2023
Outcomes in Patients With Poststroke Seizures
Misra S, Kasner S, Dawson J, Tanaka T, Zhao Y, Zaveri H, Eldem E, Vazquez J, Silva L, Mohidat S, Hickman L, Khan E, Funaro M, Nicolo J, Mazumder R, Yasuda C, Sunnerhagen K, Ihara M, Ross J, Liebeskind D, Kwan P, Quinn T, Engel J, Mishra N. Outcomes in Patients With Poststroke Seizures. JAMA Neurology 2023, 80: 1155-1165. PMID: 37721736, PMCID: PMC10507596, DOI: 10.1001/jamaneurol.2023.3240.Peer-Reviewed Original ResearchConceptsPoststroke seizuresPoor functional outcomeLate seizuresEarly seizuresStroke subtypesFunctional outcomeOdds ratioSystematic reviewJoanna Briggs Institute toolsHemorrhagic stroke subtypesOutcomes of patientsHistory of strokeTrials of interventionsRisk of biasMeta-Analyses (PRISMA) checklistPreferred Reporting ItemsMeta-regression analysisWeb of ScienceRecurrent strokeGreater disabilityPoor outcomeDementia riskSubgroup analysisBias assessmentEgger's testQuantitative assessment of burst suppression as a predictor of seizure recurrence in refractory status epilepticus
Fong M, Pu K, Jadav R, Khan T, Hirsch L, Zaveri H. Quantitative assessment of burst suppression as a predictor of seizure recurrence in refractory status epilepticus. Clinical Neurophysiology 2023, 150: 98-105. PMID: 37060844, PMCID: PMC11265649, DOI: 10.1016/j.clinph.2023.03.011.Peer-Reviewed Original ResearchSeizure forecasting: Where do we stand?
Andrzejak R, Zaveri H, Schulze‐Bonhage A, Leguia M, Stacey W, Richardson M, Kuhlmann L, Lehnertz K. Seizure forecasting: Where do we stand? Epilepsia 2023, 64: s62-s71. PMID: 36780237, PMCID: PMC10423299, DOI: 10.1111/epi.17546.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2021
Small loci of astroglial glutamine synthetase deficiency in the postnatal brain cause epileptic seizures and impaired functional connectivity
Farina MG, Sandhu MRS, Parent M, Sanganahalli BG, Derbin M, Dhaher R, Wang H, Zaveri HP, Zhou Y, Danbolt NC, Hyder F, Eid T. Small loci of astroglial glutamine synthetase deficiency in the postnatal brain cause epileptic seizures and impaired functional connectivity. Epilepsia 2021, 62: 2858-2870. PMID: 34536233, PMCID: PMC9006438, DOI: 10.1111/epi.17072.Peer-Reviewed Original ResearchConceptsPostnatal brainFunctional connectivityContinuous video-electroencephalographic recordingSpontaneous recurrent seizuresPathogenesis of epilepsyGlutamine synthetase deficiencyVideo-electroencephalographic recordingsSpecific animal modelsEx vivo studySeizure thresholdAdult patientsRecurrent seizuresFocal epilepsyAdeno-associated virusHippocampal formationAnimal modelsFocal mannerEpileptic seizuresGS deficiencySmall lociSynthetase deficiencyEpilepsyGradual returnVivo studiesBrainIncreased branched‐chain amino acids at baseline and hours before a spontaneous seizure in the human epileptic brain
Ong C, Damisah EC, Gruenbaum SE, Dhaher R, Deng Y, Sandhu MRS, Zaveri HP, Spencer DD, Eid T. Increased branched‐chain amino acids at baseline and hours before a spontaneous seizure in the human epileptic brain. Epilepsia 2021, 62: e88-e97. PMID: 33949690, PMCID: PMC11259155, DOI: 10.1111/epi.16920.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAmino Acids, Branched-ChainBrain ChemistryChildChild, PreschoolChromatography, High Pressure LiquidDrug Resistant EpilepsyElectrocorticographyElectroencephalographyEpilepsies, PartialExtracellular SpaceFemaleGlutamic AcidHumansIsoleucineMaleMicrodialysisMiddle AgedSeizuresTandem Mass SpectrometryYoung AdultConceptsSpontaneous seizuresDrug-resistant focal epilepsyExtracellular brain glutamateHuman epileptic brainBranched-chain amino acidsBranched chain amino acids valineRefractory epilepsyBrain microdialysisGlutamatergic neurotransmissionFocal epilepsySeizure onsetBrain glutamateEpileptic brainHuman patientsSeizuresBrain regionsDialysis samplesMammalian targetEpilepsyLiquid chromatography-tandem mass spectrometryBaselineBCAAIntracranial electroencephalographyChromatography-tandem mass spectrometryPatientsNetwork-Related Changes in Neurotransmitters and Seizure Propagation During Rodent Epileptogenesis
