneration is triggered by inflammation and is the pathological substrate of progressive disability in patients with MS. Therapeutic interventions can reduce inflammatory activity, thus delaying neurodegeneration and the progression of disability. Currently Disease activity and neurodegeneration are assessed mainly through clinical evaluation and magnetic resonance imaging. These measures lack sensitivity and accuracy, so new biomarkers are necessary. Several markers have been studied and to date the most promising is the neurofilament light chain (NfL). Neurofilaments (Nf) are neuron-specific components of the cytoskeleton that can be assayed in different body compartments. Many studies have shown elevated CSF Nf levels in a wide variety of neurological disorders in which axonal degeneration occurs. A correlation between NfL levels in the serum or plasma and levels in the CSF has been demonstrated for various neurologic diseases including MS and suggests that measures of ongoing neuroaxonal injury can be obtained from blood NfL levels without the need for the more invasive CSF sampling. Aim of the study: The aim of this study is to assess the relationship between serum neurofilament (NfL&NfH chain) levels and the disease type ,duration ,disease activity, severity, and other variables in Multiple sclerosis . The conclusion was that In our study serum NfL and NfH levels were elevated in patients with MS when compared to controls but they didn't correlate with the presence or number of gadolinium enhanced MRI lesions, disability, or disease severity. so, for the future studies in this field using a more sensitive methods for assessment of NFs in serum with longitudinal sampling may yield a more accurate and reproducible results.