Detection and Control of Epilepsy

描述(由研究人员提供)：癫痫是最常见的神经系统疾病之一。癫痫患者反复发作，可导致从肌肉僵硬到意识丧失的各种症状。部分性癫痫是成人癫痫患者最常见的综合征，内侧颞叶癫痫(MTLE)是最常见的部分性癫痫。癫痫的特点是大量神经元的异常同步化。目前的治疗药物无法控制25%的癫痫患者的癫痫发作。虽然电刺激大脑对抑制帕金森氏症的一些症状非常有效，但刺激抑制癫痫的水平有限。治疗效果低的原因可能是刺激靶点不充分，对机制缺乏了解，刺激参数不是最佳的。我们建议开发一种方法，通过从单一电极位置对支配两个海马区(MTLE的主要致痫灶)的连合纤维束施加电刺激来抑制癫痫发作。具体地说，我们建议1)评估低频刺激的效果2)确定高频刺激的效果3)研究刺激作用的机制，4)分析在完整的海马体外制剂中抑制/兴奋效应的空间范围，5)在无药物的小鼠癫痫遗传模型中抑制癫痫发作。目前的治疗药物无法控制25%的癫痫患者的癫痫发作活动。这一神经技术项目的结果将为电刺激抑制癫痫发作的潜在机制提供有价值的见解，并为控制癫痫患者的癫痫发作建立有效的神经假体的初步设计。与公共卫生相关：约有300万人被诊断出患有癫痫，每年给社会造成的损失约为125亿美元。然而，只有25%的患者可以从抗癫痫药物中获得一些治疗益处。我们建议开发一种替代手术切除的治疗方式，依靠对大脑的电刺激来控制癫痫发作。

DESCRIPTION (provided by investigator): Epilepsy is one of the most prevalent neurological disorder. Patients with epilepsy experience recurrent seizures that can cause a variety of symptoms ranging from muscle stiffness to loss of consciousness. Partial epilepsy is the most common syndrome in adult epilepsy patients and mesial temporal lobe epilepsy (MTLE) is the most common form of partial epilepsy. Epilepsy is characterized by the abnormal synchronization of large numbers of neurons. Current therapeutic agents cannot control seizures in 25% of all epileptic patients. Although electrical stimulation of the brain has been very effective to suppress some symptoms of Parkinson's disease, the level of seizure suppression by stimulation has been limited. The reason for this low therapeutic outcome could be attributed to an inadequate target for stimulation, lack of understanding of the mechanisms and non-optimum stimulation parameters. We propose to develop a method to suppress seizures by applying electrical stimulation to the commissural fiber tract that innervates both hippocampi (major epileptogenic foci in MTLE) from a single electrode location. Specifically, we propose to 1) evaluate the effect of low frequency stimulation 2) determine the effect of high frequency stimulation 3) study the mechanisms of the effect of stimulation, 4) analyze the spatial extent of the suppression/excitation effect in an intact hippocampal in-vitro preparation and 5) suppress seizures in a drug-free genetic model of epilepsy in mice. Current therapeutic agents are incapable of controlling seizure activity in 25% of all epileptic patients. The results of this neuro-technology project should provide valuable insights into the mechanisms underlying seizure suppression with electrical stimulation as well as establishing the preliminary design for an effective neural prosthesis for the control of seizures in patients with epilepsy. PUBLIC HEALTH RELEVANCE: About 3 million people have been diagnosed with epilepsy and the cost to the society is about $12.5B/year. Yet, only 25% of patients can receive some therapeutic benefits from anti-epileptic medication. We propose to develop an alternative therapeutic modality to surgical resection that relies on electrical stimulation of the brain to control seizures.