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Bekbolatova M, Mayer J, Jose R, Syed F, Kurgansky G, Singh P, Pao R, Zaw H, Devine T, Chan-Akeley R, Toma M. Biomechanical Effects of Seizures on Cerebral Dynamics and Brain Stress. Brain Sci 2024; 14:323. [PMID: 38671975 PMCID: PMC11048267 DOI: 10.3390/brainsci14040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Epilepsy is one of the most common neurological disorders globally, affecting about 50 million people, with nearly 80% of those affected residing in low- and middle-income countries. It is characterized by recurrent seizures that result from abnormal electrical brain activity, with seizures varying widely in manifestation. The exploration of the biomechanical effects that seizures have on brain dynamics and stress levels is relevant for the development of more effective treatments and protective strategies. This study uses a blend of experimental data and computational simulations to assess the brain's physical response during seizures, particularly focusing on the behavior of cerebrospinal fluid and the resulting mechanical stresses on different brain regions. Notable findings show increases in stress, predominantly in the posterior gyri and brainstem, during seizures and an evidence of brain displacement relative to the skull. These observations suggest a dynamic and complex interaction between the brain and skull, with maximum shear stress regions demonstrating the limited yet essential protective role of the CSF. By providing a deeper understanding of the mechanical changes occurring during seizures, this research supports the goal of advancing diagnostic tools, informing more targeted treatment interventions, and guiding the creation of customized therapeutic strategies to enhance neurological care and protect against the adverse effects of seizures.
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Affiliation(s)
- Molly Bekbolatova
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.); (R.J.); (F.S.); (G.K.); (P.S.)
| | - Jonathan Mayer
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.); (R.J.); (F.S.); (G.K.); (P.S.)
| | - Rejath Jose
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.); (R.J.); (F.S.); (G.K.); (P.S.)
| | - Faiz Syed
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.); (R.J.); (F.S.); (G.K.); (P.S.)
| | - Gregory Kurgansky
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.); (R.J.); (F.S.); (G.K.); (P.S.)
| | - Paramvir Singh
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.); (R.J.); (F.S.); (G.K.); (P.S.)
| | - Rachel Pao
- NewYork-Presbyterian Queens Hospital, New York City, NY 11355, USA;
| | - Honey Zaw
- Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, Atran Berg Building, 8th Floor, New York City, NY 10029, USA;
| | - Timothy Devine
- The Ferrara Center for Patient Safety and Clinical Simulation, Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA;
| | | | - Milan Toma
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (M.B.); (J.M.); (R.J.); (F.S.); (G.K.); (P.S.)
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Chacon LM, Garcia LG, Bosch-Bayard J, García-Ramo KB, Martin MMB, Alfonso MA, Batista SB, de la Paz Bermudez T, González JG, Coroneux AS. Relation of Brain Perfusion Patterns to Sudden Unexpected Death Risk Stratification: A Study in Drug Resistant Focal Epilepsy. Behav Sci (Basel) 2022; 12:207. [PMID: 35877277 PMCID: PMC9311833 DOI: 10.3390/bs12070207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/21/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
To explore the role of the interictal and ictal SPECT to identity functional neuroimaging biomarkers for SUDEP risk stratification in patients with drug-resistant focal epilepsy (DRFE). Twenty-nine interictal-ictal Single photon emission computed tomography (SPECT) scans were obtained from nine DRFE patients. A methodology for the relative quantification of cerebral blood flow of 74 cortical and sub-cortical structures was employed. The optimal number of clusters (K) was estimated using a modified v-fold cross-validation for the use of K means algorithm. The two regions of interest (ROIs) that represent the hypoperfused and hyperperfused areas were identified. To select the structures related to the SUDEP-7 inventory score, a data mining method that computes an automatic feature selection was used. During the interictal and ictal state, the hyperperfused ROIs in the largest part of patients were the bilateral rectus gyrus, putamen as well as globus pallidus ipsilateral to the seizure onset zone. The hypoperfused ROIs included the red nucleus, substantia nigra, medulla, and entorhinal area. The findings indicated that the nearly invariability in the perfusion pattern during the interictal to ictal transition observed in the ipsi-lateral putamen F = 12.60, p = 0.03, entorhinal area F = 25.80, p = 0.01, and temporal middle gyrus F = 12.60, p = 0.03 is a potential biomarker of SUDEP risk. The results presented in this paper allowed identifying hypo- and hyperperfused brain regions during the ictal and interictal state potentially related to SUDEP risk stratification.
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Affiliation(s)
- Lilia Morales Chacon
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Lidice Galan Garcia
- Cuban Neurosciences Center, 25th Ave, No 15202, Playa, Havana PC 11300, Cuba;
| | - Jorge Bosch-Bayard
- McGill Centre for Integrative Neuroscience, Ludmer Centre for Neuroinformatics and Mental Health, Montreal Neurological Institute, Montreal, QC H3A 0G4, Canada;
| | - Karla Batista García-Ramo
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Margarita Minou Báez Martin
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Maydelin Alfonso Alfonso
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Sheyla Berrillo Batista
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Tania de la Paz Bermudez
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Judith González González
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
| | - Abel Sánchez Coroneux
- International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana PC 11300, Cuba; (K.B.G.-R.); (M.M.B.M.); (M.A.A.); (S.B.B.); (T.d.l.P.B.); (J.G.G.); (A.S.C.)
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