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DEVELOPING NON-LINEAR AND ADAPTIVE NEURONAL SYNCHRONY AND CONNECTIVITY ANALYSIS TO PERSONALIZE CLOSED-LOOP DBS THERAPY FOR TREATING EPILEPSY
Title
DEVELOPING NON-LINEAR AND ADAPTIVE NEURONAL SYNCHRONY AND CONNECTIVITY ANALYSIS TO PERSONALIZE CLOSED-LOOP DBS THERAPY FOR TREATING EPILEPSY
Creator
Farahmand, Sina
Date
2019
Description
Epilepsy disease afflicts more than seventy million people worldwide. In approximately one third of the cases, antiepileptic medications fail...
Show moreEpilepsy disease afflicts more than seventy million people worldwide. In approximately one third of the cases, antiepileptic medications fail to control seizures. Over the last few decades, electrical stimulation of the brain has been evaluated as a potential alternative to treat surgically and medically refractory epilepsy patients. Despite some successes, most of the devices using this protocol operate based on pre-determined stimulation parameters (e.g. frequency and location of stimulation) that have little or no relationship to the individuals’ underlying brain dynamics, which we hypothesize may explain their low clinical efficacy in preventing or terminating seizures.In this study, a non-linear adaptive neuronal synchrony and connectivity analysis was developed in order to extract stimulation parameters from endogenous, multi-site brain dynamics of epilepsy patients. A non-linear analytical methodology was proposed to assess phase-synchrony dynamics in epilepsy patients as seizures evolve. This study revealed a desynchronization around seizure onset. However, the synchrony level started to increase gradually towards seizure end and reached its maximum at seizure termination. This results reveal that hyper-synchronization of the epileptic network may be a critical self-regulatory mechanism by which the brain terminates seizures. In the other phase of this study, a non-linear adaptive phase-connectivity analysis was developed in order to extract frequency and locations of stimulation that match the synchronized network dynamics at seizure termination. Matching these parameters to the endogenous brain dynamics of epilepsy patients as seizure naturally terminates may not only terminate seizures prior to their development, but it may also lead to a personalized deep brain stimulation (DBS) therapy with higher clinical efficacy.
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UNDERSTANDING MARIJUANA USE AS A TREATMENT OPTION FOR PEOPLE WITH EPILEPSY: USE, ATTITUDES, AND QUALITY OF LIFE
Title
UNDERSTANDING MARIJUANA USE AS A TREATMENT OPTION FOR PEOPLE WITH EPILEPSY: USE, ATTITUDES, AND QUALITY OF LIFE
Creator
Johnson, Kristina
Date
2021
Description
Epilepsy is the most common neurological disorder worldwide with a heterogeneous range of negative symptoms. Current treatments for epilepsy...
Show moreEpilepsy is the most common neurological disorder worldwide with a heterogeneous range of negative symptoms. Current treatments for epilepsy have side effects that can negatively impact the quality of a person’s life. Alternative treatments are being explored, including marijuana. This study aimed to understand marijuana use in adults with epilepsy across U.S. states. Rates of use, preferred method of use, and reasons to use and not use marijuana were examined. Additionally, levels of comfort discussing marijuana compared to other treatment options and with different types of providers were explored. Lastly, this was one of the first studies to examine the relationship between quality of life (QOL) and marijuana use for people with epilepsy. Participants included 128 individuals with epilepsy from 26 states, with non-legal states having significantly fewer people who reported using marijuana. Smoking was reported as the primary method of use, knowing someone else that uses as their primary reason for using, and health concerns as the primary reason not to use. There was no difference in level of comfort discussing marijuana compared to other treatments, and participants reported feeling most comfortable discussing marijuana with neurologists compared to other providers. Finally, total QOLIE-31 and the social functioning subscale were significantly lower among marijuana users; however, this difference did not remain when anxiety was entered as a covariate. In fact, the relationship between anxiety and QOL was significant, with anxiety accounting for η2 = .12 to η2 = .57 of the variance in QOLIE-31 subscale scores, controlling for marijuana use. Findings from this study further the understanding of marijuana use by people with epilepsy in the United States.
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