Liesbeth Waterschoot

High Frequency Deep Brain Stimulation in the Hippocampus Modifies Seizure Characteristics in Kindled Rats

Summary:  Purpose: This experimental animal study evaluates the effect of high frequency deep brain stimulation (HFS DBS) on seizures in the Alternate Day Rapid Kindling model for temporal lobe epilepsy (TLE). The target for HFS is the hippocampus, as this structure is often presumed to be the seizure focus in human TLE.

Vagus nerve stimulation for refractory status epilepticus.

We report on the long-term follow-up of a patient with refractory non-convulsive SE who was successfully treated with VNS. A 7-year old girl with a medical history of thrombosis in the right internal cerebral vein and right thalamic bleeding 8 days after birth, developed epilepsy at the age of 13 months. At the age of 6 she presented with a refractory non-convulsive SE. A vagus nerve stimulator was placed after 11 days of thiopental-induced coma. Three days after VNS implantation, the thiopental-induced coma was successfully withdrawn and electroencephalography showed normalization one week after start of VNS. After a follow-up of 13 months she remains seizure-free and AEDs have been partially tapered. This case illustrates a potential acute abortive effect with sustained long-term seizure reduction of VNS in a 7-year old girl who presented with refractory non-convulsive SE.

Automatic Detection of Spike and Wave Discharges in the EEG of Genetic Absence Epilepsy Rats From Strasbourg

Genetic absence epilepsy rats from Strasbourg are a strain of Wistar rats in which all animals exhibit spontaneous occurrences of spike and wave discharges (SWDs) in the EEG. In this paper, we propose a novel method for the detection of SWDs, based on the key observation that SWDs are quasi-periodic signals. The method consists of the following steps: 1) calculation of the spectrogram; 2) estimation of the background spectrum and detection of stimulation artifacts; 3) harmonic analysis with continuity analysis to estimate the fundamental frequency; and 4) classification based on the percentage of power in the harmonics to the total power of the spectrum. We evaluated the performance of the novel detection method and six SWD/seizure detection methods from literature on a large database of labeled EEG data consisting of two datasets running to a total duration of more than 26 days of recording. The method outperforms all tested SWD/seizure detection methods, showing a sensitivity and selectivity of 96% and 97%, respectively, on the first test set, and a sensitivity and selectivity of 94% and 92%, respectively, on the second test set. The detection performance is less satisfactory (as for all other methods) for EEG fragments showing more irregular and less periodic SWDs.

Serial day rapid kindling is an effective tool in screening the anti-epileptic properties of topiramate

INTRODUCTION In this study, a serial day rapid kindling protocol was used to fully kindle rats in a matter of days. Subsequently, the anticonvulsant profile of a relatively new anti-epileptic drug, topiramate, was evaluated in a cross-over design to further validate this rapid kindling model. METHODS Rats were kindled during three consecutive days, according to the serial day rapid kindling protocol. Topiramate was tested at a dose of 100mg/kg, i.p., over the next 2 days using a cross-over design. The stability of the kindled state was evaluated in all rats during two retest paradigms. During the drug-testing procedure, rats received a single i.p. injection of either topiramate or verhicle. Starting 1 h later the rats received additional kindling stimulations during which their response was measured. RESULTS Serial day rapid kindling induced a long lasting and stable fully kindled state that allowed for the anti-epileptic drug screening procedure. Topiramate reduced both the afterdischarge duration and ameliorated seizure semiology in the kindled rats. DISCUSSION Serial day rapid kindling provided a tool to rapidly kindle rats in 3 days. Using a cross-over design, clear indications on anti-epileptic activity of a given drug can be determined using few laboratory animals.