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1.
Foods ; 13(1)2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38201182

RESUMO

Oxytetracycline (OTC), enrofloxacin (EFX), and sulfachloropyridazine (SCP) are critically important antimicrobials (AMs) in both human and veterinary medicine, where they are widely used in farm animals. Lettuce has become a matrix of choice for studying the presence of residues of these AMs in plants, as the concentrations of residues detected in lettuce can range from ng to mg. While several analytical methodologies have been developed for the purpose of detecting AMs in lettuce, these currently do not detect both the parent compound and its active metabolites or epimers, such as in the case of ciprofloxacin (CFX) and 4-epi-oxitetracycline (4-epi-OTC), which also pose a risk to public health and the environment due to their AM activity. In light of this situation, this work proposes an analytical method that was developed specifically to allow for the detection of OTC, 4-epi-OTC, EFX, CFX, and SCP in a lettuce matrix. This method uses acetonitrile, methanol, 0.5% formic acid, and McIlvaine-EDTA buffer as extraction solvents, and dispersive solid-phase extraction (dSPE) for the clean-up. The analytes were detected using a liquid chromatography technique coupled to mass spectrometry (HPLC-MS/MS). Parameters such as the specificity, linearity, recovery, precision, limit of detection, and limit (LOD) of quantification (LOQ) were calculated according to the recommendations established in the European Union decision 2021/808/EC and VICH GL2: Validation of analytical procedures. The LOQ for the analytes OTC, 4-epi-OTC, CFX, and SCP was 1 µg·kg-1, whereas for EFX, it was 5 µg·kg-1 dry weight. All calibration curves showed a coefficient of determination (R2) of >0.99. The recovery levels ranged from 93.0 to 110.5% and the precision met the acceptance criteria, with a coefficient of variation of ≤14.02%. Therefore, this methodology allows for the precise and reliable detection and quantification of these analytes. The analysis of commercial samples confirmed the suitability of this method.

2.
Brain Commun ; 5(5): fcad205, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37693811

RESUMO

Many biological processes are modulated by rhythms on circadian and multidien timescales. In focal epilepsy, various seizure features, such as spread and duration, can change from one seizure to the next within the same patient. However, the specific timescales of this variability, as well as the specific seizure characteristics that change over time, are unclear. Here, in a cross-sectional observational study, we analysed within-patient seizure variability in 10 patients with chronic intracranial EEG recordings (185-767 days of recording time, 57-452 analysed seizures/patient). We characterized the seizure evolutions as sequences of a finite number of patient-specific functional seizure network states. We then compared seizure network state occurrence and duration to (1) time since implantation and (2) patient-specific circadian and multidien cycles in interictal spike rate. In most patients, the occurrence or duration of at least one seizure network state was associated with the time since implantation. Some patients had one or more seizure network states that were associated with phases of circadian and/or multidien spike rate cycles. A given seizure network state's occurrence and duration were usually not associated with the same timescale. Our results suggest that different time-varying factors modulate within-patient seizure evolutions over multiple timescales, with separate processes modulating a seizure network state's occurrence and duration. These findings imply that the development of time-adaptive treatments in epilepsy must account for several separate properties of epileptic seizures and similar principles likely apply to other neurological conditions.

3.
J Neural Eng ; 19(4)2022 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-35917811

RESUMO

Objective.Retinal prostheses have had limited success in vision restoration through electrical stimulation of surviving retinal ganglion cells (RGCs) in the degenerated retina. This is partly due to non-preferential stimulation of all RGCs near a single stimulating electrode, which include cells that conflict in their response properties and their contribution to visiual processing. Our study proposes a stimulation strategy to preferentially stimulate individual RGCs based on their temporal electrical receptive fields (tERFs).Approach.We recorded the responses of RGCs using whole-cell patch clamping and demonstrated the stimulation strategy, first using intracellular stimulation, then via extracellular stimulation.Main results. We successfully reconstructed the tERFs according to the RGC response to Gaussian white noise current stimulation. The characteristics of the tERFs were extracted and compared based on the morphological and light response types of the cells. By re-delivering stimulation trains that were composed of the tERFs obtained from different cells, we could preferentially stimulate individual RGCs as the cells showed lower activation thresholds to their own tERFs.Significance.This proposed stimulation strategy implemented in the next generation of recording and stimulating retinal prostheses may improve the quality of artificial vision.