Dhaher R, Gruenbaum SE, Sandhu MRS, Ottestad-Hansen S, Tu N, Wang Y, Lee TW, Deshpande K, Spencer DD, Danbolt NC, Zaveri HP, Eid T. Network-Related Changes in Neurotransmitters and Seizure Propagation During Rodent Epileptogenesis. Neurology 2021, 96: e2261-e2271. PMID: 33722994, PMCID: PMC8166437, DOI: 10.1212/wnl.0000000000011846.Peer-Reviewed Original ResearchConceptsSpontaneous seizuresSeizure propagationSeizure focusMesial temporal lobe epilepsyExtracellular brain levelsTemporal lobe epilepsyExtracellular glutamate levelsRelevant rodent modelsGlutamine synthetase inhibitor methionine sulfoximineTransporter subtype 1Contralateral hippocampusLobe epilepsyBrain levelsBrain microdialysisExtracellular GABANeurotransmitter levelsSeizure initiationGlutamate levelsSeizure onsetEpilepsy networkRodent modelsSubtype 1EpileptogenesisHippocampusBrain regions
2020
Beyond 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 dataYearsOral glutamine supplementation increases seizure severity in a rodent model of mesial temporal lobe epilepsy
Dhaher R, Chen EC, Perez E, Rapuano A, Sandhu MRS, Gruenbaum SE, Deshpande K, Dai F, Zaveri HP, Eid T. Oral glutamine supplementation increases seizure severity in a rodent model of mesial temporal lobe epilepsy. Nutritional Neuroscience 2020, 25: 64-69. PMID: 31900092, PMCID: PMC8970572, DOI: 10.1080/1028415x.2019.1708568.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyOral glutamine supplementationSeverity of seizuresTemporal lobe epilepsyGlutamine supplementationSeizure severityLobe epilepsyRefractory mesial temporal lobe epilepsyMale Sprague-DawleySeizure frequencyConvulsive seizuresSeizure propagationEpilepsy modelSprague-DawleyEffective treatmentRodent modelsSeizuresSupplementationSeverityPotential roleEpilepsyFunction mutationsHippocampusGlutamine synthetaseDays
2019
Slowing less than 1 Hz is decreased near the seizure onset zone
Lundstrom BN, Boly M, Duckrow R, Zaveri HP, Blumenfeld H. Slowing less than 1 Hz is decreased near the seizure onset zone. Scientific Reports 2019, 9: 6218. PMID: 30996228, PMCID: PMC6470162, DOI: 10.1038/s41598-019-42347-y.Peer-Reviewed Original ResearchConceptsSeizure onset zoneOnset zoneFocal slowingFocal cerebral dysfunctionLocation of dysfunctionFocal epilepsy patientsSlow wave activitySlow oscillationsLocal synaptic strengthsSlow oscillation activityCerebral dysfunctionReduced inhibitory activityPostictal statePostictal slowingEpilepsy patientsModulatory effectsSynaptic strengthDelta frequencyCortical mechanismsIntracranial recordingsDistinct neural mechanismsIntracranial electroencephalographyNeural mechanismsDysfunctionSleepEffects of Branched-Chain Amino Acid Supplementation on Spontaneous Seizures and Neuronal Viability in a Model of Mesial Temporal Lobe Epilepsy
Gruenbaum SE, Dhaher R, Rapuano A, Zaveri HP, Tang A, de Lanerolle N, Eid T. Effects of Branched-Chain Amino Acid Supplementation on Spontaneous Seizures and Neuronal Viability in a Model of Mesial Temporal Lobe Epilepsy. Journal Of Neurosurgical Anesthesiology 2019, 31: 247-256. PMID: 29620688, PMCID: PMC6170745, DOI: 10.1097/ana.0000000000000499.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyTemporal lobe epilepsyLobe epilepsySpontaneous seizuresNeuron lossSeizure propagationBranched-chain amino acid supplementationChronic oral supplementationSpontaneous recurrent seizuresEffect of BCAAPotential novel treatmentBranched-chain amino acid leucineAmino acid supplementationAcute seizuresBCAA supplementationChronic seizuresConvulsive seizuresOral supplementationRecurrent seizuresRefractory epilepsyDentate hilusNeuronal viabilityAcid supplementationImmunohistochemical analysisNovel treatments
2018
Seizure 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 prediction — ready for a new era
