Post-Traumatic Epilepsy

Evaluation of the impact of cerebral contusions on brain network dysfunction and epileptogenesis among patients post-traumatic epilepsy (PTE)

Sponsor Name:  Department of Defense Epilepsy Research Program Idea Development Award     

ABSTRACT

Traumatic brain injury (TBI) is a leading cause of acquired epilepsy. In veterans, 57% of seizures can be linked to TBI. Seizures not only account for heightened morbidity and mortality following TBI, but also remain the leading cause of death several years following TBI. The underlying mechanisms that may contribute to PTE are poorly understood making PTE more likely to be refractory to both medical and surgical treatments.  In addition, PTE are heterogeneous.  The injury mechanism and severity can vary a great deal and the seizure onset zone may be multifocal and differ among patients. These characteristics of PTE makes the investigation of its pathophysiology challenging. Here we propose to study the epileptogenesis of PTE among patients with cerebral contusions from close head injuries by quantitatively measure both regional and global changes in brain networks. Our underlying hypothesis is that cerebral contusions result in regional atrophic changes in brain parenchyma and global increase in network connectivity, which may in turn lead to seizures. In order to quantitatively measure these changes, we construct structural and functional connectomes from diffusion tensor images and resting state functional magnetic resonance images, respectively. Advanced mathematical tools such as graph theory will be used to generate metrics to capture the pathological changes in connectomics related to PTE. We plan to compare these changes among patients with PTE, patients with history of TBI no seizures and normal controls. These changes in connectomics may serve as biomarkers for predicting the development of PTE.