Intrinsic Optical Imaging Study to Map Neocortical Seizure in Human Epilepsy Patients
| Status: | Recruiting |
|---|---|
| Conditions: | Neurology, Epilepsy |
| Therapuetic Areas: | Neurology, Other |
| Healthy: | No |
| Age Range: | 6 - 65 |
| Updated: | 1/10/2019 |
| Start Date: | May 2002 |
| End Date: | December 2020 |
| Contact: | Theodore H Schwartz, MD |
| Email: | schwarh@med.cornell.edu |
| Phone: | 212-746-5620 |
Intraoperative Optical Mapping of Human Epileptiform and Functional Cortex
The purpose of this study is to develop a technique for the intraoperative identification of
human functional and epileptiform cortex using intrinsic signal imaging. The investigators
propose that the ability to optically monitor neuronal activity in a large area of cortex in
"real-time" will be a more sensitive and time-saving method than the electrical methods
currently available. The applications of this technique will not only theoretically increase
the safety and efficacy of many of neurosurgical procedures, but will be useful as an
investigational tool to study human cortical physiology.
human functional and epileptiform cortex using intrinsic signal imaging. The investigators
propose that the ability to optically monitor neuronal activity in a large area of cortex in
"real-time" will be a more sensitive and time-saving method than the electrical methods
currently available. The applications of this technique will not only theoretically increase
the safety and efficacy of many of neurosurgical procedures, but will be useful as an
investigational tool to study human cortical physiology.
Epilepsy is a disease affecting 1-2% of the population. Currently, the only known cure for
epilepsy is surgery, which is much more effective at eliminating seizures arising from the
medial temporal lobe compared with the neocortex. The problem with neocortical epilepsy is
that the population of neurons underlying each epileptiform discharge varies over time. In
addition, the spatial relationship between interictal events and the ictal onset zones, which
are critical in defining the region of epileptogenesis, is not well understood and essential
to the surgical treatment of epilepsy. Electrophysiological recording methods, although
currently the "gold standard" in mapping epilepsy, are inadequate to address these questions
based on restrictions due to volume conduction or sampling limitations. Optical recording
techniques can overcome many of these limitations by sampling large areas of cortex
simultaneously to provide information about blood flow, metabolism and extracellular fluid
shifts that are intimately related to excitatory and inhibitory neuronal activity. In fact,
optical recordings may actually be more sensitive to certain aspects of epileptic activity
than electrophysiologic recordings. The goal will be to translate these findings into the
operating room and map human neocortical epilepsy with the same optical techniques. Outcome
following surgical resections to treat neocortical epilepsy will be correlated with the
optical maps to determine the utility of intrinsic signal imaging in guiding brain surgery.
These experiments will set the groundwork for implementing optical recordings in general
clinical practice as a novel technique for mapping and predicting human seizures.
epilepsy is surgery, which is much more effective at eliminating seizures arising from the
medial temporal lobe compared with the neocortex. The problem with neocortical epilepsy is
that the population of neurons underlying each epileptiform discharge varies over time. In
addition, the spatial relationship between interictal events and the ictal onset zones, which
are critical in defining the region of epileptogenesis, is not well understood and essential
to the surgical treatment of epilepsy. Electrophysiological recording methods, although
currently the "gold standard" in mapping epilepsy, are inadequate to address these questions
based on restrictions due to volume conduction or sampling limitations. Optical recording
techniques can overcome many of these limitations by sampling large areas of cortex
simultaneously to provide information about blood flow, metabolism and extracellular fluid
shifts that are intimately related to excitatory and inhibitory neuronal activity. In fact,
optical recordings may actually be more sensitive to certain aspects of epileptic activity
than electrophysiologic recordings. The goal will be to translate these findings into the
operating room and map human neocortical epilepsy with the same optical techniques. Outcome
following surgical resections to treat neocortical epilepsy will be correlated with the
optical maps to determine the utility of intrinsic signal imaging in guiding brain surgery.
These experiments will set the groundwork for implementing optical recordings in general
clinical practice as a novel technique for mapping and predicting human seizures.
Inclusion Criteria:
- Medically intractable epilepsy
- Subjects undergoing neurosurgical operations requiring cortical mapping
Exclusion Criteria:
- Subjects NOT undergoing neurosurgical operations requiring cortical mapping.
We found this trial at
1
site
Click here to add this to my saved trials
