A Nomogram to Predict Seizure Outcomes after Resective Epilepsy Surgery

预测癫痫切除手术后癫痫发作结果的列线图

基本信息

批准号：
10181321
负责人：
Lara Jehi
金额：
$ 30.82万
依托单位：
CLEVELAND CLINIC LERNER COM-CWRU
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10181321
关键词：
2019-nCoV Acute Age Area Autopsy Blood Brain COVID-19 Cardiovascular Diseases Case Series Chronic lung disease Clinic Clinical Clinical Research Code Cognitive Coin Collection Critical Care Data Delirium Diabetes Mellitus Diagnosis Discipline Disease Disease Progression Drug resistance Electronic Health Record Electronic Mail Epidemiology Epilepsy Excision Feces Freedom Functional disorder Funding Gene Proteins Genes Genetic Genomics Health system Healthcare Systems Heart Hospitalization Human Human Cell Line Hypertension Image Impaired cognition Incidence Individual Infection Infrastructure Institutional Review Boards Intensive Care Units Interdisciplinary Study Kidney Kidney Diseases Knowledge Lesion Liver Malignant Neoplasms Manuals Medicine Methodology Modeling Molecular Network-based Neurologic Neurologic Effect Neurologic Symptoms Nomograms Operative Surgical Procedures Outcome Parents Patient Care Patients Performance Phenotype Physiology Population Protein Analysis Proteins Proteomics Pulmonology Registries Research Research Project Grants Residual state Resources Respiratory System Rest Risk Risk Factors Sampling Seeds Seizures Series Severities Severity of illness Smoking Statistical Models Stream Stroke Surveys Symptoms System Testing Tissue Sample Tissues Urine Validation Viral Load result Work arm base biobank brain surgery clinical care cohort coronavirus disease differential expression experimental study follow-up high risk human interactome innovation interest neurological pathology novel novel diagnostics pandemic disease personalized predictions personalized risk prediction predictive modeling prospective protein protein interaction screening statistics stroke patient tool transcriptome sequencing transcriptomics virus host interaction

项目摘要

Project Summary The full spectrum of neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection has not been clarified. Previous studies have been limited to case series and have described only neurological complications observed in patients hospitalized with COVID-19 or admitted to intensive care units. While these studies provide important information, they do not clarify the range of neurological manifestations in individuals showing different severities of symptoms during infection, the long-term neurological effects of the disease, and they do not provide any understanding of the pathophysiology of the disease. In our current project (1R01NS097719-04-A1), we have constructed a large data and biospecimen infrastructure to develop statistical models for individualized prediction of epileptic seizure-freedom and cognitive outcomes after resective brain surgery for drug resistant seizures. In this competitive revision application, we propose to pair our infrastructure (predictive modeling and genomic expertise) with institutional resources (Cleveland Clinic COVID-19 Registry and Biobank) to advance the epidemiological and mechanistic understanding of neurological complications of COVID-19, particularly epilepsy, stroke, and delirium, and to generate nomograms and online risk calculators for the relevant neurological COVID-19 complications. The objectives of this revised proposal are to characterize the incidence and manifestation phenotype of new onset seizures, stroke, and delirium in all patients diagnosed as COVID+ (3,177 as of May 7) in our healthcare system, to build and validate prediction models to identify individuals at risk of neurological complications, and to identify systematically disease modules (molecular determinants of disease pathobiology/physiology) for COVID-19 that can reveal novel underlying mechanisms for SARS-CoV-2 associated neurological manifestations. Older age, smoking, diabetes, hypertension, cardiovascular disease, kidney disease, chronic lung disease, and cancer correlate with progression to severe disease in patients hospitalized with COVID-19. We hypothesize that these factors are similarly associated with a higher risk of neurological complications. However, these “risk factors” are not specific, occur in various combinations, and have limited value as isolated indicators of specific neurological complications. Our team's expertise will be used to generate nomograms and online risk calculators for the relevant neurological complications observed in the CCHS COVID-19 registry cohort, to explore underlying mechanisms of these neurological complications using innovative human protein-protein analyses, and to generate tools that can guide decisions in clinical care.

