Neurophysiologically Based Brain State Tracking & Modulation in Focal Epilepsy

描述（由申请人提供）：大约1/3的癫痫患者（PWE）在服用抗癫痫药物（aed）后仍会癫痫发作。最近使用治疗性脑刺激的试验显示癫痫发作的减少，但很少提供无癫痫发作的结果。虽然癫痫发作只占他们生命的一小部分，只有0.01%，但PWE每天服用抗癫痫药物（AED），承受与AED相关的副作用，并且一生都在担心下一次癫痫发作。癫痫发作的明显随机性与显著的心理后果有关。我们假设，通过为患者提供准确的癫痫发作日记、实时癫痫发作预测和脑状态调节的响应性刺激，癫痫发作及其心理影响可以更有效地管理。有了准确的癫痫发作预测，患者将有能力管理自己的生活活动。最佳的癫痫管理设备需要：1)自动癫痫发作检测；2)准确的自动电子癫痫发作日记；3)癫痫发作预测；4)可编程脑刺激。在这笔拨款中，我们使用美敦力的第三代植入式设备开发癫痫管理和治疗平台。RC+S使用嵌入式科学仪器（例如传感器、分类和控制策略实施）提供慢性神经系统传感和分析，并为探索和管理癫痫神经网络提供了独特的机会。

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.