epilepsy Archives - Amazing Health Advances

Do I Need an Epileptologist?

The AHA! Team — Mon, 18 Aug 2025 05:37:03 +0000

Morgan deBlecourt via Duke Health – An epileptologist is a neurologist who specializes in caring for people with epilepsy. Epileptologists have completed an additional one to two years of subspecialty training in epilepsy care. Most people with epilepsy can see a primary care doctor or general neurologist to manage their seizures. However, you may need more advanced care if your seizures are not under control, if you have certain medical issues, or if you want a second opinion. An epileptologist is a neurologist who specializes in caring for people with epilepsy. Epileptologists have completed an additional one to two years of subspecialty training in epilepsy care. When to See an Epileptologist To confirm your epilepsy diagnosis If your seizures are not under control after three months of care by your primary care physician or after one year of care by a general neurologist If your seizures are not under control despite trying two or three different medications If you are experiencing unwanted side effects from medications If you have other medical conditions or considerations that affect or are affected by epilepsy If you are pregnant or want to become pregnant Seek Care at an Epilepsy Center “An epileptologist typically works in a designated epilepsy center, which is capable of evaluating people whose seizures are not under adequate control. An epilepsy center provides a very comprehensive approach to care,” said Duke epileptologist Aatif Husain, MD. An epilepsy center is staffed by specialists who use sophisticated testing to pinpoint your diagnosis, offer the latest treatments, address possible side effects of medications, recommend surgical options if appropriate, and help you manage the social and emotional aspects of epilepsy. “Advances over the past decade have enabled more personalized epilepsy care,” said Duke epileptologist Birgit Frauscher, MD. “With new options now available, regular re-evaluation of treatment is essential.” As a Level 4 Epilepsy Center, Duke is recognized by the National Association of Epilepsy Centers for providing the highest level of diagnostic, treatment, and surgical options. To read the original article click here.

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Robot Reduces Need for Open Brain Surgery to Map Epileptic Seizures

The AHA! Team — Fri, 03 Jan 2025 07:38:39 +0000

Debbe Geiger via Duke Health – A Medical Advance for People with Epilepsy. A robotic device is allowing doctors to pinpoint the origins of a person’s seizures through minimally invasive surgery. The device, in use at Duke and some epilepsy centers across the country, allows neurosurgeons to implant hundreds of recording electrodes into the brain through about 10 to 20 small incisions. The procedure is highly precise, and it takes less time than traditional surgical options for seizure localization. People also recover faster and have less pain. Diagnosing the Origin of Epilepsy Seizures When medications fail to stop epileptic seizures, a person’s best hope for gaining control of their seizures is often epilepsy surgery. That can only happen if doctors can identify the area of the brain responsible for the seizures and remove it safely. To identify that spot, neurosurgeons may perform a craniotomy, creating a large opening in the skull, and then place a plastic grid of electrodes on the surface of the brain to record seizures and identify where they originate. However, the electrodes can’t access the folds or the parts of the brain between the two hemispheres and its deep structures. Shorter, More Precise Brain Mapping The team at Duke’s epilepsy center has another tool in their arsenal. Robot-assisted stereoelectroencephalography (SEEG) is a minimally invasive procedure that rapidly places thin electrode wires in precise locations to map the brain and identify seizure origins. A 3D reconstruction of the brain guides where the dozen or more electrodes will be placed. The neurosurgeon uses a robotic arm to make small, two- or three-millimeter holes in the scalp through which the rigid electrode wire is passed. As opposed to grid electrodes, which sit on the surface of the brain, the wires are placed into the brain tissue with robotic assistance. The procedure takes about two to three hours. “The robot improves the efficiency of the procedure, and it reduces some of the possibility for human error. Depending on the patient’s condition, robot-assisted SEEG can be very useful for localizing seizures in a way that is more comfortable for patients,” said Duke neurosurgeon Derek Southwell, MD, PhD, of the Duke Comprehensive Epilepsy Center. Due to its minimally invasive nature, placing depth electrodes this way is much better tolerated by patients than placing grid electrodes. Once the seizure origin is identified, the electrodes are removed, and people recover quickly. That is a huge benefit over recuperating from a craniotomy. The procedure is also better for cases where the exact location of the seizure cannot be identified, or the seizure origin is in a part of the brain that is inoperable. To read the original article click here.

