2024
The human claustrum tracks slow waves during sleep
Lamsam L, Gu B, Liang M, Sun G, Khan K, Sheth K, Hirsch L, Pittenger C, Kaye A, Krystal J, Damisah E. The human claustrum tracks slow waves during sleep. Nature Communications 2024, 15: 8964. PMID: 39419999, PMCID: PMC11487173, DOI: 10.1038/s41467-024-53477-x.Peer-Reviewed Original Research
2022
Association of Serum Pyridoxal Phosphate Levels with Established Status Epilepticus
Rubinos C, Bruzzone MJ, Blodgett C, Tsai C, Patel P, Hianik R, Jadav R, Boudesseul J, Liu C, Zhu H, Wilson SE, Olm-Shipman C, Meeker R, Hirsch LJ. Association of Serum Pyridoxal Phosphate Levels with Established Status Epilepticus. Neurocritical Care 2022, 38: 41-51. PMID: 36071331, DOI: 10.1007/s12028-022-01579-z.Peer-Reviewed Original ResearchConceptsStatus epilepticusPyridoxal phosphate levelsPLP levelsPyridoxine deficiencyHigh prevalenceControl groupMethodsThis retrospective cohort studyIntensive care unit patientsYale-New Haven HospitalCritical illness severitySerum PLP levelsRetrospective cohort studyCare unit patientsNon-ICU inpatientsPhosphate levelsHistory of epilepsyRole of pyridoxineNorth Carolina HospitalsNew Haven HospitalUnit patientsCohort studyMedian ageIllness severityPyridoxine supplementationProspective study
2021
Brief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone
Yoo JY, Jetté N, Kwon C, Young J, Marcuse LV, Fields MC, Gaspard N, Hirsch LJ. Brief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone. Epilepsia 2021, 62: 742-751. PMID: 33576500, DOI: 10.1111/epi.16822.Peer-Reviewed Original ResearchConceptsParoxysmal fast activitySeizure onset zoneIctal rhythmic dischargesClinical significanceElectrographic seizuresSeizure activityRhythmic dischargesFast activityOnset zoneUncontrolled seizure activityPosterior dominant rhythmSimilar clinical significancePatient demographicsElectroencephalographic biomarkerLocalizing signFocal slowingClinical historySeizure riskEEG backgroundPatientsAdult cohortDominant rhythmSeizuresDistinct entityEEG biomarkers
2020
Development and validation of a predictive model of drug-resistant genetic generalized epilepsy.
Choi H, Detyniecki K, Bazil C, Thornton S, Crosta P, Tolba H, Muneeb M, Hirsch LJ, Heinzen EL, Sen A, Depondt C, Perucca P, Heiman GA, Adcock J, Andrade D, Cavalleri G, Costello D, Delanty N, Dugan P, Goldstein D, Kwan P, Nascimento F, O’Brien T, Radthke R, Smith P, Thomas R. Development and validation of a predictive model of drug-resistant genetic generalized epilepsy. Neurology 2020, 95: e2150-e2160. PMID: 32759205, PMCID: PMC7713754, DOI: 10.1212/wnl.0000000000010597.Peer-Reviewed Original ResearchConceptsGenetic generalized epilepsyCatamenial epilepsyGeneralized epilepsyPsychiatric conditionsOngoing longitudinal observational studyGeneralized tonic clonicTertiary epilepsy centerNegative prognostic factorCase-control studyLongitudinal observational studyClinical prediction modelAED resistanceTonic clonicPrognostic factorsSeizure typesEpilepsy centersAntiepileptic drugsAbsence seizuresObservational studyOngoing longitudinal studyEpilepsyCase statusAED responsePatientsExternal testing datasetNine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy
Nair DR, Laxer KD, Weber PB, Murro AM, Park YD, Barkley GL, Smith BJ, Gwinn RP, Doherty MJ, Noe KH, Zimmerman RS, Bergey GK, Anderson WS, Heck C, Liu CY, Lee RW, Sadler T, Duckrow RB, Hirsch LJ, Wharen RE, Tatum W, Srinivasan S, McKhann GM, Agostini MA, Alexopoulos AV, Jobst BC, Roberts DW, Salanova V, Witt TC, Cash SS, Cole AJ, Worrell GA, Lundstrom BN, Edwards JC, Halford JJ, Spencer DC, Ernst L, Skidmore CT, Sperling MR, Miller I, Geller EB, Berg MJ, Fessler AJ, Rutecki P, Goldman AM, Mizrahi EM, Gross RE, Shields DC, Schwartz TH, Labar DR, Fountain NB, Elias WJ, Olejniczak PW, Villemarette-Pittman NR, Eisenschenk S, Roper SN, Boggs JG, Courtney TA, Sun FT, Seale CG, Miller KL, Skarpaas TL, Morrell MJ. Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy. Neurology 2020, 95: 10.1212/wnl.0000000000010154. PMID: 32690786, PMCID: PMC7538230, DOI: 10.1212/wnl.0000000000010154.