Previous work in seizure prediction can be categorized, broadly, into three phases. A conceptual breakthrough was achieved in the first phase through the definition of the problem and initial attempts to predict the onset of seizures. Work in the second phase was fueled by a signal theoretical breakthrough, the description of chaos in deterministic systems, and both conceptual and theoretical progress are evident in this work. We argue that a third phase of work in this field has begun more recently. We believe this phase will be characterized by both technical advances that allow the acquisition and analyses of comprehensive data sets and the application of a wider range of analysis methods. We wish to strengthen this third phase of work by bringing a comprehensive knowledge of epilepsy, a non-prejudiced application of powerful linear and nonlinear methods, and a strong theoretical backing for these methods to bear on the problem of seizure prediction. Specifically, we concur with the suggestion that the central role of synchrony in seizure generation would suggest value for measures of synchrony and seek to test signals from multiple locations for nodal, pathway, and central disruptions in the period leading to seizures. The proposed study is composed of retrospective studies to detect changes in network locations in patients with: (1) medial temporal lobe epilepsy, and (2) superior parietal-medial frontal onset, and (3) occipital-temporal onset of seizures, and prospective studies to evaluate the specificity of these changes and their utility for both offline and real-time prediction of seizures. Fifteen patients will be studied in the retrospective studies, and 45 patients will be studied in the prospective studies. ? ?
| Durazzo, T S; Spencer, S S; Duckrow, R B et al. (2008) Temporal distributions of seizure occurrence from various epileptogenic regions. Neurology 70:1265-71 |
| Gwinn, Ryder P; Spencer, Dennis D; Spencer, Susan S et al. (2008) Local spatial effect of 50 Hz cortical stimulation in humans. Epilepsia 49:1602-10 |