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Eyelid Wearable Can Predict and Alert to Epileptic Seizure

The AHA! Team — Tue, 10 Sep 2024 09:00:10 +0000

John Jeffay via Israel21c – Blink Energy’s tiny device, fitted to one eyelid, monitors and analyzes blink patterns to detect or diagnose a wealth of health conditions. A tiny patch is fixed to your eyelid. It monitors your blink pattern and sends a warning to your smartphone that you’re about to have an epileptic seizure. Or that you’re about to fall asleep at the wheel. Or else it measures your REM (rapid eye movement) to help diagnose sleep disorders or Parkinson’s disease or a range of neurological conditions. This isn’t science fiction. This is the next step forward in the world of wearable technology. And according to Yariv Bar-On, CEO at Israel-based Blink Energy, it’s a gamechanger. The wearables market has been dominated, so far, by smartwatches and fitness trackers. The first Apple Watch was launched in April 2015, and wearable technology now includes jewelry that tracks your steps and notifies you of an incoming call, VR headsets for gamers, earbuds, smart glasses with Internet access, smart clothing integrated with electronic devices and a range of health monitors. But the world’s first eyelid wearable device opens up a whole new world of opportunity. Blink patterns Blink Energy’s device weighs just 0.4 grams (0.014 ounces) — less than half the weight of a paperclip – and is fitted to one eyelid. You barely notice it, says Bar-On. “After two minutes you forget it’s there.” But it’s performing an important function by monitoring blink patterns, which provides AI with a wealth of data. “There is one type of muscle that closes the eye, and another that opens it,” says Bar-On, an optometrist and entrepreneur. “There’s a ratio between those two muscles when they are working, and we can, with AI machine learning, identify abnormalities in the patterns of blinks.” Smartwatches and other devices measure eye movement indirectly, by collecting related data. Bar-On says they are only 80 percent accurate. His blink patch provides, for the first time, a way of readily measuring eye movement directly. He says he hopes to launch the company’s first product commercially within two years, at what he describes as an “affordable” price. Starting with epilepsy The possibilities for such technology, developed with his small team of engineers in Haifa, northern Israel, are many. The patch, held onto the eyelid with a disposable adhesive strip that lasts for 10 or 20 uses, can provide data about eye health or eye strain during the course of everyday activities. It can detect drowsiness at the wheel and has other possible uses in health and wellbeing. But the company had to start somewhere. And that somewhere is epilepsy. Bar-On wants to lessen the anxiety that people with epilepsy suffer. “My goal would be to bring epileptic patients more confidence in their daily life,” he tells ISRAEL21c. “You just wear it outside the house, knowing you don’t have to think about when the next seizure might be. The Blink device will indicate a few seconds before a seizure. But it’s not so much the detection as the fact that the wearer doesn’t have to worry about when the next seizure will be,” he says. “Knowing that the device will do that, instead of you having to, makes a big difference. Epileptic patients feel when the seizure is coming, but we can dramatically reduce the anxiety levels, which in themselves contribute to a seizure.” Blink Energy has yet to test its device on epileptic patients. The patch exists as a prototype, but there are still refinements needed before it’s ready for market. Eye mavens Bar-On cofounded Blink Energy four years ago with Nadav Cohen, a specialist in optics and vibrations, and Ziv Rotfogel, an ophthalmologist at Kaplan Medical Center in Rehovot, central Israel. “We wanted to see how we can look at the eye movement or the physiological signals that can be detected from the eye and develop a product that is beyond what it is on the market today,” he says. At first their focus was on using the blink movement to power the patch – which is why they chose the name Blink Energy. “We made a pivot almost two years ago and we developed our own sensor biomarker [which measures biological activity] with communication capabilities but without generating its own power,” he says. The product will recharge inside its own box, just like a pair of earbuds. “It’s not a me-too technology. It’s more like a really game-changing technology. I believe that in the next five to 10 years to come you’ll see many people walking down the street wearing an eyelid patch,” Bar-On predicts. “The adoption rate of wearable tech or smart wearables is already immense. This is just the start.” Blink Energy has received funding from the Israel Innovation Authority and by Israel-based MindUP, which invests in healthcare innovation. For more information, click here. To read the original article click here.