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedDepressive DisorderDrug Resistant EpilepsyElectric Stimulation TherapyEpilepsies, PartialFemaleFollow-Up StudiesHumansImplantable NeurostimulatorsIntracranial HemorrhagesMaleMemory DisordersMiddle AgedProspective StudiesProsthesis-Related InfectionsQuality of LifeRandomized Controlled Trials as TopicStatus EpilepticusSudden Unexpected Death in EpilepsySuicideTreatment OutcomeYoung AdultConceptsBrain-responsive neurostimulationQuality of lifeFocal onset seizuresAdverse eventsSeizure frequencyIntractable focal onset seizuresProspective open-label trialOverall QOLOpen-label trialSerious adverse eventsClass IV evidenceMedian percent reductionSudden unexplained deathMedian percent changeSeizure-free periodQOLIE-89SUDEP ratesLabel trialSeizure freedomEpilepsy ratesFocal seizuresOnset seizuresEpilepsy InventoryAcceptable safetyFocal epilepsyBeyond implantation effect? Long-term seizure reduction and freedom following intracranial monitoring without additional surgical interventions
Percy J, Zaveri H, Duckrow RB, Gerrard J, Farooque P, Hirsch LJ, Spencer DD, Sivaraju A. Beyond implantation effect? Long-term seizure reduction and freedom following intracranial monitoring without additional surgical interventions. Epilepsy & Behavior 2020, 111: 107231. PMID: 32615416, DOI: 10.1016/j.yebeh.2020.107231.Peer-Reviewed Original ResearchConceptsLong-term seizure freedomSeizure freedomSeizure frequencyElectrode implantationIntracranial studiesLong-term seizure reductionAdditional surgical interventionSeizure onset localizationIntracranial electroencephalogram monitoringSeizure reductionConsecutive patientsSurgical interventionEpileptogenic networksElectroencephalogram monitoringNeuromodulatory effectsRetrospective analysisIntracranial monitoringTransient improvementDepth electrodesPatientsYear 4ImplantationAdequate dataYearsAssessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures
Tatum WO, Hirsch LJ, Gelfand MA, Acton EK, LaFrance WC, Duckrow RB, Chen DK, Blum AS, Hixson JD, Drazkowski JF, Benbadis SR, Cascino GD. Assessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures. JAMA Neurology 2020, 77: 593-600. PMID: 31961382, PMCID: PMC6990754, DOI: 10.1001/jamaneurol.2019.4785.Peer-Reviewed Original ResearchConceptsPhysical examination resultsPsychogenic nonepileptic attacksVideo electroencephalogram monitoringEpileptic seizuresVideo electroencephalogramEpilepsy centersPhysical examinationElectroencephalogram monitoringNonepileptic attacksCorrect diagnosisPhysiologic nonepileptic eventsEvaluation of epilepsyExamination resultsMisdiagnosis of epilepsyDiagnostic accuracy studiesPsychogenic attacksMotor signsNonepileptic eventsDefinitive diagnosisPatient historyMAIN OUTCOMEClinic outpatientsPredictive valueSeizuresDiagnosisMesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system
Hirsch LJ, Mirro EA, Salanova V, Witt TC, Drees CN, Brown M, Lee RW, Sadler TL, Felton EA, Rutecki P, Shin HW, Hadar E, Hegde M, Rao VR, Mnatsakanyan L, Madhavan DS, Zakaria TJ, Liu AA, Heck CN, Greenwood JE, Bigelow JK, Nair DR, Alexopoulos AV, Mackow M, Edwards JC, Sotudeh N, Kuzniecky RI, Gwinn RP, Doherty MJ, Geller EB, Morrell MJ. Mesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system. Epilepsia 2020, 61: 408-420. PMID: 32072621, PMCID: PMC7154711, DOI: 10.1111/epi.16442.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnterior Temporal LobectomyDrug Resistant EpilepsyElectric Stimulation TherapyElectrocorticographyEpilepsy, Temporal LobeFemaleHumansImplantable NeurostimulatorsMaleMiddle AgedMonitoring, AmbulatoryNeurosurgical ProceduresRetrospective StudiesTemporal LobeTreatment OutcomeYoung AdultConceptsMTL resectionElectrographic seizuresTemporal lobe seizure onsetClinical seizure reductionMesial temporal resectionIntracranial EEG monitoringRNS SystemBitemporal epilepsySeizure reductionSeizure outcomeTemporal resectionPrimary outcomeRefractory epilepsyAdditional patientsEpilepsy centersUnilateral onsetBilateral onsetIcEEG recordingsSeizure onsetMTL epilepsyMedian reductionResectionPatientsEEG monitoringIcEEG data
2019
Continuous EEG Findings in Autoimmune Encephalitis.
