Health Sciences Student Fellowship
The Health Sciences Student Fellowship stimulates individuals to pursue careers in epilepsy in either research or practice settings. Predoctoral training students in the Health Sciences may be accepted at any point in their schooling-following acceptance but before beginning the first year, or in the period immediately following their final year.
SPRING 2013 AWARDS
Duke University Medical Center, Durham, NC
Efficacy and cost analysis of anti-epileptic drugs in malignant glioma
A common presenting symptom of brain tumors is seizures, and out of all patients with primary brain tumors, those diagnosed with malignant glib experience preoperative seizures the most. There is a current lack of consensus in the medical literature and no national guidelines to the use of anti-epileptic drugs for primary malignant glimpse. Patients with malignant glimpse have dismal outcomes. Those with the highest grade of malignant glib have a survival of about 12-14 months if they are able to tolerate maximum therapy of surgical resection, radiation therapy, and at least 6 months of chemotherapy. Uncontrolled seizures can be very debilitating to patients with a limited quality of life due to a terminal disease. Therefore, any understanding we can gain to prevent and treat seizures in patients with malignant glimpse may greatly improve their quality of life and potentially improve survival. The complex and lengthy treatment of malignant glimpse is costly. Understanding the economic impact on patients and society of recommending additional treatments is a critical part of healthcare.
Epilepsy is a very common disorder, affecting nearly 70 million people globally. Absence epilepsy is a type of epilepsy where patients experience brief impairments of consciousness rather than convulsions, show a specific pattern of brain activity and are more likely to have cognitive and linguistic deficits. Absence seizures occur when a part of the brain called the thalamus is overly active. The thalamus has two distinct clusters of neurons that fire back and forth with a reciprocal pattern of activity. Normally all of this activity is deliberately not very synchronized, but when all of these neurons fire at the same time it generates an absence seizure. This study examines the mechanisms that keep this activity desynchronized and how the pattern of firing transitions from normal activity to producing a seizure. Knowing the way in which activity in the thalamus produces seizures could help with the development of better drugs to treat absence epilepsy.
Tuberous Sclerosis Complex (SC) is a genetic disorder that is characterized by growth of benign tumors in many organs, including the brain, where they are referred to as "tubers". However, the relationship between these tubers and seizures is not well understood. Previous research has shown that poorly formed tissue in and around the tuber can show abnormal electrical activity, suggesting they are responsible for seizures. The purpose of the present study is a.) to determine if there is a relation between the structure of the tuber tissue and epilepsy severity in SC patients, and B.) to determine if the tuber tissue becomes more abnormal over time, and to also look for a relation of tissue changes and epilepsy. This work would allow for a better understanding of the cause of epilepsy in SC.
Daniel Vitantonio Georgetown University, Washington, DC
Corticoid-cortical connections and dominant interdict spike initiation sites The contralto cortex is known to generate a 'mirror focus' of secondary seizure activity opposite to an existing seizure focus, but how early mirror sites form prior to emergence of seizures, and whether they promote development of seizure activity, remains unknown. Interdict spikes occur in epileptic tissue prior to and in between episodes of seizure activity, and are correlated with the area of seizure activity. We hypothesize that mirror sites of the interdict spike initiation sites interact to promote dominant initiation sites at fixed spatial areas. Frequent interdict spikes initiating from a dominant site in the brain may accumulate to promote seizure activity originating from the same site. In this study, interdict spike initiation sites are imaged in a whole animal model using voltage-sensitive dye imaging, and the formation of dominant initiation sites over time is examined. Electrical stimulation of the contralto cortex will be performed to manipulate the dominant initiation sites. The proposed study will contribute to understanding the spatial property of interdict spikes, which is important because fixed spatial patterns of frequent interdict spikes may accumulate over time to promote seizures.