Study by Dr. Matarrese investigating the pathophysiology of pediatric epilepsy
Epilepsy is a neurological disease that can be treated with drugs or, in patients who don't respond to therapy, by surgically removing the area of the brain where seizures originate, called epileptogenic zone. Correctly identifying the epileptic zone is essential to ensure the success of the surgery by blocking the onset of new epileptic seizures. Unfortunately, to date, clinical methods based only on the observation of epileptic seizures, uncontrolled and unpredictable phenomena, are often ineffective.
The research work carried out by the doctoral student UCBM Margherita Matarrese and published in the prestigious scientific journal Brain proposes a new tool to help neurosurgeons identify the epileptogenic zone. The study was born from the close collaboration between the Neuroscience Research Team, led by the prof. Christos Papadelisat the children's hospital Cook Children's Health Care System of Texas andResearch Unit of Nonlinear Physics and Mathematical Models led by prof Simonetta Filippi, at theUniversità Campus Bio-Medico di Roma.
Currently, proper localization of the epileptogenic zone requires invasive monitoring that records brain activity with implanted intracerebral electrodes for long periods of time, waiting for one or more seizures to occur. With this work, on the other hand, the position of the epileptogenic zone is identified by exploiting an information present in the EEG tracings of epileptic patients regardless of the occurrence of a seizure, i.e. the spikes.
"Our research – explains Eng. Matarrese – shows that the brain area in which spikes arise is more epileptogenic than the tissue in which they propagate over time. The brain can be seen as a dense and intricate network, in which the flow of information travels using both structural and functional connections. Epilepsy impairs proper communication within this network. The removal of the area where the spikes are born allows the correct functioning of the brain to be restored, eliminating epileptic seizures and ensuring the long-term success of the surgery".
This study shows the relationship between the propagation of epileptic activity and functional connections, providing new knowledge on the pathophysiological mechanism of epilepsy. The proposed method it will assist clinicians in interpreting intracranial EEG readings, greatly reducing prolonged monitoring and improving surgical planning in children with drug-resistant epilepsy.
