A Possible Cause of Sudden Unexplained Death in Epilepsy?

A third study addressed comorbidities in patients with epilepsy, which are frequently underdiagnosed and undertreated. Researchers at the Cleveland Clinic assessed 116 children and adolescents with chronic epilepsy—60 presurgery patients, 23 postsurgical patients, and 33 inpatient psychiatric patients and reported that the most frequent co-morbidities were mood disorders (occurring in 40% of subjects), ADHD (31%), anxiety disorder (25%), and autism spectrum disorders (14.7 %). Some of these children had been previously evaluated but remained untreated secondary to their epilepsy. The study authors concluded that integrated clinical service teams in epilepsy that include psychiatrists are essential to achieving best outcomes in this population.

Patients With Epilepsy “Type” on a Computer Using Brain Waves
Neuroscientists at the Mayo Clinic in Jacksonville, Florida, have demonstrated how brain waves in patients with epilepsy can be used to type alphanumerical characters on a computer screen. For example, if a subject merely focused on the letter q in a matrix of letters, that q appeared on the monitor.

The researchers believe these findings represent concrete progress toward a mind-machine interface that may, one day, help people with a variety of disorders control devices, such as prosthetic arms and legs. “Over 2 million people in the United States may benefit from assistive devices controlled by a brain-computer interface,” said lead investigator Jerry Shih, MD, of the Department of Neurology at the Mayo Clinic. “This study constitutes a baby step on the road toward that future, but it represents tangible progress in using brain waves to do certain tasks.”

Dr. Shih and other Mayo Clinic researchers worked with Dean Krusienski, PhD, from the University of North Florida, on the study, which was conducted in two patients with epilepsy. These patients were already being monitored for seizure activity using electrocorticography (ECoG).

“There is a big difference in the quality of information you get from ECoG compared with EEG,” said Dr. Shih. “The scalp and bony skull diffuses and distorts the signal, rather like how the earth’s atmosphere blurs the light from stars. That’s why progress on developing these interfaces has been slow.”

The two patients with epilepsy sat in front of a monitor that was hooked to a computer running the investigators’ software, which was designed to interpret electrical signals coming from the electrodes. The patients were asked to look at the screen, which contained a 6-by-6 matrix with a single alphanumeric character inside each square. Every time the square with a certain letter flashed, and the patient focused on it, the computer recorded the brain’s response to the flashing letter. The patients were then asked to focus on specific letters, and the computer software recorded the information. The computer then calibrated the system with the individual patient’s specific brain wave, and when the patient then focused on a letter, the letter appeared on the screen.

“We were able to consistently predict the desired letters for our patients at or near 100% accuracy,” Dr. Shih said.