Christos Panagiotis Lisgaras, Liset M de la Prida, Edward Bertram, Mark Cunningham, David Henshall, Anli A Liu, Vadym Gnatkovsky, Simona Balestrini, Marco de Curtis, Aristea S Galanopoulou, Julia Jacobs, John G R Jefferys, Massimo Mantegazza, Cristina R Reschke, Premysl Jiruska
Electroencephalography (EEG) has been instrumental in epilepsy research for the past century, both for basic and translational studies. Its contributions have advanced our understanding of epilepsy, shedding light on the pathophysiology and functional organization of epileptic networks, and the mechanisms underlying seizures. Here we re-examine the historical significance, ongoing relevance, and future trajectories of EEG in epilepsy research. We describe traditional approaches to record brain electrical activity and discuss novel cutting-edge, large-scale techniques using micro-electrode arrays. Contemporary EEG studies explore brain potentials beyond the traditional Berger frequencies to uncover underexplored mechanisms operating at ultra-slow and high frequencies, which have proven valuable in understanding the principles of ictogenesis, epileptogenesis, and endogenous epileptogenicity. Integrating EEG with modern techniques such as optogenetics, chemogenetics, and imaging provides a more comprehensive understanding of epilepsy. EEG has become an integral element in a powerful suite of tools for capturing epileptic network dynamics across various temporal and spatial scales, ranging from rapid pathological synchronization to the long-term processes of epileptogenesis or seizure cycles. Advancements in EEG recording techniques parallel the application of sophisticated mathematical analyses and algorithms, significantly augmenting the information yield of EEG recordings. Beyond seizures and interictal activity, EEG has been instrumental in elucidating the mechanisms underlying epilepsy-related cognitive deficits and other comorbidities. Although EEG remains a cornerstone in epilepsy research, persistent challenges such as limited spatial resolution, artifacts, and the difficulty of long-term recording highlight the ongoing need for refinement. Despite these challenges, EEG continues to be a fundamental research tool, playing a central role in unraveling disease mechanisms and drug discovery.
{"title":"The role of electroencephalography in epilepsy research-From seizures to interictal activity and comorbidities.","authors":"Christos Panagiotis Lisgaras, Liset M de la Prida, Edward Bertram, Mark Cunningham, David Henshall, Anli A Liu, Vadym Gnatkovsky, Simona Balestrini, Marco de Curtis, Aristea S Galanopoulou, Julia Jacobs, John G R Jefferys, Massimo Mantegazza, Cristina R Reschke, Premysl Jiruska","doi":"10.1111/epi.18282","DOIUrl":"10.1111/epi.18282","url":null,"abstract":"<p><p>Electroencephalography (EEG) has been instrumental in epilepsy research for the past century, both for basic and translational studies. Its contributions have advanced our understanding of epilepsy, shedding light on the pathophysiology and functional organization of epileptic networks, and the mechanisms underlying seizures. Here we re-examine the historical significance, ongoing relevance, and future trajectories of EEG in epilepsy research. We describe traditional approaches to record brain electrical activity and discuss novel cutting-edge, large-scale techniques using micro-electrode arrays. Contemporary EEG studies explore brain potentials beyond the traditional Berger frequencies to uncover underexplored mechanisms operating at ultra-slow and high frequencies, which have proven valuable in understanding the principles of ictogenesis, epileptogenesis, and endogenous epileptogenicity. Integrating EEG with modern techniques such as optogenetics, chemogenetics, and imaging provides a more comprehensive understanding of epilepsy. EEG has become an integral element in a powerful suite of tools for capturing epileptic network dynamics across various temporal and spatial scales, ranging from rapid pathological synchronization to the long-term processes of epileptogenesis or seizure cycles. Advancements in EEG recording techniques parallel the application of sophisticated mathematical analyses and algorithms, significantly augmenting the information yield of EEG recordings. Beyond seizures and interictal activity, EEG has been instrumental in elucidating the mechanisms underlying epilepsy-related cognitive deficits and other comorbidities. Although EEG remains a cornerstone in epilepsy research, persistent challenges such as limited spatial resolution, artifacts, and the difficulty of long-term recording highlight the ongoing need for refinement. Despite these challenges, EEG continues to be a fundamental research tool, playing a central role in unraveling disease mechanisms and drug discovery.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isaac J Egesa, Symon M Kariuki, Collins Kipkoech, Charles R J C Newton
Objective: First unprovoked seizures and acute seizures are common and can develop into epilepsy. The risk of epilepsy following these seizures in community samples is not well established, and it is unclear whether the probability of subsequent unprovoked seizures following these seizures reaches the International League Against Epilepsy's threshold of 60%.
