High Frequency Oscillation as a Biomarker in Childhood Epilepsy

描述（由申请人提供）：该提案的目标是一种双管齐下的方法，将发作间高频振荡（HFO）建立为癫痫的空间定位生物标志物 致痫区和作为一个时间预测的生物标志物的致痫过程中的儿童癫痫。 癫痫是儿童常见的一组疾病，尽管使用了新的抗惊厥药物和手术切除了致癫痫皮质，但其中很大一部分儿童仍会每周或每天发作一次。尽管目前最好的药物和手术治疗，癫痫发作仍有增无减的原因尚不清楚。利用现有的基础设施，评估儿童癫痫和癫痫手术在加州大学洛杉矶分校，该提案旨在建立HFO作为一个空间定位的生物标志物的致痫区（假设1）。类似地，通过跟踪3组高风险癫痫前期儿童的3个专科诊所，该提案还旨在通过前瞻性连续视频EEG将HFO确立为可能继续患有癫痫的癫痫发生过程的时间预测标志物（假设2）。 这一提议的结果自然会引出下一组问题 研究目的：1）将HFO定位数据纳入临床试验的手术决策中; 2）进一步研究切除皮质标本中HFO的细胞和分子机制，以更好地了解癫痫发生和可能的抗癫痫药物机制; 3）在癫痫发作前对高危儿童进行潜在的治疗干预。帮助回答这些问题的研究是一些长期计划。

DESCRIPTION (provided by applicant): The goal of this proposal is a two-pronged approach to establish interictal high frequency oscillation (HFO) as a spatially localizing biomarker of the epileptogenic zone and as a temporally predictive biomarker of the epileptogenic process in childhood epilepsy. Epilepsy is a common group of disorders in children, a significant portion of whom will continue to have debilitating weekly or daily seizures despite new anticonvulsants and despite surgical resection of epileptogenic cortex. Why seizures continue unabated despite the best current medical and surgical therapy is unclear. Taking advantage of the already existing infrastructure that evaluates children for epilepsy and epilepsy surgery at UCLA, this proposal seeks to establish HFO as a spatially localizing biomarker of the epileptogenic zone (Hypothesis 1). Similarly, with three specialty clinics that follow 3 groups of high-risk pre- epileptic children, the proposal also aims to establish HFO as a temporally predictive marker of the epileptogenic process (Hypothesis 2) of who may go on to have epilepsy, with prospective serial video-EEGs. The results from this proposal will naturally lead to the next set of questions and research aims: 1) to incorporate HFO localization data in surgical decision-making in a clinical trial; 2) to further study the cellular and molecular mechanisms underlying HFO in resected cortical specimens to better understand epileptogenesis and possible antiepileptic drug mechanisms; 3) to enable potential therapeutic intervention in high-risk children, before seizure onset. Studies to help answer these questions are some of the long-term plans.