Sudden Death in Epilepsy: Basic and Translational Research

Sudden Death in Epilepsy: Basic and Translational Research
Author: Christopher M. DeGiorgio
Publisher: Frontiers Media SA
Total Pages: 71
Release: 2018-10-11
Genre:
ISBN: 2889455947

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Sudden Death in Epilepsy (SUDEP) is a major cause of death in people with epilepsy, accounting for up to 17% of all deaths. Research interest is exploding, focusing on epidemiology, basic mechanisms, identification of risk factors, and biomarkers. New wearable technologies are approved or in development. These incorporate accelerometers and advanced heart rate detection, which are linked to smart phones. The advent of FDA approved detection devices now allows immediate intervention by family and loved ones. The next frontier for SUDEP remains effective prevention strategies, which will likely include new devices and pharmacologic interventions. This volume is organized into three sections: Basic and Physiologic Mechanisms; Clinical Risk Factors and Inventories; and Very Early Research into Pharmacologic Interventions. It is our hope that this eBook will inform clinicians of key advances in the field, and to foster and stimulate basic and translational research with one purpose: To prevent SUDEP in those at risk.

Sudden Unexpected Death in Epilepsy

Sudden Unexpected Death in Epilepsy
Author: Claire M. Lathers
Publisher: CRC Press
Total Pages: 348
Release: 2015-04-06
Genre: Law
ISBN: 1482223880

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Sudden Unexpected Death in Epilepsy: Mechanisms and New Methods for Analyzing Risks builds on earlier works focusing on the clinical problem of sudden unexpected death in epilepsy (SUDEP). This book presents a methodology for identifying and classifying clusters of risks that lead to SUDEP. Developed over the last two years, the SUDEP Classificatio

Neuroactive Agents-mediated Changes in Neuronal Network Activity Controls Susceptibility to Sudden Unexpected Death in Epilepsy (SUDEP)

Neuroactive Agents-mediated Changes in Neuronal Network Activity Controls Susceptibility to Sudden Unexpected Death in Epilepsy (SUDEP)
Author: Srinivasa Prasad Kommajosyula
Publisher:
Total Pages: 336
Release: 2017
Genre: Epilepsy
ISBN:

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The incidence of sudden death is higher in epileptic people compared to the general population and sudden unexpected death in epilepsy (SUDEP) is second only to stroke in the years of potential life loss among the major neurological disorders. In the majority of observed human SUDEP cases, respiratory dysfunction post-seizure is shown to be the primary initiating event leading to cardiac asystole and death. During seizures, several neuroactive agents are shown to be released, including serotonin and adenosine. Previous research has shown the effects of these neuroactive agents on seizure and respiratory function independently. A role of adenosine in triggering death post-seizures in a chemically-induced seizure model has been shown, but the mechanism of death is not clear. Studies from our lab have shown the role of fluoxetine (selective serotonin-reuptake inhibitor) in preventing seizure-induced respiratory arrest (S-IRA) in DBA/1 mouse model of SUDEP, but the neuronal networks mediating S-IRA and the brain structures involved in the fluoxetine-mediated blockade of S-IRA are not known. Data from human SUDEP imaging has underlined the role of periaqueductal gray (PAG), which is also implicated in audiogenic seizure (AGSz) network and respiratory modulation in other models. The goal of my dissertation is to understand the mechanisms by which adenosine could cause SUDEP susceptibility, the neuronal networks in the DBA/1 mice that lead to S-IRA and how fluoxetine modulates the neuronal activity at these neuronal network structures to prevent S-IRA. A better understanding of these mechanisms may lead to development of potentially important targeted therapies to prevent SUDEP in future. In the first aim, I have examined the role of adenosine in mediating SUDEP. Genetically epilepsy prone rats (GEPR-9s) exhibit AGSz but the incidence of death post-seizure is very low. I tested whether decreasing adenosine breakdown could increase the incidence of death in GEPR-9s. My study shows that adenosine metabolic blockers, which prevent the metabolism of released adenosine during seizures significantly increased the duration of respiratory dysfunction, post-ictal depression, decreased the peripheral oxygen saturation and subsequently, increased the incidence of death post-seizure in GEPR-9s. These findings on the role of adenosine and role of specific adenosine receptors in SUDEP are required to be validated in another SUDEP model. This formed the core of my second specific aim and since DBA/2 mice are susceptible to AGSz, and after seizures a large percent of these DBA/2 mice show S-IRA, while the rest don't show S-IRA. Therefore, I tested if adenosine antagonism could prevent S-IRA post AGSz in DBA/2 mice, and found that caffeine a non-selective adenosine antagonist significantly decreased the incidence of S-IRA post AGSz. Administration of adenosine metabolic blockers increased the incidence of S-IRA in DBA/2 mice similar to GEPR-9s. Parallel studies from our lab have shown that administration of selective A2a antagonist but not A1 antagonist also decreased S-IRA incidence in DBA/2 mice. These data from GEPR-9s and DBA/2 mice suggests for a potentially important role of selective adenosine receptors in mediating the susceptibility to SUDEP by acting on respiratory function. In the third specific aim, I have examined the role of subcortical neuronal network structures including the PAG in mediating S-IRA and the quantitative differences in respiratory function elicited by electrical stimulation at PAG between DBA/1 and C57 mice. While the role of neuroactive agents in SUDEP has received attention, the neuronal networks mediating SUDEP in pre-clinical models are not known, specifically in DBA/1 mice an established SUDEP model susceptible to AGSz. The role of subcortical neuronal network structures including PAG in AGSz has been well-studied in other AGSz models. To decipher the neuronal networks that lead to S-IRA in DBA/1 mice, I exposed both DBA/1 mice that show AGSz and S-IRA and C57 mice that are non-susceptible to AGSz to acoustic stimulus and performed an ex vivo manganese-enhanced magnetic resonance imaging (MEMRI). Data analyses revealed the role of several brain structures in auditory, sensorimotor-limbic, respiratory networks and serotonergic raphe nuclei in DBA/1 mice. Of interest the PAG, a region implicated in other models of AGSz, respiratory modulation and human SUDEP has shown a significant increase in MEMRI signal intensity compared to C57 mice. These findings formed the rationale for the fourth specific aim to examine the quantitative differences in PAG-mediated respiratory modulation in response to electrical stimulation between C57 and DBA/1 mice. The threshold of current needed at PAG for a significant increase in respiration in DBA/1 mice is four times greater than C57 mice. Electrical stimulation at amygdala (AMG) showed marginal differences between DBA/1 and C57 mice suggesting the least possible pathological role of AMG in DBA/1 mice to mediate S-IRA. (Abstract shortened by ProQuest.)

