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Epilepsy Research: Its Scope and Challenge מחקר האפילפסיה: העתיד והאתגר by Jack M. Parent, M.D. U-M Comprehensive Epilepsy Center Department of Neurology University of Michigan Medical Center What kinds of things are being studied? Research related to epilepsy is remarkably broad and comprehensive, with programs in numerous university centers worldwide. Ongoing studies involve many scientific disciplines and areas of exploration. For example, neuroscientists study seizure-like activity of cells in a culture dish. Neurologists, radiologists, and physicists investigate new ways to view brain function in animals and humans. Nurses and physicians test experimental treatments for epilepsy. Why is it so hard to find answers? Research into epilepsy is especially challenging. The complexity of the brain limits our understanding of normal brain function, let alone how brain disturbances lead to epilepsy. To complicate matters further, the many different types of epilepsy have unique causes and consequences. This is because seizures, the defining symptom of epilepsy, may result from many different forms of abnormal brain function. Because there are literally hundreds of ways to induce seizures in the uninjured brain, figuring out the precise mechanisms in any specific form of epilepsy is a formidable undertaking. The many ways in which seizures can be produced also creates challenges for developing experimental models to study the different epilepsies. How can researchers be sure that the brain disturbance causing seizures in an animal being studied is the same kind of disturbance as in humans with a particular form of epilepsy? Despite the difficulty, however, research into epilepsy (and into nervous system function in general) has progressed at an astonishing pace over the past few decades. What are laboratory scientists working on? Laboratory research (so-called basic science) aims to answer many questions related to epilepsy. Currently, we do not understand how an injury to the brain, a defect in brain development, or a genetic abnormality leads to a specific form of epilepsy. In addition to studies of how specific changes in the brain eventually produce epilepsy (a process known as epileptogenesis), related investigations in many laboratories are directed at understanding how brief or prolonged seizures directly alter brain function. These include changes in gene expression, "rewiring" of brain connections, and the death or birth of specific brain cells. In terms of seizures themselves, researchers are studying how they start, spread, and stop; why certain types of seizures occur at specific ages or in response to distinct stimuli; and how antiepileptic medications work on brain cells to block seizures. To investigate these questions, scientists rely on many different animal models of epilepsy. That is, they study laboratory animals with spontaneous or provoked seizures to gain insight into the mechanisms underlying epilepsy in humans. Seizures involve interactions and connections between many brain areas. Therefore, mammals with intact nervous system function are typically more useful for studies of acute seizures or epileptogenesis than are experiments on cells grown in Petri dishes. Most animal studies use rodents (mainly rats and mice) because they are easy to work with, relatively inexpensive, and possess brain structures and responses to injury that are sufficiently similar to humans to allow useful conclusions to be drawn. What are clinical researchers working on? Clinical research involves scientific studies of people-both healthy ones and those with medical disorders. Clinical research related to epilepsy concentrates on the causes, diagnosis, and treatment of the different forms of epileptic disorders. The testing of new antiepileptic medications comprises a large portion of clinical epilepsy studies. Non-medicinal therapies are also being investigated, including new forms of brain surgery and methods of electrical brain stimulation. Brain imaging: Tools for viewing the structure and functioning of the brain ("neuroimaging"), such as magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and positron emission tomography (PET), are playing a rapidly expanding role in epilepsy diagnosis. Researchers are using these imaging tools in combination with electroencephalography (EEG) to improve the detection of brain abnormalities and to more precisely determine the locations where seizures begin. http://www.epilepsy.com/articles/ar_1064855158.html
Epilepsy Research: Its Scope and Challenge מחקר האפילפסיה: העתיד והאתגר by Jack M. Parent, M.D. U-M Comprehensive Epilepsy Center Department of Neurology University of Michigan Medical Center What kinds of things are being studied? Research related to epilepsy is remarkably broad and comprehensive, with programs in numerous university centers worldwide. Ongoing studies involve many scientific disciplines and areas of exploration. For example, neuroscientists study seizure-like activity of cells in a culture dish. Neurologists, radiologists, and physicists investigate new ways to view brain function in animals and humans. Nurses and physicians test experimental treatments for epilepsy. Why is it so hard to find answers? Research into epilepsy is especially challenging. The complexity of the brain limits our understanding of normal brain function, let alone how brain disturbances lead to epilepsy. To complicate matters further, the many different types of epilepsy have unique causes and consequences. This is because seizures, the defining symptom of epilepsy, may result from many different forms of abnormal brain function. Because there are literally hundreds of ways to induce seizures in the uninjured brain, figuring out the precise mechanisms in any specific form of epilepsy is a formidable undertaking. The many ways in which seizures can be produced also creates challenges for developing experimental models to study the different epilepsies. How can researchers be sure that the brain disturbance causing seizures in an animal being studied is the same kind of disturbance as in humans with a particular form of epilepsy? Despite the difficulty, however, research into epilepsy (and into nervous system function in general) has progressed at an astonishing pace over the past few decades. What are laboratory scientists working on? Laboratory research (so-called basic science) aims to answer many questions related to epilepsy. Currently, we do not understand how an injury to the brain, a defect in brain development, or a genetic abnormality leads to a specific form of epilepsy. In addition to studies of how specific changes in the brain eventually produce epilepsy (a process known as epileptogenesis), related investigations in many laboratories are directed at understanding how brief or prolonged seizures directly alter brain function. These include changes in gene expression, "rewiring" of brain connections, and the death or birth of specific brain cells. In terms of seizures themselves, researchers are studying how they start, spread, and stop; why certain types of seizures occur at specific ages or in response to distinct stimuli; and how antiepileptic medications work on brain cells to block seizures. To investigate these questions, scientists rely on many different animal models of epilepsy. That is, they study laboratory animals with spontaneous or provoked seizures to gain insight into the mechanisms underlying epilepsy in humans. Seizures involve interactions and connections between many brain areas. Therefore, mammals with intact nervous system function are typically more useful for studies of acute seizures or epileptogenesis than are experiments on cells grown in Petri dishes. Most animal studies use rodents (mainly rats and mice) because they are easy to work with, relatively inexpensive, and possess brain structures and responses to injury that are sufficiently similar to humans to allow useful conclusions to be drawn. What are clinical researchers working on? Clinical research involves scientific studies of people-both healthy ones and those with medical disorders. Clinical research related to epilepsy concentrates on the causes, diagnosis, and treatment of the different forms of epileptic disorders. The testing of new antiepileptic medications comprises a large portion of clinical epilepsy studies. Non-medicinal therapies are also being investigated, including new forms of brain surgery and methods of electrical brain stimulation. Brain imaging: Tools for viewing the structure and functioning of the brain ("neuroimaging"), such as magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and positron emission tomography (PET), are playing a rapidly expanding role in epilepsy diagnosis. Researchers are using these imaging tools in combination with electroencephalography (EEG) to improve the detection of brain abnormalities and to more precisely determine the locations where seizures begin. http://www.epilepsy.com/articles/ar_1064855158.html