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Soft, Stretchy ‘Jelly Batteries’ Inspired by Electric Eels

The AHA! Team — Thu, 25 Jul 2024 08:12:50 +0000

University of Cambridge via EurekAlert! – Researchers have developed soft, stretchable ‘jelly batteries’ that could be used for wearable devices or soft robotics, or even implanted in the brain to deliver drugs or treat conditions such as epilepsy. The researchers, from the University of Cambridge, took their inspiration from electric eels, which stun their prey with modified muscle cells called electrocytes. Like electrocytes, the jelly-like materials developed by the Cambridge researchers have a layered structure, like sticky Lego, that makes them capable of delivering an electric current. The self-healing jelly batteries can stretch to over ten times their original length without affecting their conductivity The first time that such stretchability and conductivity has been combined in a single material. The results are reported in the journal Science Advances. The jelly batteries are made from hydrogels: 3D networks of polymers that contain over 60% water. The polymers are held together by reversible on/off interactions that control the jelly’s mechanical properties. The ability to precisely control mechanical properties and mimic the characteristics of human tissue makes hydrogels ideal candidates for soft robotics and bioelectronics; however, they need to be both conductive and stretchy for such applications. “It’s difficult to design a material that is both highly stretchable and highly conductive, since those two properties are normally at odds with one another,” said first author Stephen O’Neill, from Cambridge’s Yusuf Hamied Department of Chemistry. “Typically, conductivity decreases when a material is stretched.” “Normally, hydrogels are made of polymers that have a neutral charge, but if we charge them, they can become conductive,” said co-author Dr Jade McCune, also from the Department of Chemistry. “And by changing the salt component of each gel, we can make them sticky and squish them together in multiple layers, so we can build up a larger energy potential.” Conventional electronics use rigid metallic materials with electrons as charge carriers, while the jelly batteries use ions to carry charge, like electric eels. Jelly batteries use ions to carry charge, like electric eels The hydrogels stick strongly to each other because of reversible bonds that can form between the different layers, using barrel-shaped molecules called cucurbiturils that are like molecular handcuffs. The strong adhesion between layers provided by the molecular handcuffs allows for the jelly batteries to be stretched, without the layers coming apart and crucially, without any loss of conductivity. The properties of the jelly batteries make them promising for future use in biomedical implants, since they are soft and mould to human tissue. “We can customise the mechanical properties of the hydrogels so they match human tissue,” said Professor Oren Scherman, Director of the Melville Laboratory for Polymer Synthesis, who led the research in collaboration with Professor George Malliaras from the Department of Engineering. “Since they contain no rigid components such as metal, a hydrogel implant would be much less likely to be rejected by the body or cause the build-up of scar tissue.” In addition to their softness, the hydrogels are also surprisingly tough. They can withstand being squashed without permanently losing their original shape, and can self-heal when damaged. The researchers are planning future experiments to test the hydrogels in living organisms to assess their suitability for a range of medical applications. The research was funded by the European Research Council and the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation (UKRI). Oren Scherman is a Fellow of Jesus College, Cambridge. To read the original article click here.

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Why Does Fasting Reduce Seizures?