项目摘要严重的Acciratory冠状病毒2（SARS-）的全部神经系统表现 COV-2）尚未澄清以前的研究。只有在Covid-19或接受重症监护的患者中观察到的神经系统并发症这些研究提供了重要的信息，但它们没有阐明长期神经病学期间表现出不同严重症状症状的个体表现该疾病的影响，并且不提供对疾病病理生理学的任何理解。在我们当前的项目（1R01NS097719-04-A1）中，我们构建了大型数据和生物测试基础架构开发用于个性化癫痫发作 - 自由和认知结果的个性化预测的统计模型在此竞争性修订应用中，我们建议进行抗药性癫痫发作的脑部手术。将我们的基础架构（预测建模和基因组专业知识）与机构资源相结合 COVID-19注册中心和生物库）提高了对神经学的表演和机械理解 Covid-19的并发症，尤其是癫痫，中风和del妄，并生成nom图和在线相关神经学的风险计算器199并发症。修订后的提案的目标是表征新的新的新新的新新的新新的新新的新新的新新的新新新的新新新的新新新的新新新的新新的新新网。在我们的医疗保健中，所有被诊断为covid+的患者的发作性癫痫发作，中风和del妄（截至5月7日）系统，建立和验证预测模型，以识别有神经系统汇编风险的个体，以及识别系统性疾病模块 COVID-19可以启用SARS-COV-2相关神经系统的新型新生机制表现。年龄较大，吸烟，糖尿病，高血压，心血管疾病，肾脏疾病，慢性肺病，以及癌症与患有Covid-19的患者的严重疾病相关这些因素与神经系统并发症的风险更高相似。因素不是特定的，以各种组合发生，并且作为特定的孤立指标的价值有限神经系统并发症。相关的神经学编译，探索，探索这些神经学并发症的基本机制使用创新的人蛋白 - 蛋白质分析，并生成可以指导临床护理决策的工具。

项目成果

期刊论文数量（40）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Automated analysis of cortical volume loss predicts seizure outcomes after frontal lobectomy.

DOI：
10.1111/epi.16877
发表时间：
2021-05
期刊：
Epilepsia
影响因子：
5.6
作者：
Whiting AC;Morita-Sherman M;Li M;Vegh D;Machado de Campos B;Cendes F;Wang X;Bingaman W;Jehi LE
通讯作者：
Jehi LE

Molecular subtypes of epilepsy associated with post-surgical seizure recurrence.

DOI：
10.1093/braincomms/fcad251
发表时间：
2023
期刊：
Brain communications
影响因子：
4.8
作者：
通讯作者：

Longitudinal trajectory of quality of life and psychological outcomes following epilepsy surgery.

DOI：
10.1016/j.yebeh.2020.107283
发表时间：
2020-10
期刊：
Epilepsy & behavior : E&B
影响因子：
0
作者：
Winslow J;Hu B;Tesar G;Jehi L
通讯作者：
Jehi L

Reply to commentary on "Predicting seizure freedom after epilepsy surgery, a challenge in clinical practice".

DOI：
10.1016/j.yebeh.2019.106442
发表时间：
2019-10
期刊：
Epilepsy & behavior : E&B
影响因子：
0
作者：
Jehi L;Kattan M
通讯作者：
Kattan M

Beyond seizure freedom: Dissecting long-term seizure control after surgical resection for drug-resistant epilepsy.

DOI：
10.1111/epi.17445
发表时间：
2023-01
期刊：
EPILEPSIA
影响因子：
5.6
作者：
Hsieh, Jason K.;Pucci, Francesco G.;Sundar, Swetha J.;Kondylis, Efstathios;Sharma, Akshay;Sheikh, Shehryar R.;Vegh, Deborah;Moosa, Ahsan N.;Gupta, Ajay;Najm, Imad;Rammo, Richard;Bingaman, William;Jehi, Lara
通讯作者：
Jehi, Lara