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Our research focuses on the analysis of the electroencephalographic changes that occur in patients with intractable seizures. In past work, we have used mathematical algorithms, especially neural networks and clustering algorithms, to enhance the ability to detect ictal and interictal epileptiform activity.
Our current work stems from our observations on patients who have implanted subdural electrodes. In these patients, cortical stimulation often is performed in order to localize regions subsuming motor, sensory, or language functions. When stimulating, afterdischarges often can occur, and these interfere with localization. We found that repeat pulses of stimulation, brief in duration, could terminate these afterdischarges; we call these pulse sequences brief pulse stimulation (BPS).
We have been studying these phenomena further and have found that the success of BPS depends in part, but not completely, upon the phase of the discharge at which stimulation begins. Our current work focuses on determining the circumstances under which BPS can terminate afterdischarges, and in particular on the role of synchrony in the occurrence and termination of afterdischarges. It also focuses on the factors that underlie initiation of spontaneous seizure activity in patients with epilepsy. Finally, together with colleagues at Georgetown University and the National Institutes of Health, we are studying the use of stimulation and of hypothermia as treatments for seizures.