Prediction of Seizure Recurrence. A Note of Caution

Bosl, William J.; Leviton, Alan; Loddenkemper, Tobias

doi:10.3389/fneur.2021.675728

Cited by 12 publications

(7 citation statements)

References 164 publications

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“…The fact that the very definition of epilepsy depends on seizure recurrence poses a diagnostic challenge. Predicting seizure recurrence after an initial brain insult is still a subject of scientific debate ( 50 ). Some progress has already been achieved in this light, as there are now suggested indicators to identify neurocysticercosis patients who are likely to develop epilepsy: those with a strong serologic response (4 bands to Taenia solium antigen on neurocysticercosis enzyme-linked immunoelectrotransfer blot (EITB) ( 39 ).…”

Section: Specific Neurological Disturbances Related To Neuroinflammat...mentioning

confidence: 99%

The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa

et al. 2022

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Neurological disorders related to neuroinfections are highly prevalent in Sub-Saharan Africa (SSA), constituting a major cause of disability and economic burden for patients and society. These include epilepsy, dementia, motor neuron diseases, headache disorders, sleep disorders, and peripheral neuropathy. The highest prevalence of human immunodeficiency virus (HIV) is in SSA. Consequently, there is a high prevalence of neurological disorders associated with HIV infection such as HIV-associated neurocognitive disorders, motor disorders, chronic headaches, and peripheral neuropathy in the region. The pathogenesis of these neurological disorders involves the direct role of the virus, some antiretroviral treatments, and the dysregulated immune system. Furthermore, the high prevalence of epilepsy in SSA (mainly due to perinatal causes) is exacerbated by infections such as toxoplasmosis, neurocysticercosis, onchocerciasis, malaria, bacterial meningitis, tuberculosis, and the immune reactions they elicit. Sleep disorders are another common problem in the region and have been associated with infectious diseases such as human African trypanosomiasis and HIV and involve the activation of the immune system. While most headache disorders are due to benign primary headaches, some secondary headaches are caused by infections (meningitis, encephalitis, brain abscess). HIV and neurosyphilis, both common in SSA, can trigger long-standing immune activation in the central nervous system (CNS) potentially resulting in dementia. Despite the progress achieved in preventing diseases from the poliovirus and retroviruses, these microbes may cause motor neuron diseases in SSA. The immune mechanisms involved in these neurological disorders include increased cytokine levels, immune cells infiltration into the CNS, and autoantibodies. This review focuses on the major neurological disorders relevant to Africa and neuroinfections highly prevalent in SSA, describes the interplay between neuroinfections, immune system, neuroinflammation, and neurological disorders, and how understanding this can be exploited for the development of novel diagnostics and therapeutics for improved patient care.

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Section: Specific Neurological Disturbances Related To Neuroinflammat...mentioning

confidence: 99%

The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa

et al. 2022

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“…Open Sci. 9: 220374 studies [73]. It is known that mammalian physiology and behaviour are widely influenced by light and other environmental factors, which means circadian or multidien studies require well-developed protocols before the study is conducted [74].…”

Section: Learning Patient-specific Patternsmentioning

confidence: 99%

“…Circadian (days) and multidien (multi-days) seizure cycles have also recently been studied with patient self-reported diaries and retrospectively on some long-term intracranial EEG data, which show peaks in seizure cycles as long as 30 days apart [ 69 – 72 ]. Whether the observed cycles are valid and whether they can be linked to triggers such as missed medication, mental and emotional states, the menstrual cycle, and the duration and severity of seizures require objective and prospective studies [ 73 ]. It is known that mammalian physiology and behaviour are widely influenced by light and other environmental factors, which means circadian or multidien studies require well-developed protocols before the study is conducted [ 74 ].…”

Section: Introductionmentioning

confidence: 99%

Weak self-supervised learning for seizure forecasting: a feasibility study

et al. 2022

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This paper proposes an artificial intelligence system that continuously improves over time at event prediction using initially unlabelled data by using self-supervised learning. Time-series data are inherently autocorrelated. By using a detection model to generate weak labels on the fly, which are concurrently used as targets to train a prediction model on a time-shifted input data stream, this autocorrelation can effectively be harnessed to reduce the burden of manual labelling. This is critical in medical patient monitoring, as it enables the development of personalized forecasting models without demanding the annotation of long sequences of physiological signal recordings. We perform a feasibility study on seizure prediction, which is identified as an ideal test case, as pre-ictal brainwaves are patient-specific, and tailoring models to individual patients is known to improve forecasting performance significantly. Our self-supervised approach is used to train individualized forecasting models for 10 patients, showing an average relative improvement in sensitivity by 14.30% and a reduction in false alarms by 19.61% in early seizure forecasting. This proof-of-concept on the feasibility of using a continuous stream of time-series neurophysiological data paves the way towards a low-power neuromorphic neuromodulation system.

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“…16,46,58,59 Whether the observed cycles are real and whether they can be linked to missed medication, mental and emotional states, the menstrual cycle, and the duration and severity of seizures need objective and ultra-long EEG data on a scale of months and years. 60 One observation is that mammalian physiology and behavior is widely influenced by light and other environmental factors, which means circadian or multidien studies require well-developed protocols. 61…”

Section: Perspective and Future Workmentioning

confidence: 99%