Assuntos
Células Ganglionares da Retina , Próteses Visuais , Potenciais de Ação/fisiologia , Estimulação Elétrica/métodos , Retina , Células Ganglionares da Retina/fisiologia
4.
Neurology ; 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35523589

RESUMO

BACKGROUND AND OBJECTIVES: Reliable seizure forecasting has important implications in epilepsy treatment and improving the quality of lives for people with epilepsy. High-frequency activity (HFA) is one biomarker that has received significant attention over the past two decades, but its predictive value in seizure forecasting remains uncertain. This work aimed to determine the utility of HFA in seizure forecasting. METHODS: We used seizure data and HFA (80-170 Hz) data obtained from long-term, continuous intracranial EEG recordings of drug-resistant epilepsy patients. Instantaneous rates and phases of HFA cycles were used as features for seizure forecasting. Seizure forecasts based on each individual HFA feature, and using a combined approach, were generated pseudo-prospectively (causally). To compute the instantaneous phases for pseudo-prospective forecasting, real-time phase estimation based on an autoregressive model was employed. Features were combined using a weighted average approach. The performance of seizure forecasting was primarily evaluated by the area under the curve (AUC). RESULTS: Of 15 studied patients (median recording duration: 557 days, median seizures: 151), 12 patients with more than 10 seizures after 100 recording days were included in the pseudo-prospective analysis. The presented real-time phase estimation is feasible and can causally estimate the instantaneous phases of HFA cycles with high accuracy. Pseudo-prospective seizure forecasting based on HFA rates and phases performed significantly better than chance in 11 out of 12 patients, although there were patient-specific differences. Combining rate and phase information improved forecasting performance compared to using either feature alone. The combined forecast using the best-performing channel yielded a median AUC of 0.70, a median sensitivity of 0.57, and a median specificity of 0.77. CONCLUSIONS: These findings show that HFA could be useful for seizure forecasting and represent proof of concept for utilizing prior information of patient-specific relationships between HFA and seizures in pseudo-prospective forecasting. Future seizure forecasting algorithms might benefit from the inclusion of HFA, and the real-time phase estimation approach can be extended to other biomarkers. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that high-frequency activity (80-170 Hz) in long-term continuous intracranial EEG can be useful to forecast seizures in patients with refractory epilepsy.

5.
Epilepsia ; 63(7): 1682-1692, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35395096

RESUMO

OBJECTIVE: Emerging evidence has shown that ambient air pollution affects brain health, but little is known about its effect on epileptic seizures. This work aimed to assess the association between daily exposure to ambient air pollution and the risk of epileptic seizures. METHODS: This study used epileptic seizure data from two independent data sources (NeuroVista and Seer App seizure diary). In the NeuroVista data set, 3273 seizures were recorded using intracranial electroencephalography (iEEG) from 15 participants with refractory focal epilepsy in Australia in 2010-2012. In the seizure diary data set, 3419 self-reported seizures were collected through a mobile application from 34 participants with epilepsy in Australia in 2018-2021. Daily average concentrations of carbon monoxide (CO), nitrogen dioxide (NO2 ), ozone (O3 ), particulate matter ≤10 µm in diameter (PM10 ), and sulfur dioxide (SO2 ) were retrieved from the Environment Protection Authority (EPA) based on participants' postcodes. A patient-time-stratified case-crossover design with the conditional Poisson regression model was used to determine the associations between air pollutants and epileptic seizures. RESULTS: A significant association between CO concentrations and epileptic seizure risks was observed, with an increased seizure risk of 4% (relative risk [RR]: 1.04, 95% confidence interval [CI]: 1.01-1.07) for an interquartile range (IQR) increase of CO concentrations (0.13 parts per million), whereas no significant associations were found for the other four air pollutants in the whole study population. Female participants had a significantly increased risk of seizures when exposed to elevated CO and NO2 , with RRs of 1.05 (95% CI: 1.01-1.08) and 1.09 (95% CI: 1.01-1.16), respectively. In addition, a significant association was observed between CO and the risk of subclinical seizures (RR: 1.20, 95% CI: 1.12-1.28). SIGNIFICANCE: Daily exposure to elevated CO concentrations may be associated with an increased risk of epileptic seizures, especially for subclinical seizures.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Epilepsias Parciais , Epilepsia , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Austrália/epidemiologia , Epilepsia/induzido quimicamente , Feminino , Humanos , Dióxido de Nitrogênio/análise , Convulsões/induzido quimicamente , Convulsões/etiologia
6.
EBioMedicine ; 72: 103619, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34649079

