Epileptic Seizure Forecasting
Seizures appear unpredictable and greatly affect the quality of all aspects of life for patients with epilepsy and their carers. New advances in complex systems theory suggest that transitions from normal brain activity to seizures are preceded by measurable changes in the brain’s responses to stimuli, known as critical slowing. Measurement of critical slowing will enable prediction of seizures, providing a warning system, and possibly an opportunity to deliver preventative therapies.
We will investigate if critical slowing can be used as a biomarker of seizure susceptibility in epilepsy. Critical slowing refers to the lengthening of a time period a system takes to recover to the normal state after perturbation when it is close to a tipping point or critical transition.
In many natural systems, critical slowing is the most promising way to measure the susceptibility of a catastrophic change in behaviour. We believe that critical slowing is also a property of the mammalian brain and can be used to track epilepsy-related changes. For example, we have preliminary data showing that electrically-evoked potentials can be used to track epilepsy-related critical slowing in rats, canines, and humans. We will investigate critical slowing in order to establish how it can be used to better predict transitions to seizures.
Critical slowing can be measured using electrophysiological measurements following perturbations. Perturbations may take the form of applied external electrical stimuli, sensory evoked potentials, or inter-ictal epileptic spike-wave discharges (SWDs). We will study SWDs in a one-of-a-kind, long-term continuous dataset that was collected from 15 patients for up to three years. This data represents to first and only opportunity to address this important problem. We will also study responses to electrical stimuli in data collected from humans, canines and rats.
We have already shown very strong preliminary evidence that critical slowing occurs in a state of high seizure susceptibility, and that it can be manipulated by anti-epileptic drugs. We have also shown patterns in critical slowing vary with the sleep-wake cycle, and that the sleep-wake cycle is strongly linked to seizure occurrences. However, further investigation is required to validate critical slowing as a robust biomarker of seizure susceptibility. If our hypotheses are validated, this project will lead to new opportunities to develop interventions to prevent seizures.
This project is jointly supervised by Dr Dean Freestone, Professor Mark Cook and Professor David Grayden (Department of Electrical and Electronic Engineering).
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