Moise AM, Karakis I, Herlopian A, Dhakar M, Hirsch LJ, Cotsonis G, LaRoche S, Cabrera Kang CM, Westover B, Rodriguez A. Continuous EEG Findings in Autoimmune Encephalitis. Journal Of Clinical Neurophysiology 2019, 38: 124-129. PMID: 31800465, PMCID: PMC7263965, DOI: 10.1097/wnp.0000000000000654.Peer-Reviewed Original ResearchConceptsNew-onset refractory status epilepticusRefractory status epilepticusRhythmic delta activityGeneralized rhythmic delta activityAutoimmune encephalitisStatus epilepticusDelta activityPoor outcomeAE subtypeFast activityAntibody-negative autoimmune encephalitisN-methyl-D-aspartate receptorsDefinite limbic encephalitisExtreme delta brushMulticenter retrospective reviewNew-onset seizuresContinuous EEG monitoringGlutamic acid decarboxylaseVoltage-gated potassium channelsLimbic encephalitisRetrospective reviewAE patientsElectrographic seizuresDelta brushEEG findingsComparison of machine learning models for seizure prediction in hospitalized patients
Struck AF, Rodriguez‐Ruiz A, Osman G, Gilmore EJ, Haider HA, Dhakar MB, Schrettner M, Lee JW, Gaspard N, Hirsch LJ, Westover MB, Consortium C. Comparison of machine learning models for seizure prediction in hospitalized patients. Annals Of Clinical And Translational Neurology 2019, 6: 1239-1247. PMID: 31353866, PMCID: PMC6649418, DOI: 10.1002/acn3.50817.Peer-Reviewed Original ResearchConceptsLow-risk patientsNegative predictive valueEvaluation cohortContinuous EEGElastic net logistic regressionMulticenter databaseRisk stratificationSeizure riskPatientsPredictive valueComparable AUCSecondary analysisLogistic regressionCohortFirst hourSeizure predictionEEG recordingsEEGRisk calibrationLarge proportionSeizuresComplex neural networksAdherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures.
Tolchin B, Dworetzky BA, Martino S, Blumenfeld H, Hirsch LJ, Baslet G. Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures. Neurology 2019, 92: e675-e679. PMID: 30610097, PMCID: PMC6382361, DOI: 10.1212/wnl.0000000000006848.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAdult Survivors of Child AbuseAgedAged, 80 and overCohort StudiesConversion DisorderEmergency Service, HospitalEthnicityFemaleFollow-Up StudiesHumansMaleMiddle AgedMinority GroupsOdds RatioProspective StudiesPsychotherapyQuality of LifeSeizuresTreatment Adherence and ComplianceTreatment OutcomeYoung AdultConceptsPsychogenic nonepileptic seizuresQuality of lifePNES frequencyNonepileptic seizuresProspective cohort studyEmergency department utilizationTime of referralBaseline characteristicsCohort studyED visitsSeizure frequencyED utilizationPotential confoundersWomen's HospitalTreatment outcomesMedium effect sizeLocal therapistsMultivariate modelAdherenceChildhood abuseSeizuresHospitalSignificant reductionOutcomesEffect size
2018
Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy
Detyniecki K, O'Bryan J, Choezom T, Rak G, Ma C, Zhang S, Bonito J, Hirsch LJ. Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy. Epilepsy & Behavior 2018, 88: 349-356. PMID: 30344026, DOI: 10.1016/j.yebeh.2018.09.035.Peer-Reviewed Original ResearchConceptsRescue medication useProspective observational studyEmergency department visitsHigh seizure frequencySeizure clustersAdult patientsRescue medicationClinical characteristicsSeizure frequencyActive epilepsyDepartment visitsMedication useObservational studyExact testSeizure-related outcomesFisher's exact testLogistic regression modelsSeizure clusteringAdverse outcomesEpilepsy severitySeizure diariesIndividual patientsPatientsEpilepsyFinal analysisCross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use