RESUMO

BACKGROUND: Circadian and multiday rhythms are found across many biological systems, including cardiology, endocrinology, neurology, and immunology. In people with epilepsy, epileptic brain activity and seizure occurrence have been found to follow circadian, weekly, and monthly rhythms. Understanding the relationship between these cycles of brain excitability and other physiological systems can provide new insight into the causes of multiday cycles. The brain-heart link has previously been considered in epilepsy research, with potential implications for seizure forecasting, therapy, and mortality (i.e., sudden unexpected death in epilepsy). METHODS: We report the results from a non-interventional, observational cohort study, Tracking Seizure Cycles. This study sought to examine multiday cycles of heart rate and seizures in adults with diagnosed uncontrolled epilepsy (N=31) and healthy adult controls (N=15) using wearable smartwatches and mobile seizure diaries over at least four months (M=12.0, SD=5.9; control M=10.6, SD=6.4). Cycles in heart rate were detected using a continuous wavelet transform. Relationships between heart rate cycles and seizure occurrence were measured from the distributions of seizure likelihood with respect to underlying cycle phase. FINDINGS: Heart rate cycles were found in all 46 participants (people with epilepsy and healthy controls), with circadian (N=46), about-weekly (N=25) and about-monthly (N=13) rhythms being the most prevalent. Of the participants with epilepsy, 19 people had at least 20 reported seizures, and 10 of these had seizures significantly phase locked to their multiday heart rate cycles. INTERPRETATION: Heart rate cycles showed similarities to multiday epileptic rhythms and may be comodulated with seizure likelihood. The relationship between heart rate and seizures is relevant for epilepsy therapy, including seizure forecasting, and may also have implications for cardiovascular disease. More broadly, understanding the link between multiday cycles in the heart and brain can shed new light on endogenous physiological rhythms in humans. FUNDING: This research received funding from the Australian Government National Health and Medical Research Council (investigator grant 1178220), the Australian Government BioMedTech Horizons program, and the Epilepsy Foundation of America's 'My Seizure Gauge' grant.


Assuntos
Frequência Cardíaca/fisiologia , Convulsões/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/fisiopatologia , Relógios Circadianos/fisiologia , Estudos de Coortes , Morte Súbita/etiologia , Eletroencefalografia/métodos , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Front Neurol ; 12: 713794, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34497578

RESUMO

Accurate identification of seizure activity, both clinical and subclinical, has important implications in the management of epilepsy. Accurate recognition of seizure activity is essential for diagnostic, management and forecasting purposes, but patient-reported seizures have been shown to be unreliable. Earlier work has revealed accurate capture of electrographic seizures and forecasting is possible with an implantable intracranial device, but less invasive electroencephalography (EEG) recording systems would be optimal. Here, we present preliminary results of seizure detection and forecasting with a minimally invasive sub-scalp device that continuously records EEG. Five participants with refractory epilepsy who experience at least two clinically identifiable seizures monthly have been implanted with sub-scalp devices (Minder®), providing two channels of data from both hemispheres of the brain. Data is continuously captured via a behind-the-ear system, which also powers the device, and transferred wirelessly to a mobile phone, from where it is accessible remotely via cloud storage. EEG recordings from the sub-scalp device were compared to data recorded from a conventional system during a 1-week ambulatory video-EEG monitoring session. Suspect epileptiform activity (EA) was detected using machine learning algorithms and reviewed by trained neurophysiologists. Seizure forecasting was demonstrated retrospectively by utilizing cycles in EA and previous seizure times. The procedures and devices were well-tolerated and no significant complications have been reported. Seizures were accurately identified on the sub-scalp system, as visually confirmed by periods of concurrent conventional scalp EEG recordings. The data acquired also allowed seizure forecasting to be successfully undertaken. The area under the receiver operating characteristic curve (AUC score) achieved (0.88), which is comparable to the best score in recent, state-of-the-art forecasting work using intracranial EEG.