Methods: We followed participants initially classified as having first unprovoked seizures, having acute seizures, or without seizures in a community-based survey conducted in 2003 to estimate the subsequent risk of epilepsy in 2008 and 2021. The diagnosis of epilepsy in 2008 and 2021 was based on data from a community survey and health care visits to Kilifi County Hospital and the epilepsy clinic. Poisson regression models were used to compute incident risk ratios (IRRs) for epilepsy and population-attributable risk (PAR); population-attributable risk fractions (PAFs) were computed from contingency tables.
Results: In the 5-year follow-up (censored in 2008 survey), the IRR for epilepsy was 23.3 (95% confidence interval [CI] = 14.2-38.2) for first unprovoked seizures and 10.4 (95% CI = 5.6-19.5) for acute seizures compared to the no-seizure group. By 2021 (including 2008), the IRR was 18.4 (95% CI = 11.9-28.5) for first unprovoked seizures and 7.9 (95% CI = 4.3-14.5) for acute seizures compared to the no-seizure group. The PAR for first unprovoked seizures and acute seizures was 29.0 and 8.0/1000 persons in the long-term follow-up. The PAF was 56.3% for first unprovoked seizures and 26.3% for acute seizures in the long-term follow-up. There was a high probability that a person with acute seizures (72%) or first unprovoked seizures (92%) developed epilepsy earlier than a person from the comparison group.
Significance: First unprovoked seizures and acute seizures are associated with high risk for developing epilepsy. Neurological correlates for epilepsy risk following first unprovoked seizures should be investigated to inform epilepsy diagnosis and treatment.
{"title":"Risk of epilepsy following first unprovoked and acute seizures: Cohort study.","authors":"Isaac J Egesa, Symon M Kariuki, Collins Kipkoech, Charles R J C Newton","doi":"10.1111/epi.18276","DOIUrl":"https://doi.org/10.1111/epi.18276","url":null,"abstract":"<p><strong>Objective: </strong>First unprovoked seizures and acute seizures are common and can develop into epilepsy. The risk of epilepsy following these seizures in community samples is not well established, and it is unclear whether the probability of subsequent unprovoked seizures following these seizures reaches the International League Against Epilepsy's threshold of 60%.</p><p><strong>Methods: </strong>We followed participants initially classified as having first unprovoked seizures, having acute seizures, or without seizures in a community-based survey conducted in 2003 to estimate the subsequent risk of epilepsy in 2008 and 2021. The diagnosis of epilepsy in 2008 and 2021 was based on data from a community survey and health care visits to Kilifi County Hospital and the epilepsy clinic. Poisson regression models were used to compute incident risk ratios (IRRs) for epilepsy and population-attributable risk (PAR); population-attributable risk fractions (PAFs) were computed from contingency tables.</p><p><strong>Results: </strong>In the 5-year follow-up (censored in 2008 survey), the IRR for epilepsy was 23.3 (95% confidence interval [CI] = 14.2-38.2) for first unprovoked seizures and 10.4 (95% CI = 5.6-19.5) for acute seizures compared to the no-seizure group. By 2021 (including 2008), the IRR was 18.4 (95% CI = 11.9-28.5) for first unprovoked seizures and 7.9 (95% CI = 4.3-14.5) for acute seizures compared to the no-seizure group. The PAR for first unprovoked seizures and acute seizures was 29.0 and 8.0/1000 persons in the long-term follow-up. The PAF was 56.3% for first unprovoked seizures and 26.3% for acute seizures in the long-term follow-up. There was a high probability that a person with acute seizures (72%) or first unprovoked seizures (92%) developed epilepsy earlier than a person from the comparison group.</p><p><strong>Significance: </strong>First unprovoked seizures and acute seizures are associated with high risk for developing epilepsy. Neurological correlates for epilepsy risk following first unprovoked seizures should be investigated to inform epilepsy diagnosis and treatment.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}