Epileptiform oscillations, EEG & seizure prediction

描述（由申请人提供）：全世界有5000万人患有癫痫，其中25%的患者的癫痫发作无法通过任何可用的药物或手术治疗得到控制。目前，由于我们对癫痫大脑如何产生自发性癫痫发作（癫痫发作）的理解不足，新治疗方案的开发和癫痫手术疗效的提高受到限制。越来越多的证据表明，高频癫痫样振荡（60 - 500 Hz）是癫痫脑的独特特征，在新皮层癫痫发作发生中起重要作用[1-3]。作为发展主要研究者（PI）作为临床研究者的职业生涯计划的一部分，我们提出了马约诊所和宾夕法尼亚大学之间的多学科合作，旨在了解新皮层的ictogenesis和提高定位癫痫脑区域的能力。该项目是迈向更全面了解一种常见且难以治疗的神经系统疾病的第一步。我们将开发生物工程方法来检测和量化人类颅内EEG记录的高频癫痫样振荡（HFEO）。我们将研究HFEO作为癫痫手术和癫痫发作预测的致痫性脑特征的临床实用性。我们相信理解HFEO的细胞和网络机制将提高我们定位局灶性致癫痫脑区域的能力，这是目前限制癫痫手术成功的区域，同时为合理开发新疗法奠定基础，如用于癫痫预测和预防的植入式设备。拟议的项目将继续合作，结合宾夕法尼亚大学的神经科学和神经工程实力与马约诊所的大型外科癫痫实践的临床实力，从而为发展中的临床医生研究提供了一个肥沃的环境。主要研究者已经证明了独立的以患者为基础的研究的潜力，并通过该项目提供的培训，将开发一个独立的研究计划，将神经工程和临床研究的进展转化为临床实践。

DESCRIPTION (provided by applicant): Worldwide, 50 million people suffer from epilepsy, and for 25% of these patients the seizures are not controlled by any available medical or surgical treatments. Development of new treatment options and improving the efficacy of epilepsy surgery are presently limited by our poor understanding of how epileptic brain generates spontaneous seizures (ictogenesis). There is accumulating evidence that high-frequency epileptiform oscillations (60 - 500 Hz) are a unique signature of epileptic brain, and play an important role in neocortical seizure ictogenesis [1-3]. As part of a program to develop the principal investigator's (PI) career as a clinician-investigator, we propose a multidisciplinary collaboration between the Mayo Clinic and University of Pennsylvania directed at understanding neocortical ictogenesis and improving the ability to localize regions of epileptogenic brain. This project is an initial step toward a more complete understanding of a common, and difficult to treat, neurological disease. We will develop bioengineering methods to detect and quantify high-frequency epileptiform oscillations (HFEO) from human intracranial EEG recordings. We will investigate the clinical usefulness of HFEO as a signature of epileptogenic brain for epilepsy surgery and seizure prediction. We believe understanding the cellular and network mechanisms underlying HFEO will improve our ability to localize regions of focal epileptogenic brain, an area presently limiting the success of epilepsy surgery, while laying the foundation for the rational development of new therapies such as implantable devices for seizure prediction and prevention. The proposed project will continue a collaboration that combines the neuroscience and neuroengineering strengths of the University of Pennsylvania with the clinical strength of the Mayo Clinic's large surgical epilepsy practice, thus providing a fertile environment for a developing clinician-investigator. The principal investigator has demonstrated potential for independent patient-based research, and with the training provided by this project will develop an independent research program translating advances in neuroengineering and clinical research into clinical practice.