10.
EClinicalMedicine ; 37: 100934, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34386736

RESUMO

BACKGROUND: While the effects of prolonged sleep deprivation (≥24 h) on seizure occurrence has been thoroughly explored, little is known about the effects of day-to-day variations in the duration and quality of sleep on seizure probability. A better understanding of the interaction between sleep and seizures may help to improve seizure management. METHODS: To explore how sleep and epileptic seizures are associated, we analysed continuous intracranial electroencephalography (EEG) recordings collected from 10 patients with refractory focal epilepsy undergoing ordinary life activities between 2010 and 2012 from three clinical centres (Austin Health, The Royal Melbourne Hospital, and St Vincent's Hospital of the Melbourne University Epilepsy Group). A total of 4340 days of sleep-wake data were analysed (average 434 days per patient). EEG data were sleep scored using a semi-automated machine learning approach into wake, stages one, two, and three non-rapid eye movement sleep, and rapid eye movement sleep categories. FINDINGS: Seizure probability changes with day-to-day variations in sleep duration. Logistic regression models revealed that an increase in sleep duration, by 1·66 ± 0·52 h, lowered the odds of seizure by 27% in the following 48 h. Following a seizure, patients slept for longer durations and if a seizure occurred during sleep, then sleep quality was also reduced with increased time spent aroused from sleep and reduced rapid eye movement sleep. INTERPRETATION: Our results suggest that day-to-day deviations from regular sleep duration correlates with changes in seizure probability. Sleeping longer, by 1·66 ± 0·52 h, may offer protective effects for patients with refractory focal epilepsy, reducing seizure risk. Furthermore, the occurrence of a seizure may disrupt sleep patterns by elongating sleep and, if the seizure occurs during sleep, reducing its quality.

11.
Animals (Basel) ; 11(6)2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208604

RESUMO

Antimicrobials premixes are the presentation of choice to administer drugs simultaneously to groups of animals in intensive husbandry systems that require treatment for pathologies of bacterial origin. Among the premixes available for use in poultry, florfenicol and oxytetracycline are commonly administered via food or water. However, their actual concentration in premixes must meet on-label statements to ensure plasma concentrations reach effective therapeutic levels. Hence, this work was designed for the purpose of verifying whether the concentration of antimicrobial present in five premixes matched their on-label statement. Three oxytetracycline premixes, and two of florfenicol, were analysed using a Xevo TQ-S micro UPLC-MS/MS, and an ABSciex API4000 HPLC-MS/MS, respectively. Analytical methodologies were implemented and validated, showing an R2 ≥ 0.99 for the calibration curves. Oxytetracycline was detected in these premixes at concentrations exceeding on-label statements by 13.28%, 21.54%, and 29.68%, whereas florfenicol concentrations detected in premixes were 13.06% and 14.75% lower than expected. Consequently, this work shows that the concentration of active ingredients that are present in commercial formulations effectively differ from those stated on premix labels, and it also highlights how unpredictable their range of variability might be. This must be addressed through solid and updated laws that guarantee an effective pharmaceutical product.