AHA Publisher — Wed, 14 Sep 2022 07:00:03 +0000

Boston Children’s Hospital via Newswise – Calorie restriction has long been associated with reduced seizures in epilepsy. New research from Boston Children’s Hospital helps explain how fasting affects neurons in the brain and could lead the way to new approaches that would avoid the need for fasting or restrictive diets. The findings were published August 30 in the journal Cell Reports. “This study is the first step in understanding how dietary therapies for epilepsy work,” says first author Christopher J. Yuskaitis, MD, PhD, a neurologist with the Epilepsy Center and Epilepsy Genetics Program at Boston Children’s Hospital. “The mechanisms have until now been completely unknown.” DEPDC5, mTOR, and Fasting To connect the dots between diet and seizures, the researchers began with existing knowledge. They knew that the well-known mTOR cellular pathway is involved in many neurological disorders and had shown previously that over-activation of this pathway in neurons increases susceptibility to seizures. Studies by others had shown that mTORC activity is inhibited by acute fasting, though these studies didn’t look at the brain. Finally, Yuskaitis and colleagues knew that signaling by a protein called DEPDC5 acts as a brake on the mTOR pathway. That was intriguing, since mutations in the DEPDC5 gene have recently been found in many people with epilepsy. DEPDC5 mutations have been linked to focal epilepsy, infantile spasms, and sudden death in children. “When we used an animal model that knocks out DEPDC5 specifically in the brain, we found that we could reduce seizures by using an mTOR inhibitor,” says Yuskaitis. “That gave us the idea to explore the connection between DEPDC5, mTOR, and fasting.” Amino Acid Sensing In the new study, they showed in a mouse seizure model that mTOR signaling was reduced in the brain after fasting. Additional studies of cultured rat neurons in a dish suggest that this fasting effect is primarily driven by the lack of three amino acids (leucine, arginine, and glutamine). Going further, the team demonstrated that the presence of these nutrients is sensed by the DEPDC5 protein. When they knocked out DEPDC5 in the brain, mTOR activity was not reduced and fasting no longer protected the mice against seizures. “Amino acid sensing seems to be critical for the beneficial effects of fasting on seizures,” says Yuskaitis. “This suggests that patients with DEPDC5 mutations can’t sense the loss of amino acids and may not benefit from dietary manipulation. But patients who don’t have DEPDC5 mutations may benefit from a targeted dietary strategy.” This could take the form of diets with lower levels of the three amino acids, or medications or supplements that block absorption of those amino acids, he adds. Next Step: Ketogenic Diet This study is only a first step. Yuskaitis and colleagues now want to try diets in animal models that eliminate specific amino acids and observe the effects on seizures. They also want to explore how the ketogenic diet, a popular approach to treating epilepsy, helps curb seizures. No one currently knows why this low-carbohydrate, high-fat diet works. “We’re hoping this will hope us uncover additional dietary-based therapies other than ketogenic diet, which is sometimes difficult to follow long term due to side effects,” says Yuskaitis. Such work may also provide a new lens on neurologic disorders overall. “Using these rare genetic disorders, we are starting to gain fundamental insights into the role of nutrients in brain function,” says senior investigator Mustafa Sahin, MD, PhD, managing director of the Rosamund Stone Zander Translational Neuroscience Center at Boston Children’s. “Findings from these rare disorders may open doors for better treatments of epilepsy in general.” To read the original article click here.

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AI Algorithm That Detects Brain Abnormalities Could Help Cure Epilepsy

