Machine learning applications in epilepsy

Abstract

Machine learning leverages statistical and computer science principles to develop algorithms capable of improving performance through interpretation of data rather than through explicit instructions. Alongside widespread use in image recognition, language processing, and data mining, machine learning techniques have received increasing attention in medical applications, ranging from automated imaging analysis to disease forecasting. This review examines the parallel progress made in epilepsy, highlighting applications in automated seizure detection from electroencephalography (EEG), video, and kinetic data, automated imaging analysis and pre‐surgical ...

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Toward evidence‐based severity assessment in rat models with repeated seizures: II. Chemical post–status epilepticus model

Abstract

Objective

Considering the complexity of neuronal circuits and their epilepsy‐associated alterations, epilepsy models cannot be completely replaced by in vitro experimental approaches. Decisions about ethical approval of in vivo studies require a thorough weighing of the animal’s burden and the benefit regarding the expected gain in knowledge.

Methods

Based on combined behavioral, biochemical, and physiological analyses, we assessed the impact on animal well‐being and condition in different phases of the pilocarpine post–status epilepticus (SE) model in rats.

Results

As a consequence of SE, increased levels ...

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When can we trust responders? Serious concerns when using 50% response rate to assess clinical trials

Abstract

Individual seizure rates are highly volatile, with large fluctuations from month‐to‐month. Nevertheless, changes in individual mean seizure rates are used to measure whether or not trial participants successfully respond to treatment. This study aims to quantify the challenges in identifying individual treatment responders in epilepsy. A power calculation was performed to determine the trial duration required to detect a significant 50% decrease in seizure rates (<  .05) for individuals. Seizure rate simulations were also performed to determine the number of people ...

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An animal model of genetic predisposition to develop acquired epileptogenesis: The FAST and SLOW rats

Abstract

Epidemiological data and gene association studies suggest a genetic predisposition to developing epilepsy after an acquired brain insult, such as traumatic brain injury. An improved understanding of genetic determinants of vulnerability is imperative for early disease diagnosis and prognosis prediction, with flow‐on benefits for the development of targeted antiepileptogenic treatments as well as optimal clinical trial design. In the laboratory, one approach to investigate why some individuals are more vulnerable to acquired epilepsy than others is to examine unique rodent ...

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Operative posterior disconnection in epilepsy surgery: Experience with 29 patients

Abstract

Objective

It has been suggested that multilobar epilepsies caused by lesions restricted to the posterior cerebral quadrant (ie, the parietal, temporal, and occipital lobes) can be treated successfully by a procedure termed posterior disconnection. The objective of the present paper was to identify determinants of the epileptological outcome following posterior disconnection surgery.

Methods

The authors retrospectively analyzed a series of 29 consecutive patients undergoing posterior disconnection surgery between 2005 and 2017 for the treatment of refractory posterior quadrantic epilepsy. Specifically, all presurgical and ...

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Both gain‐of‐function and loss‐of‐function de novo CACNA1A mutations cause severe developmental epileptic encephalopathies in the spectrum of Lennox‐Gastaut syndrome

Abstract

Objective

Developmental epileptic encephalopathies (DEEs) are genetically heterogeneous severe childhood‐onset epilepsies with developmental delay or cognitive deficits. In this study, we explored the pathogenic mechanisms of DEE‐associated de novo mutations in the CACNA1A gene.

Methods

We studied the functional impact of four de novo DEE‐associated CACNA1A mutations, including the previously described p.A713T variant and three novel variants (p.V1396M, p.G230V, and p.I1357S). Mutant cDNAs were expressed in HEK293 cells, and whole‐cell voltage‐clamp recordings were conducted to test the impacts on CaV2.1 channel function. Channel ...

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