Descrizione del progetto
Uno sguardo più attento alle oscillazioni ad alta frequenza per curare le crisi epilettiche
L’epilessia, caratterizzata da convulsioni non prevedibili, è il quarto disturbo neurologico più diffuso. La chirurgia cerebrale, pur essendo in grado di curare le convulsioni, è complessa e spesso inefficace. Il progetto Epilepsy_Core, finanziato dall’UE, studierà le oscillazioni ad alta frequenza che rappresentano nuovi marcatori dell’aspetto centrale dell’epilessia focale, rilevabili nell’elettroencefalografia invasiva a lungo termine. In particolare, sveleranno la riflessione diretta a livello micro ad alta frequenza nell’esame elettroencefalografico della corteccia alterata. Saranno utilizzati tre prerequisiti di segnale a livello macro per aggiornare le registrazioni intraoperatorie e l’analisi dei segnali. Il progetto testerà le soluzioni tecniche e ottimizzerà le analisi con l’apprendimento automatico supervisionato. Inoltre, riesaminerà i dati provenienti da 200 interventi chirurgici cerebrali non guidati con livelli diversi di epilettogenesi e deterioramento cognitivo.
Obiettivo
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.
Campo scientifico
Parole chiave
Programma(i)
Argomento(i)
Meccanismo di finanziamento
ERC-STG - Starting GrantIstituzione ospitante
3584 CX Utrecht
Paesi Bassi