NEW STRATEGIES FOR NEOCORTICAL EPILEPSY

新皮质癫痫的新策略

• 批准号: 7217285
• 负责人: Steven Mark Rothman
• 金额: $ 5.92万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-01 至 2007-07-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7217285
• 关键词: Acute; Address; Age; Anticonvulsants; Applications Grants; Brain; Brain Injuries; Chronic; Devices; Epilepsy; Evaluation; Excision; Focal Seizure; Future; Heating; Human; Individual; Industry; Localized; Maps; Medical; Modeling; Neocortex; Neurologic; Patients; Pharmaceutical Preparations; Population; Refractory; Research Personnel; Risk; Rodent; Role; Scientific Advances and Accomplishments; Seizures; Subgroup; Surgical Management; Syndrome; Techniques; Testing; Therapeutic; Time; Tissues; Toxic effect; computer program; improved; man; neocortical; prevent; programs; research study

DESCRIPTION (provided by applicant): The treatment of many human epileptic syndromes remains unsatisfactory. While anticonvulsant medications allow about 75% of epileptics to achieve excellent seizure control, the remaining 25% of patients suffer from a combination of continued seizures and medication toxicity. It is unlikely that a single medical breakthrough will provide a cure for all of these refractory patients. Focal neocortical epilepsies have proven particularly difficult to manage. While some respond to anticonvulsants, a large fraction remains intractable to medical therapy. This group can respond to cortical resection, but surgical management is problematic. Exact identification of the epileptogenic focus can be complicated and there is a risk of unanticipated, irreversible neurological deficits after resection. Focal cortical cooling has the potential to improve the evaluation and treatment of this epileptic subgroup. The aims of the experiments described in this application are to investigate the potential of focal cooling with thermoelectric (Peltier) chips to rapidly terminate chronic seizure discharges, determine the degree of cooling required to stop these seizures, determine whether cooling can prevent seizures, and develop computer programs that recognize and anticipate seizures in "real time". In addition, the potential pathological consequences of cortical cooling will be determined. These experiments represent a necessary first step toward utilizing these techniques for the therapy of human epilepsy. These experiments will utilize models of acute and chronic rodent neocortical seizures and small Peltier devices developed for the microelectronics industry. If Peltier devices can control focal seizures in our models, they will be refined for future experiments to investigate their potential role in mapping and controlling epileptogenic neocortex in man.

描述（由申请人提供）：许多人类癫痫综合症的治疗仍然不令人满意。尽管抗惊厥药允许大约75％的癫痫剂获得出色的癫痫发作控制，但其余25％的患者患有持续癫痫发作和药物毒性的组合。单一的医疗突破不太可能为所有这些难治性患者提供治疗方法。事实证明，局灶性新皮层癫痫病特别困难。虽然有些人对抗惊厥药反应，但很大一部分仍然对医疗治疗很棘手。该组可以对皮质切除术进行反应，但手术管理是有问题的。癫痫病重点的确切鉴定可能是复杂的，并且在切除后存在意外，不可逆的神经缺陷的风险。局灶性皮质冷却有可能改善该癫痫亚组的评估和治疗。本应用中描述的实验的目的是研究用热电（Peltier）芯片进行焦点冷却的潜力，以快速终止慢性癫痫发作放电，确定阻止这些癫痫发作所需的冷却程度，确定冷却是否可以防止癫痫发作，并开发出“实时时间”中识别和预测癫痫发作的计算机程序。另外，将确定皮质冷却的潜在病理后果。这些实验是利用这些技术进行人癫痫治疗的必要第一步。这些实验将利用急性和慢性啮齿动物新皮质癫痫发作的模型以及为微电子行业开发的小型毛皮器设备。 如果Peltier设备可以控制我们的模型中的局灶性癫痫发作，则将对它们进行完善，以进行将来的实验，以研究其在MAN中映射和控制癫痫新皮质的潜在作用。