The Mechanism of cTBS Targeting Dentate Nucleus for DRE
Transcranial Magnetic StimulationDrug Resistant Epilepsy1 moreIn our previous cross-over study--the continuous θ burst stimulation (cTBS) targeting cerebellum dentate nucleus of 44 drug-refractory epilepsy (DRE) patients, a significant reduction in seizure frequency was observed. However, the mechanism of this target to reduce seizures is still unknown. This study aims to explore the mechanism of cTBS targeting cerebellum dentate nucleus for DRE, in order to provide theoretical support for this treatment method. A total of 50 patients with DRE will have 2-week cTBS treatment via accurate navigation to bilateral cerebellar dentate nucleus. Participants will be took TMS-EEG, functional magnetic resonance imaging, and diffusion tensor imaging (DTI) pre- and post- treatment. These three examinations will help to analyze the brain functional connectivity and suggest the mechanism of action of this treatment.
Human Epilepsy Project 3
Idiopathic Generalized EpilepsyBy carrying a careful, large-scale and ambitious prospective study of a cohort of participants with generalized epilepsy, the study team hopes to clarify the likelihood of response and remission in this type of epilepsy, and try to explore the underlying biological drivers of treatment response, including novel realms of exploration such as impact of the microbiome, and genetics. The identification of biomarkers that predict the likelihood of disease response would allow epilepsy patients to make more informed decisions about the factors affecting their quality of life, including plans for driving, relationships, pregnancy, schooling, work, and play. In addition to its impact on clinical care, the data and specimens collected in HEP3, including sequential electrophysiology, biochemical profiles and neuroimaging and banked DNA for future genomics studies, have the potential to provide new insights into the biological basis of IGE, thereby advancing the discovery of effective treatments and cures. By enrolling both newly diagnosed subjects (prognosis unknown) as well as subjects with established IGE who are already determined to be treatment resistant or treatment responsive, the study team can immediately test potential biomarkers in a confirmation cohort, which will accelerate identification of predictive biomarkers.
Status Epilepticus Unicenter Population (STEP UP) Study
Epileptic SeizuresThe aim of this observational single-center cohort study is to gain a deeper understanding regarding the effects of treatment adaption based on information from outcome prediction models, risk stratification, as well as treatment monitoring, detection, prevention, and management of complications on course and outcome of adult patients with status epilepticus (SE).
Population Pharmacokinetics of Antiepileptic in Pediatrics
EpilepsyThe purpose of this study is to develop population pharmacokinetic models for antiepileptic drugs in a pediatric population. The interest of these models is multiple: describe the pharmacokinetics of these molecules in children and explain the inter-individual variability of concentrations through covariates such as weight, age, co-treatments, genetic polymorphisms and renal function; estimate maximum, minimum and exposure concentrations from the individual pharmacokinetic parameters for each patient; propose adaptations of doses for certain classes of children (according to age, weight etc.) and individualize the doses.
Real-World Evidence in Patient-Reported Outcomes for Medical Cannabis (MC-RWE)
PainSleep3 moreThis prospective observational study aims to describe the effectiveness of MC on pain, epilepsy, sleep and /or anxiety/depression in a cohorts of patients authorized to use MC, using pre-defined, validated self assessment scales.
Modification of Epilepsy Screen Questionnaire and Treatment Feasibility Evaluation
EpilepsyAtypical presentations in epilepsy may include confusion status, acute maniac or delirious condition, loss of cognitive ability such as speech, interaction skills, or other praxis. Current diagnosis of epilepsy did not address on definition of seizure. The new insights of seizure semiology and their treatment response, suggest the screen tool and diagnostic criteria of epilepsy can be revised. In this study, we have two aims. The first aim is to develop a screening questionnaire by adding new semiology of epilepsy, including abnormality in psychiatry, cognition, and sleep, and to test its accuracy. The second aim is to evaluate the benefits in cognition of anti-epileptic drug intervention in participants with positive screening results.
Prospective Open-label Evaluation of Cenobamate Adjunctive Treatment of Adults With Refractory Focal...
Focal EpilepsyTo evaluate the efficacy, safety and tolerability of cenobamate as adjunctive treatment of refractory focal epilepsy
De-identified UNMH EEG Corpus Database Creation With Fully De-identified Clinical Information
EpilepsyStatus Epilepticus1 moreThis proposal outlines the steps required for the creation of a pilot database of EEG recordings and de-identified medical records from patients internally referred within the UNMH Comprehensive Epilepsy Center. The UNMH EEG Corpus would be the first database of its kind. Other public databases contain either patient EEG signals or medical records, but without both kinds of information, it is impossible to relate pre-treatment neurobiomarkers with post-treatment prognosis. The database will also contain information that can improve seizure localization based off of scalp and intracranial EEG, and the requisite data for the creation of algorithms that forecast seizure activity; a development that could ultimately lead to novel responsive neural stimulation procedures that suppress seizures before they begin.
Computational Neuroscience of Language Processing in the Human Brain
LanguageEpilepsyLanguage is a signature human cognitive skill, but the precise computations that support language understanding remain unknown. This study aims to combine high-quality human neural data obtained through intracranial recordings with advances in computational modeling of human cognition to shed light on the construction and understanding of speech.
NEED: Neuromed Epilepsy EEG Database. A Large EEG Database of Epilepsy Patients for Research Community....
Automatic Seizure DetectionFor one-third of patients with drug-resistant epilepsy alternative approaches must be investigated in order to improve the quality of their life. A possible approach is to find automatic methods to detect/predict seizures, in order to adopt interventional actions to stop or abort the seizure or to limit its side effect. The main problem in this case is to evaluate the reproducibility of such methods and to standardize them, because there is a lack of availability of long-term electroencephalography (EEG) data. In this study we want to create a large long-term EEG database, called NEED (Neuromed Epilepsy EEG Database), whos aim is to give researchers a way to test their method in a large collection of data. The database will contain long-term EEG recordings of 200 patients as well as extensive metadata and standardized annotation of the data sets and will be made freely available for the download to the research community.