Graph Theory for Epilepsy, and 3 Other News Bites

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Graph theory, frequently used in mathematics, now has been applied to epilepsy research to advance understanding of brain connections. And there’s news in pediatric epilepsy research: scientists have created a new, easier assessment for epilepsy in children. In general, new treatments are greatly needed for neonatal seizures, as discussed in a recent editorial. Also, miniature implantable pumps may deliver drugs right to antiseizure brain targets, using electrical currents.

Turn the pages to find out more about these latest developments in epilepsy diagnosis and patient care:

Graph Theory Could Shed Light on Epilepsy

• Because the brain is a highly connected network, graph theory (a mathematical system applied to graphs) may be used to understand brain conditions.

• A Wisconsin-based research group used graph theory to study resting MRI taken from patients who had epilepsy compared with controls who did not.

• They examined brain organization that occurs because of epilepsy by studying the whole brain as well as specific regions.

• The technique demonstrated increased global efficiency and decreased local efficiency of brain connections.

• The results demonstrated that epilepsy changes the whole brain in a consistent pattern but may change individual regions differently.

Short Epilepsy Assessment for Quality of Life in Children

• Quality of life is an important measurement for epilepsy research.

• The Quality of Life Childhood Epilepsy (QOLCE) questionnaire is completed by parents for children with epilepsy, age 4 to 18 years.

• Researchers in Ontario sought to develop an easier-to-take version of the questionnaire.

• The investigators used statistical techniques, including principal component analysis and factor analysis, to reduce items in the questionnaire, with data from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES, N = 373).

• A total of 21 items were removed, producing a 55-item version with evidence of reliability and validity.

• Because the shortened QOLCE-55 has fewer items, this version may be easier to fill out and could facilitate epilepsy research that focuses on quality of life.

Treatments Needed for Neonatal Seizures

• Seizures after neonatal loss of oxygen are extremely challenging to treat.

• A recent safety and dose-finding study examined the antiepileptic combination phenobarbital plus bumetanide (the NEMO trial) but was halted based on limited perceived efficacy and possible increased risk of hearing loss.

• “This decision could have been overcautious: 0.2 mg/kg bumetanide reduced seizure burden, and might not have increased hearing loss,” according to an editorial published in Nature Reviews Neurology.

• Based on the lack of available treatments for neonatal seizures, greater attention to study design and subanalyses of potential treatments may be warranted, so that the development of promising interventions is not abandoned prematurely.

Miniature Pump Could Deliver Epilepsy Treatment

• A minipump to deliver epilepsy drugs into the brain has been developed by researchers at the Institute of Systems Neuroscience, École des Mines de Saint-Étienne, and Linköping University.

• An electrical current activates drug delivery into the brain.

• Ions carry the drugs and are pumped to the target region, specifically gamma-aminobutyric acid receptors.

• Tested in mice with experimental epilepsy, the pump was effective for quieting overactive neurons.

• Human trials hopefully will follow.

Take-aways:

• Graph theory has revealed that epilepsy changes the whole brain in a consistent pattern but may change individual regions differently.

• A new version of the QOLCE that has fewer items could facilitate epilepsy research that focuses on quality of life.

• There are few treatments for neonatal seizures, making it pertinent that the development of promising interventions should not be abandoned prematurely.

• Researchers developed a minipump to deliver epilepsy drugs into the brain using electrical currents.