Putative roles for homeostatic plasticity in epileptogenesis

Epilepsia, Journal Year: 2023, Volume and Issue: 64(3), P. 539 - 552

Published: Jan. 8, 2023

Homeostatic plasticity allows neural circuits to maintain an average activity level while preserving the ability learn new associations and efficiently transmit information. This dynamic process usually protects brain from excessive activity, like seizures. However, in certain contexts, homeostatic might produce seizures, either response acute provocation or more chronically as a driver of epileptogenesis. Here, we review three seizure conditions which likely plays important role: drug withdrawal posttraumatic disconnection epilepsy, cyclic Identifying mechanisms active at different stages development could allow better targeting therapies, including determining when neuromodulation be most effective, proposing ways prevent epileptogenesis, how disrupt cycle recurring clusters.

Language: Английский

---

Seizure occurrence is linked to multiday cycles in diverse physiological signals

Epilepsia, Journal Year: 2023, Volume and Issue: 64(6), P. 1627 - 1639

Published: April 15, 2023

The factors that influence seizure timing are poorly understood, and unpredictability remains a major cause of disability. Work in chronobiology has shown cyclical physiological phenomena ubiquitous, with daily multiday cycles evident immune, endocrine, metabolic, neurological, cardiovascular function. Additionally, work chronic brain recordings identified risk is linked to activity. Here, we provide the first characterization relationships between modulation diverse set signals, activity, timing.In this cohort study, 14 subjects underwent ambulatory monitoring multimodal wrist-worn sensor (recording heart rate, accelerometry, electrodermal temperature) an implanted responsive neurostimulation system interictal epileptiform abnormalities electrographic seizures). Wavelet filter-Hilbert spectral analyses characterized circadian wearable recordings. Circular statistics assessed physiology.Ten met inclusion criteria. mean recording duration was 232 days. Seven had reliable electroencephalographic detections (mean = 76 Multiday were present all device signals across subjects. Seizure phase locked five (temperature), four (heart phasic activity), three (accelerometry, rate variability, tonic activity) Notably, after regression behavioral covariates from six seven locking residual signal.Seizure associated multiple processes. Chronic can situate rare paroxysmal events, like seizures, within broader context individual. Wearable devices may advance understanding enable personalized time-varying approaches epilepsy care.

Language: Английский

---

Unearthing the mechanisms of responsive neurostimulation for epilepsy

Communications Medicine, Journal Year: 2023, Volume and Issue: 3(1)

Published: Nov. 16, 2023

Responsive neurostimulation (RNS) is an effective therapy for people with drug-resistant focal epilepsy. In clinical trials, RNS results in a meaningful reduction median seizure frequency, but the response highly variable across individuals, many receiving minimal or no benefit. Understanding why this variability occurs will help improve use of therapy. Here we advocate reexamination assumptions made about how reduces seizures. This now possible due to large patient cohorts having used device, some long-term. Two foundational have been that device's intracranial leads should target focus/foci directly, and stimulation be triggered only detected epileptiform activity. Recent studies called into question both hypotheses. Here, discuss these exciting new suggest future approaches selection, lead placement, device programming could outcomes.

Language: Английский

---

Hippocampal network activity forecasts epileptic seizures

Nature Medicine, Journal Year: 2024, Volume and Issue: 30(10), P. 2787 - 2790

Published: July 12, 2024

Language: Английский

---

Synchronization-based graph spatio-temporal attention network for seizure prediction

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: Feb. 3, 2025

Epilepsy is a common neurological disorder in which abnormal brain waves propagate rapidly the form of graph network during seizures, and seizures are extremely sudden. So, designing accurate reliable prediction methods can provide early warning for patients, crucial improving their lives. In recent years, large number studies have been conducted using deep learning models on epileptic open electroencephalogram (EEG) datasets with good results, but due to individual differences there still some subjects whose seizure features cannot be accurately captured more difficult differentiate, poor results. Important time-varying information may overlooked if only space considered. To address these issues, we propose synchronization-based spatio-temporal attention (SGSTAN). This model effectively leverages intricate embedded within EEG recordings through correlations. Experimental results public demonstrate efficacy our approach. On CHB-MIT dataset, method achieves accuracy, specificity, sensitivity scores 98.2%, 98.07%, 97.85%, respectively. case challenging that classify, achieved an outstanding average classification accuracy 97.59%, surpassing previous studies.