AHA Publisher — Mon, 15 Aug 2022 07:00:16 +0000

University College London via Newswise – An artificial intelligence (AI) algorithm that can detect subtle brain abnormalities which cause epileptic seizures has been developed by a UCL-led team of international researchers. The Multicentre Epilepsy Lesion Detection project (MELD) used over 1,000 patient MRI scans from 22 global epilepsy centres to develop the algorithm, which provides reports of where abnormalities are in cases of drug-resistant focal cortical dysplasia (FCD) – a leading cause of epilepsy. FCDs are areas of the brain that have developed abnormally and often cause drug-resistant epilepsy. It is typically treated with surgery, however identifying the lesions from an MRI is an ongoing challenge for clinicians, as MRI scans in FCDs can look normal. To develop the algorithm, the team quantified cortical features from the MRI scans, such as how thick or folded the cortex/brain surface was, and used around 300,000 locations across the brain. Researchers then trained the algorithm on examples labelled by expert radiologists as either being a healthy brain or having FCD – dependant on their patterns and features. The findings, published in Brain, found that overall the algorithm was able to detect the FCD in 67% of cases in the cohort (538 participants). Previously, 178 of the participants had been considered MRI negative, which means that radiologists had been unable to find the abnormality – yet the MELD algorithm was able to identify the FCD in 63% of these cases. This is particularly important, as if doctors can find the abnormality in the brain scan, then surgery to remove it can provide a cure. Co-first author, Mathilde Ripart (UCL Great Ormond Street Institute of Child Health) said: “We put an emphasis on creating an AI algorithm that was interpretable and could help doctors make decisions. Showing doctors how the MELD algorithm made its predictions was an essential part of that process.” Co-senior author, Dr Konrad Wagstyl (UCL Queen Square Institute of Neurology) added: “This algorithm could help to find more of these hidden lesions in children and adults with epilepsy, and enable more patients with epilepsy to be considered for brain surgery that could cure the epilepsy and improve their cognitive development. Roughly 440 children per year could benefit from epilepsy surgery in England.” Around 1% of the world’s population have the serious neurological condition epilepsy, that is characterised by frequent seizures. In the UK some 600,000 people are affected. While drugs treatments are available for the majority of people with epilepsy, 20-30% do not respond to medications. In children who have had surgery to control their epilepsy, FCD is the most common cause, and in adults it is the third most common cause. Additionally, of patients who have epilepsy that have an abnormality in the brain that cannot be found on MRI scans, FCD is the most common cause. Co-first author, Dr. Hannah Spitzer (Helmholtz Munich) said: “Our algorithm automatically learns to detect lesions from thousands of MRI scans of patients. It can reliably detect lesions of different types, shapes and sizes, and even many of those lesions that were previously missed by radiologists.” Co-senior author, Dr Sophie Adler (UCL Great Ormond Street Institute of Child Health) added: “We hope that this technology will help to identify epilepsy-causing abnormalities that are currently being missed. Ultimately it could enable more people with epilepsy to have potentially curative brain surgery.” This study on FCD detection uses the largest MRI cohort of FCDs to date, meaning it is able to detect all types of FCD. The MELD FCD classifier tool can be run on any patient with a suspicion of having an FCD who is over the age of 3 years and has an MRI scan. The MELD project is supported by the Rosetrees Trust. To read the original article click here.

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Neurosurgery Team Performs Groundbreaking Laser Hemispherectomy on Child with Epilepsy

