Temporal stability of intracranial EEG abnormality maps for localizing epileptogenic tissue

Abstract

Objective

Identifying abnormalities in interictal intracranial EEG, by comparing patient data to a normative map, has shown promise for the localization of epileptogenic tissue and prediction of outcome. The approach typically uses short interictal segments of around one minute. However, the temporal stability of findings has not been established.

Methods

Here, we generated a normative map of iEEG in non-pathological brain tissue from 249 patients. We computed regional band power abnormalities in a separate cohort of 39 patients for the duration of their ...

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Sudden unexpected death in epilepsy during cenobamate clinical development

Abstract

Objective

We assessed mortality, sudden unexpected death in epilepsy (SUDEP), and standardized mortality ratio (SMR) among adults treated with cenobamate during the cenobamate clinical development program.

Methods

We retrospectively analyzed deaths among all adults with uncontrolled focal (focal to bilateral tonic-clonic [FBTC], focal impaired awareness, focal aware) or primary generalized tonic-clonic (PGTC) seizures who received ≥1 dose of adjunctive cenobamate in completed and ongoing phase 2 and 3 clinical studies. In patients with focal seizures from completed studies, median baseline seizure frequencies ranged ...

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The role of the orexin system in the bidirectional relation between sleep and epilepsy: new chances for patients with epilepsy by the antagonism to orexin receptors?

Abstract

Epilepsy is a common neurological disorder, affecting patients of all ages, reducing the quality of life and associated with several comorbidities. Sleep impairment is a frequent condition in patients with epilepsy (PWE), and the relation between sleep and epilepsy has been considered bidirectional since one can significantly influence the other, and vice versa. The orexin system has been described more than 20 years ago and is implicated in several neuro-biological functions, other than in controlling the sleep-wake cycle. Considering the relation ...

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kcna1a mutant zebrafish model episodic ataxia type 1 (EA1) with epilepsy and respond to first‐line therapy carbamazepine

Abstract

Objective

KCNA1 mutations are associated with a rare neurological movement disorder known as episodic ataxia type 1 (EA1), and epilepsy is a common comorbidity. Current medications only provide partial relief to ataxia and/or seizures, making new drugs needed. Here, we characterized zebrafish kcna1a
-/-
as a model of EA1 with epilepsy and compared the efficacy of the first-line therapy carbamazepine in kcna1a
-/-
zebrafish to Kcna1
-/-
rodents.

Methods

CRISPR/Cas9 mutagenesis was used to introduce a mutation in the sixth ...

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Deep brain stimulation of the anterior nucleus of the thalamus increases slow wave activity in NREM sleep

Abstract

Objective

Previous studies suggest that intermittent deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) affects physiological sleep architecture. Here, we investigated the impact of continuous ANT-DBS on sleep in epilepsy patients in a multicenter cross-over study in ten patients.

Methods

We assessed sleep stage distribution, delta power, delta energy, and total sleep time (TST) in standardized 10/20 polysomnography (PSG) investigations before and 12 months after DBS lead implantation.

Results

In contrast to previous studies, we found no disruption of sleep architecture ...

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Functional evaluation of epilepsy associated KCNT1 variants in multiple cellular systems reveals a predominant gain of function impact on channel properties

Abstract

Objective:

Gain of function variants in the sodium activated potassium channel KCNT1 have been associated with pediatric epilepsy disorders. Here we systematically examine a spectrum of KCNT1 variants and establish their impact on channel function in multiple cellular systems.

Methods

KCNT1 variants identified from published reports and genetic screening of pediatric epilepsy patients were expressed in Xenopus oocytes and HEK cell lines. Variant impact on current magnitude, current-voltage relationships and sodium ion modulation were examined.

Results

We determined basic properties of KCNT1 in Xenopus oocyte ...

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Long‐term epilepsy outcome dynamics revealed by natural language processing of clinic notes

Abstract

Objective

Electronic medical records allow for retrospective clinical research with large patient cohorts. However, epilepsy outcomes are often contained in free text notes that are difficult to mine. We recently developed and validated novel natural language processing (NLP) algorithms to automatically extract key epilepsy outcome measures from clinic notes. In this study, we assessed the feasibility of extracting these measures to study the natural history of epilepsy at our center.

Methods

We applied our previously validated NLP algorithms to extract seizure freedom, seizure ...

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Stimulation‐induced respiratory enhancement in corticothalamic regions

Abstract

Objective

We aimed to identify corticothalamic areas and electrical stimulation paradigms that optimally enhance breathing.

Methods

Twenty-nine patients with medically intractable epilepsy were prospectively recruited in an epilepsy monitoring unit while undergoing stereoelectroencephalographic evaluation. Direct electrical stimulation in cortical and thalamic regions was carried out using low (<1 Hz) and high (≥10 Hz) frequencies, and low (<5 mA) and high (≥5 mA) current intensities, with pulse width of .1 ms. Electrocardiography, arterial oxygen saturation (SpO2), end-tidal carbon dioxide (ETCO2), oronasal airflow, and abdominal and thoracic plethysmography were ...

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