12.
Neurobiol Dis ; 154: 105347, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33771663

RESUMO

The seemingly random and unpredictable nature of seizures is a major debilitating factor for people with epilepsy. An increasing body of evidence demonstrates that the epileptic brain exhibits long-term fluctuations in seizure susceptibility, and seizure emergence seems to be a consequence of processes operating over multiple temporal scales. A deeper insight into the mechanisms responsible for long-term seizure fluctuations may provide important information for understanding the complex nature of seizure genesis. In this study, we explored the long-term dynamics of seizures in the tetanus toxin model of temporal lobe epilepsy. The results demonstrate the existence of long-term fluctuations in seizure probability, where seizures form clusters in time and are then followed by seizure-free periods. Within each cluster, seizure distribution is non-Poissonian, as demonstrated by the progressively increasing inter-seizure interval (ISI), which marks the approaching cluster termination. The lengthening of ISIs is paralleled by: increasing behavioral seizure severity, the occurrence of convulsive seizures, recruitment of extra-hippocampal structures and the spread of electrographic epileptiform activity outside of the limbic system. The results suggest that repeated non-convulsive seizures obey the 'seizures-beget-seizures' principle, leading to the occurrence of convulsive seizures, which decrease the probability of a subsequent seizure and, thus, increase the following ISI. The cumulative effect of repeated convulsive seizures leads to cluster termination, followed by a long inter-cluster period. We propose that seizures themselves are an endogenous factor that contributes to long-term fluctuations in seizure susceptibility and their mutual interaction determines the future evolution of disease activity.


Assuntos
Epilepsia do Lobo Temporal/fisiopatologia , Convulsões/fisiopatologia , Animais , Eletroencefalografia/métodos , Eletroencefalografia/tendências , Epilepsia do Lobo Temporal/induzido quimicamente , Masculino , Ratos , Ratos Sprague-Dawley , Ratos Wistar , Convulsões/induzido quimicamente , Toxina Tetânica/toxicidade , Fatores de Tempo
13.
Neurology ; 96(9): 439-448, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33408149

RESUMO

For the past 2 decades, high-frequency oscillations (HFOs) have been enthusiastically studied by the epilepsy community. Emerging evidence shows that HFOs harbor great promise to delineate epileptogenic brain areas and possibly predict the likelihood of seizures. Investigations into HFOs in clinical epilepsy have advanced from small retrospective studies relying on visual identification and correlation analysis to larger prospective assessments using automatic detection and prediction strategies. Although most studies have yielded promising results, some have revealed significant obstacles to clinical application of HFOs, thus raising debate about the reliability and practicality of HFOs as clinical biomarkers. In this review, we give an overview of the current state of HFO research and pinpoint the conceptual and methodological issues that have hampered HFO translation. We highlight recent insights gained from long-term data, high-density recordings, and multicenter collaborations and discuss the open questions that need to be addressed in future research.


Assuntos
Eletroencefalografia , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Biomarcadores , Ondas Encefálicas , Humanos , Convulsões/fisiopatologia
14.
Neurology ; 96(7): e1070-e1081, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-33361261

RESUMO

OBJECTIVE: To determine the utility of high-frequency activity (HFA) and epileptiform spikes as biomarkers for epilepsy, we examined the variability in their rates and locations using long-term ambulatory intracranial EEG (iEEG) recordings. METHODS: This study used continuous iEEG recordings obtained over an average of 1.4 years from 15 patients with drug-resistant focal epilepsy. HFA was defined as 80- to 170-Hz events with amplitudes clearly larger than the background, which was automatically detected with a custom algorithm. The automatically detected HFA was compared with visually annotated high-frequency oscillations (HFOs). The variations of HFA rates were compared with spikes and seizures on patient-specific and electrode-specific bases. RESULTS: HFA included manually annotated HFOs and high-amplitude events occurring in the 80- to 170-Hz range without observable oscillatory behavior. HFA and spike rates had high amounts of intrapatient and interpatient variability. Rates of HFA and spikes had large variability after electrode implantation in most of the patients. Locations of HFA and spikes varied up to weeks in more than one-third of the patients. Both HFA and spike rates showed strong circadian rhythms in all patients, and some also showed multiday cycles. Furthermore, the circadian patterns of HFA and spike rates had patient-specific correlations with seizures, which tended to vary across electrodes. CONCLUSION: Analysis of HFA and epileptiform spikes should consider postimplantation variability. HFA and epileptiform spikes, like seizures, show circadian rhythms. However, the circadian profiles can vary spatially within patients, and their correlations to seizures are patient-specific.