Chen B, Choi H, Hirsch LJ, Legge A, Buchsbaum R, Detyniecki K. Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use. Seizure 2018, 62: 38-42. PMID: 30273800, DOI: 10.1016/j.seizure.2018.09.014.Peer-Reviewed Original ResearchConceptsBehavioral side effectsMore antiepileptic drugsAntiepileptic drugsSide effectsAdult patientsSpecific antiepileptic drugsAntiepileptic drug useCertain antiepileptic drugsHistory of depressionAED usePatientsDrug useSignificant predictorsSignificant increasePsychosisDepressionZNSConfoundersEpilepsyDoseSeizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram
Joshi RB, Duckrow RB, Goncharova II, Gerrard JL, Spencer DD, Hirsch LJ, Godwin DW, Zaveri HP. Seizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram. Epilepsia 2018, 59: 2075-2085. PMID: 30187919, DOI: 10.1111/epi.14559.Peer-Reviewed Original ResearchConceptsAED taperYale-New Haven HospitalAdult epilepsy patientsSeizure forecasting algorithmsElectrode contact pairsSeizure onset areaSeizure susceptibilityClinical recordsDrug taperElectrophysiological changesEpilepsy patientsIntracranial electroencephalographic dataMagnitude-squared coherenceModulatory activitySeizuresPatientsOnset areaPreseizurePostseizureProgressive desynchronizationIntracranial electroencephalogramDaysIctogenesisEffect of timeHospitalSeizure cluster: Definition, prevalence, consequences, and management
Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K. Seizure cluster: Definition, prevalence, consequences, and management. Seizure 2018, 68: 9-15. PMID: 29871784, DOI: 10.1016/j.seizure.2018.05.013.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedChildChild, PreschoolEpilepsyHumansInfantMiddle AgedSeizuresYoung AdultConceptsRescue medicationSeizure clustersAcute managementEpilepsy patientsRectal diazepam gelTertiary epilepsy centerEmergency room visitsHealth care utilizationRefractory epilepsy patientsQuality of lifeAcute seizuresBuccal midazolamClinical characteristicsMost patientsCare utilizationEpilepsy centersRoom visitsRisk factorsOnly FDAHigh riskMedicationsPatientsSeizuresPrevalenceCaregivers
2017
The importance of early immunotherapy in patients with faciobrachial dystonic seizures
Thompson J, Bi M, Murchison AG, Makuch M, Bien CG, Chu K, Farooque P, Gelfand JM, Geschwind MD, Hirsch LJ, Somerville E, Lang B, Vincent A, Leite MI, Waters P, Irani SR, Dogan-Onugoren M, Rae-Grant A, Illes Z, Szots M, Malter M, Widman G, Surges R, Archibald N, Reid J, Duncan C, Richardson A, Lilleker J, Iorio R, Blaabjerg M, Abeler K, Shin Y. The importance of early immunotherapy in patients with faciobrachial dystonic seizures. Brain 2017, 141: 348-356. PMID: 29272336, PMCID: PMC5837230, DOI: 10.1093/brain/awx323.Peer-Reviewed Original ResearchMeSH KeywordsADAM ProteinsAdultAgedAged, 80 and overAnalysis of VarianceAntibodiesAnticonvulsantsCognition DisordersDisabled PersonsFemaleFlow CytometryFollow-Up StudiesGreen Fluorescent ProteinsHEK293 CellsHumansImmunotherapyIntracellular Signaling Peptides and ProteinsLimbic EncephalitisMaleMiddle AgedNerve Tissue ProteinsProtein TransportProteinsRetrospective StudiesSeizuresSurveys and QuestionnairesTransfectionYoung AdultConceptsFaciobrachial dystonic seizuresDystonic seizuresCognitive impairmentAddition of immunotherapySerum sodium levelsNormal brain MRIEarly immunotherapyLGI1 antibodiesLimbic encephalitisEpileptogenic mechanismsConsecutive patientsAntiepileptic drugsNormal patientsBrain MRIPatientsSodium levelsImmunotherapyIgG1 antibodiesSeizuresNormal cognitionImpairmentEarly cessationCessationAntibodiesComplex internalizationPresurgical language fMRI: Mapping of six critical regions