Sudden Unexpected Death in Epilepsy (SUDEP)

Sudden Unexpected Death in Epilepsy (SUDEP)
Author: James H. Orlando
Publisher:
Total Pages: 4
Release: 2019
Genre: Epileptics
ISBN:

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Discusses sudden unexpected death in epilepsy (SUDEP), deaths in people with epilepsy that are not caused by injury, drowning, or other known causes.

Ontology-driven Web-based Medical Image Sharing Interface for Epilepsy Research

Ontology-driven Web-based Medical Image Sharing Interface for Epilepsy Research
Author: Wu, Xi
Publisher:
Total Pages: 60
Release: 2017
Genre: Computing platforms
ISBN:

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Epilepsy is a disorder of the brain that causes recurrent seizures. In all the epilepsy-related deaths, 7.5 to 17 percent are from Sudden Unexpected Death in Epilepsy (SUDEP) which has an incidence rate of up to 9 per 1000 patient-years in epilepsy surgery candidates. Possible factors of SUDEP have been explored but the precise mechanism remains mysterious. [1] Neuroimaging techniques such as MRI provides a critical data source for investigators to research and share a larger cohort of potential SUDEP patients. Sharing neuroimaging data to engage more researchers is critical since the image data we collected on an SUDEP patient is still limited and not able to grow. To address the unique challenges of sharing neuroimaging data across institutions with good semantic precision, ImageSFERE - a web-based platform for Image Sharing for Epilepsy Research is developed. ImageSFERE features a dedicated questionnaire and standardized epilepsy neuroimaging common data elements to capture patient-related image metadata, enhance the system efficiency, and enable precise and federated queries. The multi-section questionnaire consists of 244 questions were well-designed to record different aspects of patient information. ImageSFERE also enables slice-level and repository-level image annotations which improve the relevance of images and annotations. We have successfully processed 8 separated repositories (over 23GB of data) of DICOM patient de-identified images from different institutions using ImageSFERE uploading interface and made available for query.

Sudden Death in Epilepsy

Sudden Death in Epilepsy
Author: Claire M. Lathers
Publisher: CRC Press
Total Pages: 1047
Release: 2010-11-08
Genre: Law
ISBN: 1439802238

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Though it is one of the most common causes of death in epilepsy patients, SUDEP is still infrequently and even reluctantly named on autopsy reports. This under-reporting equates to a lack of attention and earnest investigation into the cause, predisposition, and prevention of SUDEP. There is as yet little effort to establish an actionable strategy