Assuntos
Encéfalo/fisiopatologia , Epilepsia Resistente a Medicamentos/fisiopatologia , Eletroencefalografia , Convulsões/fisiopatologia , Adulto , Eletrodos Implantados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Nat Commun ; 11(1): 2172, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32358560

RESUMO

The human brain has the capacity to rapidly change state, and in epilepsy these state changes can be catastrophic, resulting in loss of consciousness, injury and even death. Theoretical interpretations considering the brain as a dynamical system suggest that prior to a seizure, recorded brain signals may exhibit critical slowing down, a warning signal preceding many critical transitions in dynamical systems. Using long-term intracranial electroencephalography (iEEG) recordings from fourteen patients with focal epilepsy, we monitored key signatures of critical slowing down prior to seizures. The metrics used to detect critical slowing down fluctuated over temporally long scales (hours to days), longer than would be detectable in standard clinical evaluation settings. Seizure risk was associated with a combination of these signals together with epileptiform discharges. These results provide strong validation of theoretical models and demonstrate that critical slowing down is a reliable indicator that could be used in seizure forecasting algorithms.


Assuntos
Encéfalo/fisiopatologia , Epilepsias Parciais/diagnóstico , Convulsões/diagnóstico , Algoritmos , Biomarcadores , Eletrocorticografia , Humanos , Modelos Neurológicos , Fatores de Risco
16.
Epilepsia ; 61(4): 776-786, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32219856

RESUMO

OBJECTIVE: Seizure unpredictability is rated as one of the most challenging aspects of living with epilepsy. Seizure likelihood can be influenced by a range of environmental and physiological factors that are difficult to measure and quantify. However, some generalizable patterns have been demonstrated in seizure onset. A majority of people with epilepsy exhibit circadian rhythms in their seizure times, and many also show slower, multiday patterns. Seizure cycles can be measured using a range of recording modalities, including self-reported electronic seizure diaries. This study aimed to develop personalized forecasts from a mobile seizure diary app. METHODS: Forecasts based on circadian and multiday seizure cycles were tested pseudoprospectively using data from 50 app users (mean of 109 seizures per subject). Individuals' strongest cycles were estimated from their reported seizure times and used to derive the likelihood of future seizures. The forecasting approach was validated using self-reported events and electrographic seizures from the Neurovista dataset, an existing database of long-term electroencephalography that has been widely used to develop forecasting algorithms. RESULTS: The validation dataset showed that forecasts of seizure likelihood based on self-reported cycles were predictive of electrographic seizures for approximately half the cohort. Forecasts using only mobile app diaries allowed users to spend an average of 67.1% of their time in a low-risk state, with 14.8% of their time in a high-risk warning state. On average, 69.1% of seizures occurred during high-risk states and 10.5% of seizures occurred in low-risk states. SIGNIFICANCE: Seizure diary apps can provide personalized forecasts of seizure likelihood that are accurate and clinically relevant for electrographic seizures. These results have immediate potential for translation to a prospective seizure forecasting trial using a mobile diary app. It is our hope that seizure forecasting apps will one day give people with epilepsy greater confidence in managing their daily activities.


Assuntos
Algoritmos , Previsões/métodos , Prontuários Médicos , Aplicativos Móveis , Convulsões , Eletroencefalografia , Humanos , Funções Verossimilhança , Convulsões/fisiopatologia , Autorrelato
17.
Biomaterials ; 230: 119648, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791841

RESUMO

Implantable medical devices are now in regular use to treat or ameliorate medical conditions, including movement disorders, chronic pain, cardiac arrhythmias, and hearing or vision loss. Aside from offering alternatives to pharmaceuticals, one major advantage of device therapy is the potential to monitor treatment efficacy, disease progression, and perhaps begin to uncover elusive mechanisms of diseases pathology. In an ideal system, neural stimulation, neural recording, and electrochemical sensing would be conducted by the same electrode in the same anatomical region. Carbon fiber (CF) microelectrodes are the appropriate size to achieve this goal and have shown excellent performance, in vivo. Their electrochemical properties, however, are not suitable for neural stimulation and electrochemical sensing. Here, we present a method to deposit high surface area conducting diamond on CF microelectrodes. This unique hybrid microelectrode is capable of recording single-neuron action potentials, delivering effective electrical stimulation pulses, and exhibits excellent electrochemical dopamine detection. Such electrodes are needed for the next generation of miniaturized, closed-loop implants that can self-tune therapies by monitoring both electrophysiological and biochemical biomarkers.