Language: Английский

---

Thalamic deep brain stimulation modulates cycles of seizure risk in epilepsy

Scientific Reports, Journal Year: 2021, Volume and Issue: 11(1)

Published: Dec. 20, 2021

Abstract Chronic brain recordings suggest that seizure risk is not uniform, but rather varies systematically relative to daily (circadian) and multiday (multidien) cycles. Here, one human seven dogs with naturally occurring epilepsy had continuous intracranial EEG (median 298 days) using novel implantable sensing stimulation devices. Two pet the subject received concurrent thalamic deep (DBS) over multiple months. All subjects circadian cycles in rate of interictal epileptiform spikes (IES). There was phase locking IES five out eight subjects, respectively. Thalamic DBS modified (all 3 subjects) (analysis limited participant) clustering subject. Multiscale excitability are features canine modifiable by DBS.

Language: Английский

---

Anterior nucleus of the thalamus seizure detection in ambulatory humans

Epilepsia, Journal Year: 2021, Volume and Issue: 62(10)

Published: Aug. 21, 2021

Abstract There is a paucity of data to guide anterior nucleus the thalamus (ANT) deep brain stimulation (DBS) with sensing. The clinical Medtronic Percept DBS device provides constrained sensing power within frequency band (power‐in‐band [PIB]), recorded in 10‐min averaged increments. Here, four patients temporal lobe epilepsy were implanted an investigational providing full bandwidth chronic intracranial electroencephalogram (cEEG) from bilateral ANT and hippocampus (Hc). PIB‐based seizure detection was assessed. Detection parameters cEEG PIB center frequency, bandwidth, epoch duration. Performance evaluated against epileptologist‐confirmed Hc seizures, assessed by area under precision‐recall curve (PR‐AUC). Data included 99 days cEEG, 20, 278, 3, 18 seizures for Subjects 1–4. best detector had 7‐Hz 5‐Hz width, 10‐s duration (group PR‐AUC = .90), 75% sensitivity .38 false alarms per day Subject 1, 100% .0 3 4. 2 did not propagate ANT. relative change maximal ipsilateral onset all detected seizures. Chronic recordings provide direct guidance

Language: Английский

---

Responsive Neurostimulation Targeting the Anterior, Centromedian and Pulvinar Thalamic Nuclei and the Detection of Electrographic Seizures in Pediatric and Young Adult Patients

Frontiers in Human Neuroscience, Journal Year: 2022, Volume and Issue: 16

Published: April 12, 2022

Responsive neurostimulation (RNS System) has been utilized as a treatment for intractable epilepsy. The RNS System delivers stimulation in response to detected abnormal activity, via leads covering the seizure foci, detections of predefined epileptiform activity with goal decreasing frequency and severity. While thalamic are often implanted combination cortical strip leads, implantation bilateral alone is less common, ability detect electrographic seizures using uncertain.The present study retrospectively evaluated fourteen patients depth thalamus, or without concomitant determine thalamus. Detailed patient presentations lead trajectories were reviewed alongside electroencephalographic (ECoG) analyses.Anterior nucleus (ANT) whether unilateral combined lead, successfully terminated demonstrated by Cases 2 3. Similarly, centromedian (CMT) one also seen 6 9. Bilateral pulvinar likewise produced reliable detection Patient 14. Detections nuclei did not appear be affected was pediatric adult at time implantation. Sole paralleled terms preventing propagation seizures.Thalamic promising target multifocal generalized onsets. These areas provide modifiable, reversible therapeutic option who candidates surgical resection ablation.

Language: Английский

---

Seizure forecasting using minimally invasive, ultra‐long‐term subcutaneous electroencephalography: Individualized intrapatient models

Epilepsia, Journal Year: 2022, Volume and Issue: 64(S4)

Published: April 8, 2022

One of the most disabling aspects living with chronic epilepsy is unpredictability seizures. Cumulative research in past decades has advanced our understanding dynamics seizure risk. Technological advances have recently made it possible to record pertinent biological signals, including electroencephalogram (EEG), continuously. We aimed assess whether patient-specific forecasting using remote, minimally invasive ultra-long-term subcutaneous EEG.

Language: Английский

---

Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation

Brain Communications, Journal Year: 2022, Volume and Issue: 4(3)

Published: May 2, 2022

Abstract Early implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioural inputs from patients. Recent provide sensing but have not yet developed analytics accurately tracking and quantifying behaviour seizures. Here we describe a distributed co-processor providing intuitive bi-directional between patient, implanted neural device, local computing resources. Automated analysis of continuous streaming electrophysiology is with patient reports using handheld device integrated cloud resources seizures, interictal epileptiform spikes symptoms during therapeutic stimulation. The classification algorithms seizures were parameterized long-term ambulatory data nine humans eight canines epilepsy, then implemented prospectively in out-of-sample testing two pet four drug-resistant living their natural environments. Accurate seizure diaries are needed as the primary clinical outcome measure to guide brain-stimulation optimization. system described here enables spikes, correlation reports. In future, will allow more detailed investigation impact on

Language: Английский

---