Perturbative Seizure Prediction and Detection of a Seizure Permissive State

项目摘要 在200万患有癫痫的美国人中，近30%的人尽管接受了治疗，但仍有癫痫发作。 现在，越来越多的人接受刺激设备作为治疗神经调节的手段。至 提供复杂的反馈刺激，一个人可以在癫痫发作时及早做出反应，以便将 它的影响和扩散，或者一个人可以在癫痫发作前做出反应，以另一种状态。确定合适的 在相当长的一段时间里，压力状态一直是一个中心主题，现在被归类为“癫痫” 对这种压力状态的识别既可以指示何时刺激，以避免 癫痫发作即将来临。但是，缉获量预测社区的经验是，所有衡量标准都使用了 到目前为止，对于显著的灵敏度水平，产生了显著的误检率。 这项工作将在破伤风毒素颞叶癫痫模型中进行。我们已经开发出一种 不受干扰地应用低频电刺激调节神经元活动的系统 我们有能力记录长期植入的动物的神经活动(Sunderam等人，2006年)，因此 可以应用反馈刺激。通过头部加速度测量，我们能够确定 警觉(Sunderam等人，2007年)。 这笔赠款的目的有三个方面。第一，调查是否将增加警戒状态作为一种歧视 该功能改进了对压力状态的识别。 第二，实现并测试了一种通过小幅度刺激来检测大脑状态的主动探头 大脑状态的变化，表明处于压力状态。 我们预计在实施被动和主动预测方法后，我们仍将观察到 严重的错误预测率。 第三个目标是通过刺激来探索这些检测的性质(A)如果错误预测是 简单的错误分类或(B)如果所识别的压力状态是癫痫发作许可状态--这种状态仅 有时转变为癫痫--和“错误的预测”是这种状态的正确识别。 从基础科学的角度来看，这应该让我们深入了解癫痫的产生过程和长期 治疗。从更实际的短期应用角度来看，癫痫发作允许状态的检测和 相关的转移概率将在开发有用的反馈干预措施方面有很大的用处。 具体地说，然后针对干预-例如电刺激-响应于检测到 状态以修改此转移概率。这项工作在未来几年的扩展将是测试一系列 对压力检测的反应刺激具有防止癫痫发作的能力。

Project Summary Nearly 30% of the two million Americans suffering from epilepsy continue to have seizures despite treatment. There is now a growing acceptance of stimulation devices as a mean for therapeutic neuromodulation. To provide sophisticated feedback stimulation, one can either respond early into the seizure in order to minimize its impact and spread, or one can respond before the seizure to some other state. Identification of a suitable preseizure state has been a central theme for quite a while that now falls under the rubric of "seizure prediction." Identification of such a preseizure state could both indicate when to stimulate in order to avert an oncoming seizure. But, the experience in the seizure prediction community has been that all measures used so far yield a significant false detection rate for significant levels of sensitivity. This work will be performed in the tetanus toxin model for temporal lobe epilepsy. We have developed a system for applying low frequency electrical stimulation for modulation of neuronal activity without interfering with our ability to record neural activity in chronically implanted animals (Sunderam, et al, 2006), and therefore can apply feedback stimulation. With head acceleration measurements, we are able to determine state of vigilance (Sunderam, et al, 2007). The aims of this grant are three fold. First, to investigate if the addition of state of vigilance as a discrimination feature improves identification of preseizure states. Second, to implement and test an active probe of brain state through small amplitude stimulations to detect changes in brain state indicative of a preseizure state. We expect after implementing both the passive and active prediction methods that we will still observe significant false prediction rates. The third aim is to probe through stimulation the nature of these detections (a) if the false predictions are simply misclassifications OR (b) if the identified preseizure state is seizure permissive - a state that only sometimes transitions to seizure - and the 'false predictions' are correct identifications of this state. From a basic science standpoint, this should give insight into the seizure generation process and long-term treatment. From a more practical short-term application standpoint, detection of a seizure permissive state and the relevant transition probabilities will have great utility in the development of a useful feedback intervention. Specifically, one then targets intervention - for example electrical stimulation - in response to detection of the state to modify this transition probability. The extension of this work in future years will be to test a range of responsive stimuli to preseizure detections for their ability to prevent seizure.