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The core and effects of epilepsy: from chronic disease to curable disorder through innovative guided surgery

Objective

Epilepsy burdens 1% of the population. Brain surgery can cure seizures and stop cognitive decline, but it is complex and often unsuccessful. I aim to advance cure from epileptic brain disease radically by 1) pinpointing the core of epilepsy and 2) understanding the effects on normal brain functioning.

High-frequency oscillations (HFOs) are novel markers of the core of focal epilepsy, discovered in long-term invasive EEG. I initiated direct HFO-based guidance of epilepsy surgery with intra-operative invasive electrodes. However, HFOs still appear stochastic epiphenomena. Therefore, I will now uncover the direct microlevel high-frequency EEG reflection of the distorted cortex. I will use three macrolevel signal prerequisites for seizure and HFO generation to innovate intra-operative recording and signal analysis: susceptible (evoke with long-distance electrical stimulation; cross-frequency coupling), sudden (low-noise adhesive electrodes; auto-regression) & spreading (high-density recordings; functional connectivity). I will pilot test technical solutions and optimize analyses with supervised machine learning based on pivotal epileptogenic versus healthy tissue and on postsurgical outcomes.
Next, I will explore the broad effect of epileptic on physiological high frequency brain activity taking cognitive performance as epitome, especially in people without seizures.

Current electrocorticography data come from limited, diverse and complex cases with no gold standards for diseased and normal cortex. I will therefore obtain data from 200 otherwise unguided brain surgeries with different levels of epileptogenicity and cognitive impairment: highly epileptogenic tumors (simple), gliomas (many) and meningiomas which compress healthy brain (uniform; partly without seizures).

I will integrate techniques in a neurosurgical real-time recording and projecting device that simplifies finding and removing epileptogenic tissue to stop the distorting effect in focal brain disorders.

Field of science

  • /medical and health sciences/clinical medicine/surgery
  • /medical and health sciences/basic medicine/neurology/epilepsy
  • /natural sciences/computer and information sciences/artificial intelligence/machine learning

Call for proposal

ERC-2018-STG
See other projects for this call

Funding Scheme

ERC-STG - Starting Grant

Host institution

UNIVERSITAIR MEDISCH CENTRUM UTRECHT
Address
Heidelberglaan 100
3584 CX Utrecht
Netherlands
Activity type
Higher or Secondary Education Establishments
EU contribution
€ 1 500 000

Beneficiaries (1)

UNIVERSITAIR MEDISCH CENTRUM UTRECHT
Netherlands
EU contribution
€ 1 500 000
Address
Heidelberglaan 100
3584 CX Utrecht
Activity type
Higher or Secondary Education Establishments