AHA Publisher — Wed, 14 Jul 2021 07:00:37 +0000

University of Chicago Medical Center via Newswise – For only the second time in the world, doctors at the University of Chicago Medicine Comer Children’s Hospital and the Department of Neurosurgery used a minimally invasive surgery to disconnect the right and left sides of the brain and the left epilepsy-generating zones of a boy with epilepsy, stopping his seizures. Neurosurgeon Peter Warnke, MD, performed the 8-hour laser functional hemispherectomy surgery in February 2021. The patient, 11-year-old Zachary Kurek from northwest Indiana, suffered a stroke at birth, causing him to lose most of the function of the left side of his brain. His epilepsy was getting worse as he got older, causing dozens of seizures a day that medication couldn’t control. Anything startling, such as a loud noise or a barking dog, could trigger a seizure, causing his body to lock up and fall. He suffered countless bad bruises, a few broken bones and teeth, embarrassment, stress and the inability to do many normal activities. His mother said he was becoming depressed, angry and unable to sleep. With Zachary facing a lifetime of these seizures and with very limited function in his left cerebral hemisphere as a result of the stroke, Warnke and his team studied the boy’s case. They determined that they could completely disconnect the right and left sides of his brain, and separate any epileptogenic tissue in the left hemisphere, without worsening his verbal or physical functioning. That way, if seizure activity occurred in the left side of his brain, it would be unable to send signals to the right side of the brain or to the fibers that transmit seizure activity, and Zachary’s body wouldn’t react. The neurosurgery team used sophisticated imaging of his brain’s fiber connections that would need to be disconnected by lasers. A laser hemispherectomy is a highly complex, risky and challenging operation to help people with epilepsy. UChicago Medicine, which is a Level IV Pediatric Epilepsy Center, has performed about 250 laser surgeries, Warnke estimated. But to completely disconnect a whole hemisphere with implanted laser fibers was a new challenge. Rather than remove a portion of the skull to access the brain, as traditionally done in a procedure called a callosotomy, Warnke and his team drew on their previous research, which they were first to publish, suggesting that interstitial lasers could be used to disconnect the two hemispheres of the brain. “If we could replace open surgery with this, that would be a major breakthrough,” said Warnke, UChicago Medicine’s Director of Stereotactic and Functional Neurosurgery. “We’ve entered uncharted territory, but added a new level of safety as the surgery is carried out in the MRI scanner. It provides continuous vision and real-time monitoring of the brain temperature and imaging of the cell damage produced.” Not only have the seizures stopped, but his whole attitude has changed. He’s optimistic and happy now. Since the surgery, Zachary hasn’t had a single seizure, his parents said. Warnke described his progress as “remarkable.” “Where we’re at now is amazing,” said his mother Amanda Morey. “Not only have the seizures stopped, but his whole attitude has changed. He’s optimistic and happy now.” Warnke performed the surgery using an MRI-guided Visualase laser ablation system. Five small holes about the size of coffee stirrers were drilled into Zachary’s head and catheters were inserted. Five laser fibers were inserted into those catheters and moved deep into Zachary’s brain. Constant guidance from an MRI, providing the exact location and temperature of the laser fibers every seven seconds, allowed Warnke to use the laser’s heated tip to ablate and seal off the connections between the two brain hemispheres. In the future, laser epilepsy surgery at Comer Children’s will be done using a new state-of-the-art robot purchased in March 2021. The robot will be able to insert the laser fibers in the brain with greater speed and precision, shortening the surgery time. Julia Henry, MD, Zachary’s neurologist and epileptologist, said UChicago Medicine treats more children for seizures than any other hospital in the Chicago area and recently added some new epilepsy specialists to the team. Zachary’s case was discussed by a team of doctors with a wealth of experience and knowledge. When medications weren’t working, Henry told Zachary’s mother about different surgical treatment options available to him. He then underwent additional EEG evaluation and specialized imaging, which concluded that he’d be a good candidate for a hemispherectomy. With the family’s consent, Henry then brought Zachary’s case to the Epilepsy Surgery Conference for review. That’s where Warnke proposed doing the surgery with a new laser technique. Henry encourages parents whose children are not having success with seizure medications to talk to their doctors about surgical options. While a laser hemispherectomy might not be appropriate for every patient with epilepsy, Henry said the risk of death is less than 1%, and between 73% and 83% of children have their seizures cured by surgery. “This surgery is a big and scary procedure. Disconnecting half my child’s brain? That’s a lot for any parent to process. But the results can be so dramatic,” Henry said. “The kids come to us so impaired. They have bad, frequent seizures. Life is really a struggle. There are a lot of patients who might be good candidates for this, and this minimally invasive approach might open up the option for them.” Zachary remains on anti-seizure medication for now because it’s still possible he could have a seizure. But he’s relishing his improved quality of life and plans to return to school in the fall. He may even get to participate in gym and recess, something that had been nearly impossible until now. Mother and son were getting out of the car recently when a wind gust suddenly slammed the car door shut. Instinctively, Zachary braced himself for a seizure but then realized nothing was happening. He looked at his mom and smiled, and said, “Oh yeah! I don’t have seizures anymore!” “There was so much that he went through, and I was very hesitant to do this surgery at first. I kept thinking about all the ‘what ifs’,” Amanda said. “Knowing what I know now, I wouldn’t have hesitated, and I wouldn’t have waited this long. It worked out perfectly for him.” To read the original article click here.

