Neurophysiologically Based Brain State Tracking & Modulation in Focal Epilepsy

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DESCRIPTION (provided by applicant): Approximately 1/3 of people living with epilepsy (PWE) continue to have seizures despite anti-epileptic drugs (AEDs). Recent trials using therapeutic brain stimulation show reductions in seizures, but rarely provide seizure free outcomes. Although seizures occupy a small fraction of their life, as little as 0.01%, PWE take anti-epileptic drugs (AED) daily, suffer AED related side effects, and spend their lives dreading when the next seizure will strike. The apparent randomness of seizures is associated with significant psychological consequences. We hypothesize that epilepsy can be more effectively managed, both the seizures and their psychological impact, by providing patients with accurate seizure diaries, real-time seizure forecasting, and responsive stimulation for brain state modulation. With accurate seizure forecasting patients would be empowered to manage their life activities. The optimal epilepsy management device requires: 1) Automated seizure detection 2) Accurate Automated Electronic Seizure Diaries 3) Seizure Forecasting and 4) Programmable Brain Stimulation. In this grant we develop an epilepsy management and therapy platform using Medtronic's 3rd generation device implantable device. The RC+S provides chronic nervous system sensing and analytics using embedded scientific instrumentation (e.g. - sensors, classification, and control policy implementation), and provides a unique opportunity for exploring and managing epileptic neural networks.