Assuntos
Diamante , Potenciais de Ação , Fibra de Carbono , Estimulação Elétrica , Microeletrodos
18.
Curr Treat Options Neurol ; 21(10): 47, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31559493

RESUMO

PURPOSE OF REVIEW: Two large-scale controlled clinical trials have provided Class I evidence for the benefit of deep brain stimulation (DBS) as a therapy for refractory epilepsy. However, the efficacy has been variable, with some patients not achieving any improvement in their seizure control. This disparity could be the result of suboptimal stimulation parameters/electrodes or alternatively a difference in the type of seizures being treated. This review presents the most recent clinical results with a focus on two major targets for DBS, the anterior nucleus of the thalamus (ANT) and the hippocampus. We detail the etiologies where DBS might work best, and provide evidence for the use of recorded neural responses for the optimization of stimulation parameters and closed-loop control of devices. RECENT FINDINGS: Stimulation of the hippocampus may work well for both focal and generalized seizures, whereas ANT stimulation may be best for focal seizures only. Studies have demonstrated that changes in stimulation-evoked response shape can be used as a biomarker for stimulation efficacy. Furthermore, new biomarkers have been identified that could be used for closed-loop stimulation. Improvements in patient screening and stimulation optimization are needed for patients to achieve optimal seizure control. Furthermore, therapy should be adjusted to suit individual patient needs. Recording evoked responses during the application of DBS could be used to measure the effectiveness of DBS and titrate stimulation as needed.

19.
Nat Neurosci ; 21(12): 1742-1752, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30482946

RESUMO

The mechanism of seizure emergence and the role of brief interictal epileptiform discharges (IEDs) in seizure generation are two of the most important unresolved issues in modern epilepsy research. We found that the transition to seizure is not a sudden phenomenon, but is instead a slow process that is characterized by the progressive loss of neuronal network resilience. From a dynamical perspective, the slow transition is governed by the principles of critical slowing, a robust natural phenomenon that is observable in systems characterized by transitions between dynamical regimes. In epilepsy, this process is modulated by synchronous synaptic input from IEDs. IEDs are external perturbations that produce phasic changes in the slow transition process and exert opposing effects on the dynamics of a seizure-generating network, causing either anti-seizure or pro-seizure effects. We found that the multifaceted nature of IEDs is defined by the dynamical state of the network at the moment of the discharge occurrence.


Assuntos
Hipocampo/fisiopatologia , Rede Nervosa/fisiopatologia , Convulsões/fisiopatologia , Animais , Região CA1 Hipocampal/fisiopatologia , Eletroencefalografia , Humanos , Masculino , Ratos Sprague-Dawley , Ratos Wistar , Sinapses/fisiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-29988378

RESUMO

Neural prostheses that can monitor the physiological state of a subject are becoming clinically viable through improvements in the capacity to record from neural tissue. However, a significant limitation of current devices is that it is difficult to fabricate electrode arrays that have both high channel counts and the appropriate electrical properties required for neural recordings. In earlier work, we demonstrated nitrogen doped ultrananocrystalline diamond (N-UNCD) can provide efficacious electrical stimulation of neural tissue, with high charge injection capacity, surface stability and biocompatibility. In this work, we expand on this functionality to show that N-UNCD electrodes can also record from neural tissue owing to its low electrochemical impedance. We show that N-UNCD electrodes are highly flexible in their application, with successful recordings of action potentials from single neurons in an in vitro retina preparation, as well as local field potential responses from in vivo visual cortex tissue. Key properties of N-UNCD films, combined with scalability of electrode array fabrication with custom sizes for recording or stimulation along with integration through vertical interconnects to silicon based integrated circuits, may in future form the basis for the fabrication of versatile closed-loop neural prostheses that can both record and stimulate.

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