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Virtual Reality Boosts Brain Rhythms Crucial for Neuroplasticity, Learning and Memory

AHA Publisher — Wed, 14 Jul 2021 00:50:23 +0000

University of California – Los Angeles Health Sciences via EurekAlert – A new discovery in rats shows that the brain responds differently in immersive virtual reality environments versus the real world. The finding could help scientists understand how the brain brings together sensory information from different sources to create a cohesive picture of the world around us. It could also pave the way for “virtual reality therapy” for learning and memory-related disorders ranging including ADHD, Autism, Alzheimer’s disease, epilepsy and depression. Mayank Mehta, PhD, is the head of W. M. Keck Center for Neurophysics and a professor in the departments of physics, neurology, and electrical and computer engineering at UCLA. His laboratory studies a brain region called the hippocampus, which is a primary driver of learning and memory, including spatial navigation. To understand its role in learning and memory, the hippocampus has been extensively studied in rats as they perform spatial navigation tasks. When rats walk around, neurons in this part of the brain synchronize their electrical activity at a rate of 8 pulses per second, or 8 Hz. This is a type of brain wave known as the “theta rhythm,” and it was discovered more than six decades ago. Disruptions to the theta rhythm also impair the rat’s learning and memory, including the ability to learn and remember a route through a maze. Conversely, a stronger theta rhythm seems to improve the brain’s ability to learn and retain sensory information. Therefore, researchers have speculated that boosting theta waves could improve or restore learning and memory functions. But until now, nobody has been able to strengthen these brain waves. “If that rhythm is so important, can we use a novel approach to make it stronger?” asks Dr. Mehta. “Can we retune it?” Damage to neurons in the hippocampus can interfere with people’s perception of space – “why Alzheimer’s disease patients tend to get lost,” says Dr. Mehta. He says he suspected that the theta rhythm might play a role in this perception. To test that hypothesis, Dr. Mehta and his colleagues invented an immersive virtual reality environment for the rats that was far more immersive than commercially available VR for humans. The VR allows the rats to see their own limbs and shadows, and eliminates certain unsettling sensations such as the delays between head movement and scene changes that can make people dizzy. “Our VR is so compelling,” Dr. Mehta says, “that the rats love to jump in and happily play games.” To measure the rats’ brain rhythms, the researchers placed tiny electrodes, thinner than a human hair, into the brain among the neurons. “It turns out that amazing things happen when the rat is in virtual reality,” says Dr. Mehta. “He goes to the virtual fountain and drinks water, takes a nap there, looks around and explores the space as if it is real.” Remarkably, Dr. Mehta says, the theta rhythm becomes considerably stronger when the rats run in the virtual space in comparison to their natural environment “We were blown away when we saw this huge effect of VR experience on theta rhythm enhancement,” he says. This discovery suggests that the unique rhythm is an indicator of how the brain discerns whether an experience is real or simulated. For instance, as you walk toward a doorway, the input from your eyes will show the doorway getting larger. “How do I know I took a step and it’s not the wall coming at me?” Dr. Mehta says. Answer: The brain uses other information, such as the shift of balance from one foot to the other, the acceleration of your head through space, the relative changes in the positions of other stationary objects around you, and even the feeling of air moving against your face to decide that you are moving, not the wall. On the other hand, a person “moving” through a virtual reality world would experience a very different set of stimuli. “Our brain is constantly doing this, it’s checking all kinds of things,” Dr. Mehta says. The different theta rhythms, he says, may represent different ways that brain regions communicate with each other in the process of gathering all this information. When they looked closer, Dr. Mehta’s team also discovered something else surprising. Neurons consist of a compact cell body and long tendrils, called dendrites, that snake out and form connections with other neurons. When the researchers measured activity in the cell body of a rat brain experiencing virtual reality, they found a different electrical rhythm compared with the rhythm in the dendrites. “That was really mind blowing,” Dr. Mehta said. “Two different parts of the neuron are going in their own rhythm.” The researchers dubbed this never-before-seen rhythm “eta.” It turned out this rhythm was not limited to the virtual reality environment: with extremely precise electrode placement, the researchers were then able to detect the new rhythm in rats walking around a real environment. Being in VR, however, strengthened the eta rhythm – something no other study in the past sixty years has been able to do so strongly, either using pharmacological tools or otherwise, according to Dr. Mehta. Previous studies have shown that the precise frequency of the rhythm makes a big difference to neuroplasticity, he says, just as the precise pitch of a musical instrument is critical for creating the right melody. This opens up an unprecedented opportunity to design VR therapy that can retune and boost brain rhythms and as a way to treat learning and memory disorders. “This is a new technology that has tremendous potential,” he says. “We have entered a new territory.” To read the original article click here.

