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van Blooijs D, Leijten FSS, van Rijen PC, Meijer HGE, Huiskamp GJM. Evoked directional network characteristics of epileptogenic tissue derived from single pulse electrical stimulation. Hum Brain Mapp 2018; 39:4611-4622. [PMID: 30030947 PMCID: PMC6220882 DOI: 10.1002/hbm.24309] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 01/07/2023] Open
Abstract
We investigated effective networks constructed from single pulse electrical stimulation (SPES) in epilepsy patients who underwent intracranial electrocorticography. Using graph analysis, we compared network characteristics of tissue within and outside the epileptogenic area. In 21 patients with subdural electrode grids (1 cm interelectrode distance), we constructed a binary, directional network derived from SPES early responses (<100 ms). We calculated in‐degree, out‐degree, betweenness centrality, the percentage of bidirectional, receiving and activating connections, and the percentage of connections toward the (non‐)epileptogenic tissue for each node in the network. We analyzed whether these network measures were significantly different in seizure onset zone (SOZ)‐electrodes compared to non‐SOZ electrodes, in resected area (RA)‐electrodes compared to non‐RA electrodes, and in seizure free compared to not seizure‐free patients. Electrodes in the SOZ/RA showed significantly higher values for in‐degree and out‐degree, both at group level, and at patient level, and more so in seizure‐free patients. These differences were not observed for betweenness centrality. There were also more bidirectional and fewer receiving connections in the SOZ/RA in seizure‐free patients. It appears that the SOZ/RA is densely connected with itself, with only little input arriving from non‐SOZ/non‐RA electrodes. These results suggest that meso‐scale effective network measures are different in epileptogenic compared to normal brain tissue. Local connections within the SOZ/RA are increased and the SOZ/RA is relatively isolated from the surrounding cortex. This offers the prospect of enhanced prediction of epilepsy‐prone brain areas using SPES.
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Affiliation(s)
- Dorien van Blooijs
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frans S S Leijten
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter C van Rijen
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hil G E Meijer
- Department of Applied Mathematics, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Geertjan J M Huiskamp
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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2
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Rosenow F, van Alphen N, Becker A, Chiocchetti A, Deichmann R, Deller T, Freiman T, Freitag CM, Gehrig J, Hermsen AM, Jedlicka P, Kell C, Klein KM, Knake S, Kullmann DM, Liebner S, Norwood BA, Omigie D, Plate K, Reif A, Reif PS, Reiss Y, Roeper J, Ronellenfitsch MW, Schorge S, Schratt G, Schwarzacher SW, Steinbach JP, Strzelczyk A, Triesch J, Wagner M, Walker MC, von Wegner F, Bauer S. Personalized translational epilepsy research - Novel approaches and future perspectives: Part I: Clinical and network analysis approaches. Epilepsy Behav 2017; 76:13-18. [PMID: 28917501 DOI: 10.1016/j.yebeh.2017.06.041] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/05/2017] [Indexed: 01/01/2023]
Abstract
Despite the availability of more than 15 new "antiepileptic drugs", the proportion of patients with pharmacoresistant epilepsy has remained constant at about 20-30%. Furthermore, no disease-modifying treatments shown to prevent the development of epilepsy following an initial precipitating brain injury or to reverse established epilepsy have been identified to date. This is likely in part due to the polyetiologic nature of epilepsy, which in turn requires personalized medicine approaches. Recent advances in imaging, pathology, genetics and epigenetics have led to new pathophysiological concepts and the identification of monogenic causes of epilepsy. In the context of these advances, the First International Symposium on Personalized Translational Epilepsy Research (1st ISymPTER) was held in Frankfurt on September 8, 2016, to discuss novel approaches and future perspectives for personalized translational research. These included new developments and ideas in a range of experimental and clinical areas such as deep phenotyping, quantitative brain imaging, EEG/MEG-based analysis of network dysfunction, tissue-based translational studies, innate immunity mechanisms, microRNA as treatment targets, functional characterization of genetic variants in human cell models and rodent organotypic slice cultures, personalized treatment approaches for monogenic epilepsies, blood-brain barrier dysfunction, therapeutic focal tissue modification, computational modeling for target and biomarker identification, and cost analysis in (monogenic) disease and its treatment. This report on the meeting proceedings is aimed at stimulating much needed investments of time and resources in personalized translational epilepsy research. Part I includes the clinical phenotyping and diagnostic methods, EEG network-analysis, biomarkers, and personalized treatment approaches. In Part II, experimental and translational approaches will be discussed (Bauer et al., 2017) [1].
