Genetic and transcriptomic profiling of the epileptic network in patients with surgically treated seizures

项目摘要 医学难治性癫痫影响近1/300的人，对于这些患者， 这是唯一能让你摆脱癫痫的方法具有与以下相关的异常神经影像学结果的患者 异常脑电图（EEG）活动有最好的机会，癫痫发作后的自由 手术在没有明确的神经影像学异常的患者中，立体脑电图（sEEG）可以定位癫痫 并增加未来切除手术的成功率。sEEG是一种微创手术， 电极被放置在整个大脑中，并在大脑中识别癫痫发作区，癫痫周围网络 和非癫痫脑区。去除sEEG电极后，贴壁细胞可用于评估基因组 材料，以便更好地理解定义癫痫网络的分子过程。整体 本申请的目的是了解难治性癫痫的发展机制， 我们的目标是开发一种精确的医学治疗方法。我们将评估基因， 在接受难治性癫痫治疗的儿童和年轻成人中切除脑组织的转录组学 切除手术后的sEEG。我们的中心假设是患有难治性癫痫的患者 1）癫痫相关分子通路中的体细胞突变，其不存在于生殖系中， 2)独特的基因表达谱将被确定在癫痫组织与失调， 已知的神经递质和炎症通路，与癫痫周围和非癫痫脑组织相比。

PROJECT SUMMARY Medically-refractory epilepsy affects nearly 1 in 300 people, and for these patients resective brain surgery may be the only change for seizure freedom. Patients with abnormal neuroimaging findings which correlate with abnormal electroencephalography (EEG) activity have the best chance of seizure freedom after epilepsy surgery. In patients without clear neuroimaging abnormalities, stereo-EEG (sEEG) can localize an epileptic lesion and increase the success of a future resective surgery. sEEG is a minimally invasive procedure where electrodes are placed throughout, and within the brain to identify the seizure onset zone, peri-epileptic network and nonepileptic brain regions. After sEEG electrode removal, adherent cells can be used to evaluate genomic material in order to better understand the molecular processes that define an epileptic network. The overall objective of this application is to understand the mechanisms in the development of intractable epilepsy with the goal of developing a precision medicine approach to therapy. We will evaluate the genetics and transcriptomics of brain tissue resected in children and young adults with intractable epilepsy undergoing sEEG followed by resective surgery. Our central hypothesis that patients who develop intractable epilepsy have 1) somatic mutations in epilepsy-related molecular pathways which are not present in the germline and 2) unique gene expression profiles will be identified in epileptic tissue with dysregulation of known neurotransmitter and inflammatory pathways, compared to peri-epileptic and non-epileptic brain tissue.