Seizure focus delineation using spontaneous and stimulus evoked EEG features Abstract an estimated 50 million people worldwide suffer from epilepsy. Of these, it is expected that ~30% continue to have seizures despite maximal medical therapy. The seizures of these patients may be controlled through appropriate surgical intervention if the region of brain giving rise to seizure activity is full circumscribed. Buildingon preliminary work, this study will pursue three research aims focused on (a) using brief recordings of neural activity, sophisticated signal processing techniques and advanced decision algorithms to delineate the epileptogenic region in patients with intractable epilepsy; augment this procedure with (b) examinations of the stimulation-response characteristics of different brain regions and (c) move toward non-invasive methodologies including high-density scalp EEG and transcranial magnetic stimulation that leverage the above approaches. The other major goal of the proposed project is to allow Dr. Cash to build on a successful record of mentoring and build a mentoring program tailored to the needs of residents and fellows in neurology who are preparing for a career in patient oriented research. The primary aims of this aspect of the proposal are to (a) bolster existing individual mentoring capabilities, (b) create group based career development experiences and (c) broaden the ability of residents and fellows to obtain mentoring and foundational research experiences in translational neuroscience. These goals ultimately are intended to greatly improve the ability of highly qualified, motived junior investigators to reach independence and begin productive patient-oriented research careers.

Public Health Relevance

This proposal has two related goals. The first is to utilize sophisticated signal processing techniques and stimulation-response characteristics to better delineate the seizure focus in patients with intractable epilepsy. The second is to create a mentorship program in patient oriented research focused on the needs of neurology residents and fellows within the outstanding environments of Harvard and Massachusetts General Hospital / Brigham and Women's Hospital.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24NS088568-04
Application #
9469574
Study Section
Neurological Sciences Training Initial Review Group (NST)
Program Officer
Whittemore, Vicky R
Project Start
2015-05-01
Project End
2020-03-31
Budget Start
2018-04-01
Budget End
2019-03-31
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
Halgren, Milan; Fabó, Daniel; Ulbert, István et al. (2018) Superficial Slow Rhythms Integrate Cortical Processing in Humans. Sci Rep 8:2055
Naftulin, Jason S; Ahmed, Omar J; Piantoni, Giovanni et al. (2018) Ictal and preictal power changes outside of the seizure focus correlate with seizure generalization. Epilepsia 59:1398-1409
Lam, Alice D; Maus, Douglas; Zafar, Sahar F et al. (2017) SCOPE-mTL: A non-invasive tool for identifying and lateralizing mesial temporal lobe seizures prior to scalp EEG ictal onset. Clin Neurophysiol 128:1647-1655
Sinha, Nishant; Dauwels, Justin; Kaiser, Marcus et al. (2017) Predicting neurosurgical outcomes in focal epilepsy patients using computational modelling. Brain 140:319-332
Lam, Alice D; Deck, Gina; Goldman, Alica et al. (2017) Silent hippocampal seizures and spikes identified by foramen ovale electrodes in Alzheimer's disease. Nat Med 23:678-680
Lam, Alice D; Zepeda, Rodrigo; Cole, Andrew J et al. (2016) Widespread changes in network activity allow non-invasive detection of mesial temporal lobe seizures. Brain 139:2679-2693
Struck, Aaron F; Cole, Andrew J; Cash, Sydney S et al. (2015) The number of seizures needed in the EMU. Epilepsia 56:1753-9