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Affiliation(s)
- Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Epilepsy Center Marburg, Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1).
| | - Natascha van Alphen
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Albert Becker
- Institute for Neuropathology, University Bonn, 53105 Bonn, Germany
| | - Andreas Chiocchetti
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Ralf Deichmann
- Brain Imaging Center (BIC) Frankfurt, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Thomas Deller
- Institute of Clinical Neuroanatomy, Dr. Senckenberg Anatomy, Neuroscience Center, Goethe University Frankfurt, 60590 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Thomas Freiman
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Johannes Gehrig
- Emmy-Noether Group Kell, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Anke M Hermsen
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Peter Jedlicka
- Institute of Clinical Neuroanatomy, Dr. Senckenberg Anatomy, Neuroscience Center, Goethe University Frankfurt, 60590 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Christian Kell
- Emmy-Noether Group Kell, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Karl Martin Klein
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Epilepsy Center Marburg, Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Susanne Knake
- Epilepsy Center Marburg, Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Dimitri M Kullmann
- Institute of Neurology, University College London (UCL), London WC1E 6BT, United Kingdom
| | - Stefan Liebner
- Edinger-Institute Frankfurt, Neuroscience Center, Goethe University Frankfurt, 60590 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Braxton A Norwood
- Epilepsy Center Marburg, Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany
| | - Diana Omigie
- Max-Planck-Institute for Empirical Aesthetics, 60322 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Karlheinz Plate
- Edinger-Institute Frankfurt, Neuroscience Center, Goethe University Frankfurt, 60590 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Andreas Reif
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Philipp S Reif
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Yvonne Reiss
- Edinger-Institute Frankfurt, Neuroscience Center, Goethe University Frankfurt, 60590 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Jochen Roeper
- Institute of Neurophysiology, Neuroscience Center, Goethe-University Frankfurt, 60590 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Michael W Ronellenfitsch
- Dr. Senckenberg Institute for Neurooncology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Stephanie Schorge
- Institute of Neurology, University College London (UCL), London WC1E 6BT, United Kingdom
| | - Gerhard Schratt
- Institute of Physiological Chemistry, Philipps-University Marburg, 35043 Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Stephan W Schwarzacher
- Institute of Clinical Neuroanatomy, Dr. Senckenberg Anatomy, Neuroscience Center, Goethe University Frankfurt, 60590 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Joachim P Steinbach
- Dr. Senckenberg Institute for Neurooncology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Epilepsy Center Marburg, Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Jochen Triesch
- Frankfurt Institute for Advanced Studies (FIAS), 60438 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Marlies Wagner
- Institute of Neuroradiology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Matthew C Walker
- Institute of Neurology, University College London (UCL), London WC1E 6BT, United Kingdom
| | - Frederic von Wegner
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
| | - Sebastian Bauer
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Center of Neurology and Neurosurgery, Goethe University Frankfurt, 60528 Frankfurt, Germany; Epilepsy Center Marburg, Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), 60528 Frankfurt, Germany(1)
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4
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Freestone DR, Karoly PJ, Peterson ADH, Kuhlmann L, Lai A, Goodarzy F, Cook MJ. Seizure Prediction: Science Fiction or Soon to Become Reality? Curr Neurol Neurosci Rep 2016; 15:73. [PMID: 26404726 DOI: 10.1007/s11910-015-0596-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This review highlights recent developments in the field of epileptic seizure prediction. We argue that seizure prediction is possible; however, most previous attempts have used data with an insufficient amount of information to solve the problem. The review discusses four methods for gaining more information above standard clinical electrophysiological recordings. We first discuss developments in obtaining long-term data that enables better characterisation of signal features and trends. Then, we discuss the usage of electrical stimulation to probe neural circuits to obtain robust information regarding excitability. Following this, we present a review of developments in high-resolution micro-electrode technologies that enable neuroimaging across spatial scales. Finally, we present recent results from data-driven model-based analyses, which enable imaging of seizure generating mechanisms from clinical electrophysiological measurements. It is foreseeable that the field of seizure prediction will shift focus to a more probabilistic forecasting approach leading to improvements in the quality of life for the millions of people who suffer uncontrolled seizures. However, a missing piece of the puzzle is devices to acquire long-term high-quality data. When this void is filled, seizure prediction will become a reality.
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Affiliation(s)
- Dean R Freestone
- Department of Medicine, St. Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, VIC, Australia, 3065. .,Department of Statistics, Columbia University, New York, NY, 10027, USA.
| | - Philippa J Karoly
- Department of Medicine, St. Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, VIC, Australia, 3065.,Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia, 3000
| | - Andre D H Peterson
- Department of Medicine, St. Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, VIC, Australia, 3065
| | - Levin Kuhlmann
- Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia, 3000
| | - Alan Lai
- Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia, 3000
| | - Farhad Goodarzy
- Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia, 3000
| | - Mark J Cook
- Department of Medicine, St. Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, VIC, Australia, 3065.
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