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Major Epilepsy Study Offers Much-Needed Answers on 3 Lifesaving Seizure Drugs

AHA Publisher — Mon, 09 Dec 2019 08:00:33 +0000

University of Virginia Health System via EurekAlert – There are effective treatments to stop life-threatening epilepsy seizures when the initial treatment has failed, a sweeping new study reveals. The study offers important answers about three such emergency drugs that are used to treat prolonged seizures, known as status epilepticus, even though physicians have had little understanding of the drugs’ effectiveness. Until now, there has been no clear indication of which is best or how much should be given. The study found that the three drugs – intravenous levetiracetam, fosphenytoin, and valproate – were all about equally effective at stopping the potentially deadly seizures when the default choice, benzodiazepines, proved unable to do so. The results were so clear that the shocked researchers stopped their trial early. “When we planned the study, we didn’t even know if these drugs work 10%, 25% or 50% of the time,” said investigator Jaideep Kapur, MBBS, PhD, the head of the University of Virginia Brain Institute. “So the big, big takeaway is that each of these drugs works about 45 percent of the time. And this is an important finding because it tells us patients can get better. They don’t have to be placed on a on a ventilator [breathing machine].” Effect on Clinical Practice The study’s findings, published in the prestigious New England Journal of Medicine, both affirm existing clinical practices and suggest a major change. Doctors can feel confident that their preferred drug of choice is as effective as the other options, Kapur noted, but they also should significantly increase how much levetiracetam they give when they choose it. “Prior to this, people were using their best guess as to which drug to use and how much of it to use. And this puts those things to rest and tells you exactly how much of which to use, and what to expect,” said Kapur, of the UVA School of Medicine’s Department of Neurology. The trial organizers tested the maximum safe dose of each of the drugs so there would be no question whether too little had been used to gauge the medicine’s effectiveness. In so doing, they gave twice as much levetiracetam as many doctors administer. “When I started 25 years ago, there was not a single scientifically proven drug [for status epilepticus]. We didn’t know which drug to use, even for the first-line treatment, and how much of them to use,” Kapur said. “And 25 years later, we can treat more than 80% of the patients – 85% of the patients – using scientifically proven drugs. 85% of our patients will get better, will stop having seizures and start waking up. That is the effect of scientific research on improving care of patients, and this is real.” About the Epilepsy Seizure Trial The randomized, double-blinded trial looked at the effect of the drugs in 384 patients at 57 emergency departments in the United States between November 2015 and the end of October 2017. The researchers originally planned to study 795 patients over five years, but the results were so clear that was deemed unnecessary. “Clinical trials are notorious for going over long and over budget, and we came in under budget,” Kapur said. That was possible, he said, because of the participation of many top experts in both the United States and Europe. Participating sites included the University of Michigan, Medical University of South Carolina, UVA, Children’s National Medical Center in Washington, D.C., and many more. “It was an amazingly accomplished group of people,” Kapur said. “We had the best experts from all over the United States and Europe. For me, it’s been a great joy working with the team as the leader of the Brain Institute. That’s the spirit I want to bring to UVA. That’s really what motivated me to start the Brain Institute: to fashion these teams within UVA, so that we can do really significant, societally impactful research.” UVA Emergency Medicine physician Stephen Huff, MD, led the study at the UVA site, which enrolled seven subjects. Amy Fansler, Emily Gray and Lea Becker helped organize the study. Kapur expressed his gratitute to all the patients who participated in the study. “President Ryan [UVA President Jim Ryan] has said we must be great and good,” Kapur said, “and this is the kind of good we want to do.” Next Steps The researchers are now looking more closely at the drugs’ effectiveness and dosing in children. That will offer important information on how best to treat the young patients, as the causes of status epilepticus in adults and children often differ. To read the original article click here.

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