Seizure prediction and prevention

Innovative Medizinische Forschung, Medizinische Fakultät Münster (IMF)

A. Lüttjohann

Wavelet energy of three different LFP channels calculated along a pre-SWD -> SWD transition and the product of the energies (lowest pane) indicating synchrony between channels. Note the pre-ictal increase in synchrony, circled in pink in the pre-ical period predicting the generation of an SWD

Generalized spike and wave discharges (SWD), the electrophysiological hallmark of absence epilepsy, have long been regarded as sudden and unpredictable phenomena. With advances in signal analysis, however, it could be revealed that SWD are preceded by changes in brain network communication. Most recently an algorithm capable for fast on line analysis of EEG, which aims to detect changes in synchrony between different brain areas (recording channels) has been developed and implemented in a ready to use on-line closed loop DBS system. In this system electrical pulses, aimed to desynchronize brain activity, are automatically delivered to the brain as soon as a change in synchrony (precursor activity) leading to SWD is detected. With the ultimate goal of epileptology to achieve seizure freedom this research project aims:  
a) to identify parameters in terms of an optimal channel combination and frequency band(s) to be analyzed by the algorithm, that results in/allows on-line SWD precursor detection with highest sensitivity and specificity (for SWD prediction);
b) to search for optimal DBS protocols, in terms of frequency, duration of stimulation and brain structure to be stimulated, which achieve SWD prevention in an on-line closed-loop SWD precursor detection system, with maximal effectiveness and least side effects.