Benjamin CF, Walshaw PD, Hale K, Gaillard WD, Baxter LC, Berl MM, Polczynska M, Noble S, Alkawadri R, Hirsch LJ, Constable RT, Bookheimer SY. Presurgical language fMRI: Mapping of six critical regions. Human Brain Mapping 2017, 38: 4239-4255. PMID: 28544168, PMCID: PMC5518223, DOI: 10.1002/hbm.23661.Peer-Reviewed Original ResearchConceptsLanguage lateralityWernicke's areaLanguage regionsBasal temporal language areaHum Brain MappTemporal language areaTumor patientsLanguage cortexIndependent cliniciansClinical fMRIExperienced cliniciansCliniciansLanguage mappingLanguage-critical areasSpeech areasAngular gyrusExner's areaLateralityFMRI taskBroca's areaBlind reviewNeurosurgical planningLanguage areasClinical neuropsychologistsFMRI dataBrief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults
Yoo JY, Marcuse LV, Fields MC, Rosengard JL, Traversa MV, Gaspard N, Hirsch LJ. Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults. Journal Of Clinical Neurophysiology 2017, 34: 222-229. PMID: 28463933, DOI: 10.1097/wnp.0000000000000357.Peer-Reviewed Original ResearchConceptsIctal rhythmic dischargesIll adultsRhythmic dischargesSeizure onset areaAdult patientsElectrographic characteristicsStatus epilepticusAcute findingsIll patientsRefractory epilepsyClinical historySeizure onsetClinical significanceEpileptiform dischargesAmbulatory settingPatientsBenign patternControl groupEpilepsyRhythmic activityOnset areaAlpha activityAdultsBrief runsEEG recordingsPrevalence and risk factors of seizure clusters in adult patients with epilepsy
Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Wong RA, Jiang A, Kato K, Buchsbaum R, Detyniecki K. Prevalence and risk factors of seizure clusters in adult patients with epilepsy. Epilepsy Research 2017, 133: 98-102. PMID: 28475999, DOI: 10.1016/j.eplepsyres.2017.04.016.Peer-Reviewed Original ResearchConceptsSymptomatic generalized epilepsyIdiopathic generalized epilepsySeizure clustersEpilepsy typeStatus epilepticusCortical dysplasiaGeneralized epilepsyFocal epilepsySeizure onsetCNS infectionSeizure freedomMore AEDsRisk factorsCentral nervous system infectionCongenital brain injuryEpilepsy risk factorsNervous system infectionPotential clinical factorsComplex partial seizuresEarly seizure onsetEpilepsy detailsRescue medicationAdult patientsPatient demographicsSystem infectionBrain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy
Geller EB, Skarpaas TL, Gross RE, Goodman RR, Barkley GL, Bazil CW, Berg MJ, Bergey GK, Cash SS, Cole AJ, Duckrow RB, Edwards JC, Eisenschenk S, Fessler J, Fountain NB, Goldman AM, Gwinn RP, Heck C, Herekar A, Hirsch LJ, Jobst BC, King‐Stephens D, Labar DR, Leiphart JW, Marsh WR, Meador KJ, Mizrahi EM, Murro AM, Nair DR, Noe KH, Park YD, Rutecki PA, Salanova V, Sheth RD, Shields DC, Skidmore C, Smith MC, Spencer DC, Srinivasan S, Tatum W, Van Ness PC, Vossler DG, Wharen RE, Worrell GA, Yoshor D, Zimmerman RS, Cicora K, Sun FT, Morrell MJ. Brain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia 2017, 58: 994-1004. PMID: 28398014, DOI: 10.1111/epi.13740.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyMesial temporal sclerosisSeizure-free periodTemporal lobe epilepsySeizure reductionAdverse eventsLobe epilepsyIntractable mesial temporal lobe epilepsySerious device-related adverse eventsIntractable partial-onset seizuresMedian percent seizure reductionMesial temporal lobe originBilateral mesial temporal lobe epilepsyDevice-related adverse eventsBrain-responsive neurostimulationImplant site infectionPercent seizure reductionPartial-onset seizuresProspective clinical trialsTemporal lobe originVagus nerve stimulationEffective treatment optionPercent of subjectsPreimplantation baselineTemporal sclerosis