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Diagnosing

There is no single disease called “Epilepsy”. Actually, doctors have identified numerous forms of epilepsy until today, several of them only in the past 10 years. Each form of epilepsy calls for different diagnostic validation, varies in severeness and responds very differently to drugs or surgery.

Getting diagnosis right in the first place is a central task for the Epinext federation. This requires examinations on different levels, ranging from “simple” EEG measurements over blood analysis to cellular activity analysis – solidifying the uniquely close collaboration between Epinext scientists and clinicians as the central advantage of our federation.

Healthcare networks for ED and DRE

Correct and early diagnosis of epilepsy, especially drug-resistant epilepsy (DRE) is paramount for a successful treatment. However, too many health professionals and neuroscientists still can‘t easily access specialist information or study actual patient cases. Epinext will work with patients and doctors alike to close these gaps:

  • Clinicians come together with children and adult patients in actual hospitals, in ambulatory consultations and day care units to discuss symptoms and share their knowledge.
  • Publicly available educational resources for patients, external general practitioners and epilepsy specialists will be provided to improve diagnosis and accurate referral of DRE patients to facilities such as the Epinext federation.
  • Epinext will set up a new dedicated database for clinical records of epilepsy cases and share it among clinicians and researchers, in accordance with strong ethical and data protection guidelines.

Simultaneous EEG-MEG-SEEG recordings and network identification

Understanding how the different parts of a patient‘s brain connect is vital to make a reliable judgement about the if and how of surgical intervention. The established diagnostic tools of recording the EEG (electroencephalography) and MEG (magnetoencephalography) signals are gentle for patients because they‘re not invasive. In some cases, invasive recordings with stereotaxic EEG (SEEG) are necessary to better understand the epilptogenic network organization.

Therefore, Epinext will take on the technical challenge to record SEEG, EEG and MEG in total synchronization for a series of patients, determining the complex relationship of surface and in-depth measurements to a greater extent. These results can be translated into software-based, predictive surgery and spare more patients to invasive procedure to have their individual SEEG signals recorded.

Stress related Epilepsies and Depression

Epinext scientists have uncovered that forms of epilepsy which developed from emotional stress (EMO-TLE, Emotionally induced temporal lobe epilepsy) might be linked to low levels of BNDF (brain-derived neurotrophic factor). Patients with EMO-TLE are very sensitive to stress and also at risk for depression. But on a positive note, they respond well to biofeedback therapy.

Epinext researchers will work with a series of children and adult EMO-TLE patients to find out if results from animal studies can be translated to humans, basically measuring their BNDF levels to identify it as a biological cause of their condition.

Dynamics of human neurons involved in patho-physiological cortical activity patterns in vivo

When a healthy adult brain works normal, most activities involve only a network of neurons, distributed in certain areas of the brain. These neuronal activities are driven by microcircuits, powered by GABA molecules. Research has shown that a dysfunction of these microcircuits is linked to brain disorders like epilepsy.

Contrary to popular belief in the neuroscience community, Epinext biologists have shown that neurons driven by GABA are very active between seizures in an awake mouse brain – confirming an earlier, purely theoretical prediction from the Epinext mathematicians.

Analyzing the dynamics of such neurons during epileptic events in the human brain can help understanding what and where something is happening. But this kind of measurement has remained elusive so far.

What Epinext will do to overcome this limitation is to create an “atlas” of neuron types by analyzing brain tissue resected from a surgery, comparing epileptic and non-epileptic cortices.

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