Hal Blumenfeld, MD, PhD
Mark Loughridge and Michele Williams Professor of Neurology and Professor of Neuroscience and of NeurosurgeryCards
About
Titles
Mark Loughridge and Michele Williams Professor of Neurology and Professor of Neuroscience and of Neurosurgery
Director, Yale Clinical Neuroscience Imaging Center (CNIC)
Biography
Dr. Blumenfeld's clinical and research work focuses on epilepsy, cognition and brain imaging. He directs Yale's Clinical Neuroscience Imaging Center (CNIC), a new multi-disciplinary core facility for innovative study and treatment of brain disorders. Teaching activities include a textbook titled Neuroanatomy Through Clinical Cases, Sinauer Assoc., Publ. 2002, 2010, 2020.
Appointments
Neurology
ProfessorPrimaryNeuroscience
ProfessorSecondaryNeurosurgery
ProfessorSecondary
Other Departments & Organizations
- Blumenfeld Lab
- Center for Brain & Mind Health
- Center for Neuroepidemiology and Clinical Neurological Research
- Clinical Neurosciences Imaging Center (CNIC)
- Dean's Workshops
- Discovery to Cure Internship
- Epilepsy & Seizures
- Interdepartmental Neuroscience Program
- Kavli Institute for Neuroscience
- MR Center
- Neural Disorders
- Neurology
- Neuroscience
- Neuroscience Track
- Neurosurgery
- Pediatric Epilepsy Program
- Quantitative Neuroscience with Magnetic Resonance
- Wu Tsai Institute
- Yale Combined Program in the Biological and Biomedical Sciences (BBS)
- Yale Medicine
- Yale Ventures
Education & Training
- Associate Research Scientist
- Yale School of Medicine (2000)
- Fellow
- Yale School of Medicine (1998)
- Resident
- Massachusetts General Hospital (1996)
- PhD
- Columbia University (1992)
- MD
- Columbia University (1990)
Research
Overview
Expertise: Combined electrophysiology and neuroimaging Human functional neuroanatomy Epilepsy, human studies and animal models Cortical-subcortical mechanisms of consciousness.
For more information visit: http://www.yale.edu/blumenfeld/
Absence Epilepsy, EEG-fMRI and Attention
Absence seizures are brief episodes of staring and unresponsiveness. Seen most commonly in children, they can disrupt school and attention performance. The mechanisms for impaired attention in absence epilepsy are not known. To determine how brain networks are affected by absence seizures we perform simultaneous fMRI and EEG recordings in children during absence seizures. We also test attention both during seizures and under normal conditions. Our work has revealed abnormal activity in specific brain regions which may serve as new targets for treatment.
Neuronal Activity and Neuroimaging in Generalized Seizures
Are “generalized” seizures truly generalized? Our work using high field (9.4-11.7T)fMRI and electrophysiology recordings from animal models suggests that s ocalled generalized absence and tonic-clonic seizures are in fact localized to specific bilateral cortical-subcortical networks. These findings may help develop targeted therapies with better efficacy and fewer side effects. In addition our direct recordings of neuronal electrical activity improve the interpretation of indirect neuroimaging measurements of brain function.
Impaired Consciousness in Temporal Lobe Epilepsy
Temporal lobe seizures are the most common form of localized epilepsy. How do focal seizures impair consciousness? We propose a “network inhibition hypothesis” in which temporal lobe seizures inhibit subcortical arousal systems, causing depressed cortical function. In support of this hypothesis, we found sleep-like changes in the cortex with intracranial EEG and SPECT during temporal lobe seizures. We are now using high field (9.4 T, 11.7 T) fMRI,single neuron recordings, neurotransmitter studies, and optogenetic techniques in animal models to reveal the fundamental mechanisms of these changes, and to test novel treatment approaches.
Virtual Reality Driving Safety and other BedsideTesting in Epilepsy
One of the most devastating effects of altered consciousness in epilepsy is impaired driving safety. To determine how epileptic seizures affect performance, we use virtual-reality driving simulation during video/EEG monitoring while patients are in the hospital. In addition, we have developed a prospective bedside testing battery, the Responsiveness in Epilepsy Scale (RES). These testing methods provide better information to patients and physicians making decisions about driving, and may help identify brain areas crucial for impaired consciousness in epilepsy.
Technical Advances in Epilepsy Surgery Localization
Some patients have seizures that are so severe that they cannot be controlled by medicine. Many of these patients can be cured if we can identify a specific damaged region of the brain that can safely be removed and prevent the triggering of their seizures. We have recently developed novel approaches to target surgery to the correct location in the brain, including:(i) 3D color movies of the “brainwave” electroencephalogram (EEG) in patients with epilepsy show where the seizures start, making safe and effective surgery much more feasible; (ii) innovative methods using single photon emission computed tomography (SPECT) and positron emission tomography (PET) tracers can pinpoint the region of seizure onset for surgical planning.
Preventing Epilepsy
One crucial goal is the prevention of epilepsy before it even begins. We found in a genetic form of epilepsy that if we treat rat pups with anti-seizure medication from a very early age (even before seizures started) we greatly reduce their tendency to have seizures as adults. In addition, we found in a recent review of human studies of the same form of epilepsy that early and effective treatment may improve long-term outcome. This is a paradigm shift from current treatment strategies which view seizure medications as suppressing the symptoms, not the underlying disease. The findings also raise the hope that as genes are identified and enable epilepsy to be predicted, beneficial treatments may be started even before symptoms begin.
Medical Subject Headings (MeSH)
Academic Achievements and Community Involvement
Clinical Care
Overview
Hal Blumenfeld, MD, PhD, is a neurologist at Yale Medicine specializing in epilepsy. He is also the director of the Clinical Neuroscience Imaging Center at Yale School of Medicine.
Dr. Blumenfeld’s interest in the brain and consciousness began in college, where he majored in philosophy. He then studied medicine at Columbia University and completed his neurology residency at Massachusetts General Hospital. He arrived at Yale University in 1996 for his fellowship, where he was mentored by neurologists Susan and Dennis Spencer and has remained on the faculty ever since.
As a physician, Dr. Blumenfeld has a lot of empathy for his patients. “I think that one of the most important things about medicine is really trying to understand things from the patient’s viewpoint and to really care about what our patients are feeling,” he says.
Epilepsy patients in particular face unique challenges because their seizures are unpredictable and can have a severe impact on their lives. These episodes can be frightening, and Dr. Blumenfeld views his role of a physician as one who gives people back a sense of control by reducing seizures and minimizing treatment side effects.
To that end, Dr. Blumenfeld’s focus when working with patients is on developing the right treatment plan. He understands that each patient is unique and will react differently to medications and procedures.
In addition to seeing patients, Dr. Blumenfeld conducts research on treatments to restore consciousness during and after seizures for epilepsy patients. He is also the Mark Loughridge and Michele Williams Professor of Neurology, Professor of Neuroscience and of Neurosurgery at the Yale School of Medicine.
Clinical Specialties
Fact Sheets
Epilepsy in Children and Teens
Learn More on Yale MedicinePediatric Sepsis
Learn More on Yale MedicineMyasthenia Gravis
Learn More on Yale MedicineGuillain-Barré Syndrome
Learn More on Yale Medicine
Yale Medicine News
Links & Media
News
- May 02, 2023Source: Yale Scientific
A Staring Spell
- January 10, 2023
Study Identifies Neuronal Basis of Impaired Consciousness in Absence Epilepsy
- December 08, 2022Source: YaleNews
Eyes Offer a Window Into the Mystery of Human Consciousness
- December 06, 2022Source: Yale News
Eyes offer a window into the mystery of human consciousness