Researchers from Brigham have actually traced lesions related to epilepsy to a shared brain circuit, showing a special function that deep brain circuits play in the origin and management of epilepsy. These ingenious findings highlight the possible to leverage this particular brain circuit as a directional guide for brain stimulation treatments aimed at handling epilepsy.
Scientists from Brigham have traced sores associated with epilepsy to a typical brain circuit.
Over 30 million individuals around the globe are impacted by focal epilepsy, often connected to brain sores caused by conditions like stroke. It remains uncertain why specific sore areas trigger epilepsy while others dont. A recent study conducted by scientists from the Brigham and Womens Hospital, a crucial factor to the Mass General Brigham health care system, discovered a typical brain circuit that may connect varied lesion places causing epilepsy.
In a paper released in JAMA Neurology, the scientists utilized a technique called lesion network mapping to determine this brain circuit with findings that point to possible targets for brain stimulation.
” Were learning more and more about where in the brain epilepsy originates from and what brain circuits we require to regulate to treat patients with epilepsy,” said lead author Frederic Schaper, MD, Ph.D., an Instructor of Neurology at Harvard Medical School and scientist at the Brigham and Womens Center for Brain Circuit Therapeutics. “Using a wiring diagram of the human brain, sore network mapping allows us to look beyond the individual lesion place and map its connected brain circuit.”
Schaper and the team studied 5 datasets of over 1,500 patients with brain sores. Taking part centers throughout the US and Europe consisted of the Brigham and Womens Hospital, Massachusetts General Hospital, Boston Childrens Hospital, Northwestern University, and University Hospitals of Turku in Finland, Maastricht in the Netherlands, and Barcelona in Spain. They studied a range of brain sores such as stroke, injury, and growths, which enabled them to look for common network connections connected with epilepsy across different areas and types of mental retardation.
Among the datasets included combat veterans from the Vietnam Head Injury Study, which was initially created in the 1960s because brain damage from combat shrapnel wounds resulted in a considerable increase in the occurrence of epilepsy.
” In our studies, up to 50 percent of Vietnam battle veterans suffered a minimum of one seizure post-injury, often several years after the injury,” stated co-author Jordan Grafman, Ph.D. of the Shirley Ryan AbilityLab in Chicago. “However, it has remained unclear why lesions to some locations trigger epilepsy and others do not.”.
The Brigham researchers compared the locations of brain damage in clients that established epilepsy to clients that did not, and found that sores associated with epilepsy were distributed throughout the brain. However, these exact same lesion locations were linked to a common brain network, suggesting the brain connections interfered with by the sores, instead of the places of the sores themselves, were the key.
These findings may have medical ramifications for anticipating the danger of epilepsy after mental retardation.
” If we can map a sore to the brain network we recognized, we might be able to approximate how likely someone is to get epilepsy after a stroke,” Schaper stated. “This is not a medical tool yet, however we prepared for future studies investigating making use of human brain networks to anticipate epilepsy danger.” The crucial brain connections they recognized were not on the brains surface but lay deep within the brain in areas called the basal ganglia and cerebellum. The authors specify that for decades, these deep brain structures have been shown to modulate and control seizures in animal models of epilepsy and are hypothesized to imitate a brain “brake.”.
Based upon these findings, the scientists analyzed outcome data of 30 patients with drug-resistant epilepsy who underwent deep brain stimulation (DBS) to deal with seizures. They discovered that clients did a lot much better if the DBS website was connected to the exact same brain network, they determined using brain sores.
” When configuring a DBS electrode to improve seizures, its hard to know which area to promote since it can take months before the clients seizures enhance,” stated senior author Michael Fox, MD, Ph.D., an Associate Professor of Neurology at Harvard Medical School and founding director of the Brigham and Womens Center for Brain Circuit Therapeutics. “Identifying this brain circuit for epilepsy may help us target the ideal spot to enhance patient outcomes.”.
The authors keep in mind that the existing study was a retrospective analysis using existing datasets and an electrical wiring diagram of healthy individuals. When available, future research studies could use a patients circuitry diagram and prospectively test the energy of this circuit as a clinical tool.
” Now we understand more about what brain circuits might play a role in both the cause and control of epilepsy, this opens up appealing opportunities to assist our treatments,” stated Schaper. “Future medical trials are needed to identify if this circuit can successfully assist brain stimulation treatment for epilepsy and advantage patients.”.
Recommendation: “Mapping Lesion-Related Epilepsy to a Human Brain Network” by Frederic L. W. V. J. Schaper, Janne Nordberg, Alexander L. Cohen, Christopher Lin, Joey Hsu, Andreas Horn, Michael A. Ferguson, Shan H. Siddiqi, William Drew, Louis Soussand, Anderson M. Winkler, Marta Simó, Jordi Bruna, Sylvain Rheims, Marc Guenot, Marco Bucci, Lauri Nummenmaa, Julie Staals, Albert J. Colon, Linda Ackermans, Ellen J. Bubrick, Jurriaan M. Peters, Ona Wu, Natalia S. Rost, Jordan Grafman, Hal Blumenfeld, Yasin Temel, Rob P. W. Rouhl, Juho Joutsa and Michael D. Fox, 3 July 2023, JAMA Neurology.DOI: 10.1001/ jamaneurol.2023.1988.
Financing: The present analysis was moneyed by grants from the American Epilepsy Society (grant no. 846534) and NIH (grant no. R01NS127892, R01MH113929, R21MH126271, R56AG069086, R21NS123813), Sidney R. Baer Jr Foundation, the Nancy Lurie Marks Foundation, the Kaye Family Research Fund, the Ellison/ Baszucki Foundation, and the Mathers Foundation.
MDF and SHS are clinical specialists for Magnus Medical and separately own patents on utilizing brain connectivity to guide brain stimulation.
A current research study conducted by scientists from the Brigham and Womens Hospital, a key factor to the Mass General Brigham healthcare system, discovered an usual brain circuit that may connect varied sore places leading to epilepsy.
They studied a variety of brain lesions such as stroke, trauma, and tumors, which permitted them to search for typical network connections associated with epilepsy across various regions and types of brain damage.
” If we can map a lesion to the brain network we recognized, we may be able to estimate how most likely somebody is to get epilepsy after a stroke,” Schaper said.” The essential brain connections they recognized were not on the brains surface area however were situated deep within the brain in regions called the basal ganglia and cerebellum. The authors specify that for years, these deep brain structures have been revealed to regulate and control seizures in animal designs of epilepsy and are assumed to act like a brain “brake.”.
