Project Details
Description
Project Summary/Abstract
Approximately 20% of patients with recurring seizures have focal drug-resistant epilepsy. It remains
challenging to localize the epileptogenic zone (EZ), defined as the region of brain that must be resected or
modulated to obtain seizure freedom. No precise localization for the EZ is currently available, and the seizure
onset zone remains the gold standard for defining the EZ. Low Frequency EEG Activity (LFA) is relatively
understudied and prior data suggests that LFA can improve EZ localization. This proposal’s objective is to fully
evaluate the potential of LFA for EZ localization and to clarify pathophysiologic mechanisms that underlie LFA.
To this end, a retrospective analysis of 94 patients will examine the potentially efficacy of LFA for estimating
the EZ, and a cohort of 40 patients will be prospectively enrolled for more detailed assessments. Clinical
outcomes from treated patients will be used to retrospectively determine the EZ, which can be used to evaluate
the EZ as estimated by LFA. Prospective patients will receive simultaneous recordings from clinical EEG
macroelectrodes as well as from research-grade microelectrodes, which record neuronal units using DC-
capable amplifiers. In addition, cutting edge techniques for magnetic resonance spectroscopy will be used to
determine neurotransmitter levels for these same brain regions. Finally, non-invasive high density EEG in
conjunction with invasive EEG will be used to assess the potential for non-invasive estimation of the EZ.
We expect that this proposal will lead to more accurate non-invasive and invasive localization of the EZ, which
would lead to improved patient outcomes. Understanding the mechanisms underlying LFA will improve
biomarker development and application to clinical use and could influence treatment-related decisions. An
informative EEG biomarker based on LFA from non-invasive evaluations means patients could potentially
avoid invasive EEG monitoring.
For this mentored award, the career plan includes the overall goal of independence as a clinician investigator
studying epilepsy with the following training objectives: (1) learn about study design for human research, (2)
obtain formal instruction in informatics and biostatistics, (3) understand biomarker development, (4) learn about
microelectrode recordings and MR spectroscopy, (5) improve grant writing skills, (6) develop relationships with
extramural researchers, and (7) maintain and improve awareness of current literature. The environment for
career development includes a multidisciplinary team including epilepsy, neuroradiology, and biostatistics with
prior lab experience and support in microelectrode recordings and EEG biomarker development.
Status | Active |
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Effective start/end date | 7/1/19 → 5/31/24 |
Funding
- National Institute of Neurological Disorders and Stroke: $187,167.00
- National Institute of Neurological Disorders and Stroke: $186,479.00
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