Kuhlmann L, Lehnertz K, Richardson MP, Schelter B, Zaveri HP. Seizure prediction — ready for a new era. Nature Reviews Neurology 2018, 14: 618-630. PMID: 30131521, DOI: 10.1038/s41582-018-0055-2.Peer-Reviewed Original ResearchConceptsUnpredictability of seizuresThe roles of surgery and technology in understanding focal epilepsy and its comorbidities
Spencer DD, Gerrard JL, Zaveri HP. The roles of surgery and technology in understanding focal epilepsy and its comorbidities. The Lancet Neurology 2018, 17: 373-382. PMID: 29553383, DOI: 10.1016/s1474-4422(18)30031-0.Peer-Reviewed Original ResearchConceptsFocal epilepsyNeuropsychiatric disordersComplete seizure controlPoor postsurgical outcomeRole of surgeryRefractory focal epilepsyOnset areaComorbid neuropsychiatric disordersSeizure onset areaBehavioral seizuresSeizure controlSurgical outcomesPostsurgical outcomesEpileptogenic tissueEpilepsy networkHigh prevalenceStructural brain networksIndividualised therapyPatientsBrain regionsEpilepsyElectrophysiological recordingsIntracranial electrophysiological recordingsStructural MRIGold standard
2016
The relationship between seizures, interictal spikes and antiepileptic drugs
Goncharova II, Alkawadri R, Gaspard N, Duckrow RB, Spencer DD, Hirsch LJ, Spencer SS, Zaveri HP. The relationship between seizures, interictal spikes and antiepileptic drugs. Clinical Neurophysiology 2016, 127: 3180-3186. PMID: 27292227, DOI: 10.1016/j.clinph.2016.05.014.Peer-Reviewed Original ResearchConceptsFirst seizureSeizure occurrenceAED taperSpike rateEEG monitoringMarker of inhibitionIntracranial EEG monitoringOccurrence of seizuresScalp EEG monitoringConsecutive patientsAntiepileptic drugsDrug taperHigh spike ratesInterictal spikesSeizuresDay 4Intracranial electrodesPatientsAEDsSignificant relationship50 Hz hippocampal stimulation in refractory epilepsy: Higher level of basal glutamate predicts greater release of glutamate
Cavus I, Widi GA, Duckrow RB, Zaveri H, Kennard JT, Krystal J, Spencer DD. 50 Hz hippocampal stimulation in refractory epilepsy: Higher level of basal glutamate predicts greater release of glutamate. Epilepsia 2016, 57: 288-297. PMID: 26749134, DOI: 10.1111/epi.13269.Peer-Reviewed Original ResearchConceptsBasal glutamate levelsRefractory epilepsyGlutamate effluxBasal glutamateGlutamate levelsElectrical stimulationEpileptic hippocampusGlutamate releaseSeizure groupHz stimulationBrain glutamate releaseHippocampus of patientsStimulation-induced increaseEpilepsy monitoring unitStimulation-induced changesEpileptogenic hippocampusInduced seizuresSeizure inductionSpontaneous seizuresInterictal levelsGlutamate increaseAtrophic hippocampusElectroencephalography evaluationHippocampal stimulationHippocampal electrodes
2015
Inhibition of glutamine synthetase in the central nucleus of the amygdala induces anhedonic behavior and recurrent seizures in a rat model of mesial temporal lobe epilepsy
Gruenbaum SE, Wang H, Zaveri HP, Tang AB, Lee TS, Eid T, Dhaher R. Inhibition of glutamine synthetase in the central nucleus of the amygdala induces anhedonic behavior and recurrent seizures in a rat model of mesial temporal lobe epilepsy. Epilepsy & Behavior 2015, 51: 96-103. PMID: 26262937, PMCID: PMC4663049, DOI: 10.1016/j.yebeh.2015.07.015.Peer-Reviewed Original ResearchMeSH KeywordsAmygdalaAnalysis of VarianceAnhedoniaAnimalsBrainCentral Amygdaloid NucleusComorbidityDepressive DisorderDisease Models, AnimalElectroencephalographyEnzyme InhibitorsEpilepsy, Temporal LobeGlutamate-Ammonia LigaseHippocampusMaleMethionine SulfoximineNeuronsRatsRats, Sprague-DawleySeizuresConceptsMesial temporal lobe epilepsyTemporal lobe epilepsyRecurrent seizuresLobe epilepsyCentral nucleusMale Sprague-Dawley ratsPrevalence of depressionSprague-Dawley ratsGlutamine synthetase inhibitor methionine sulfoximineMeasures of anhedoniaRight CeA.Seizure activityAnhedonic behaviorDentate gyrusMedial amygdalaSucrose preferenceRat modelCommon causeAstrocytic enzymeBasolateral amygdalaLateral amygdalaOsmotic pumpPatientsEpilepsyAmygdalaDelta rhythm in wakefulness: evidence from intracranial recordings in human beings
Sachdev RN, Gaspard N, Gerrard JL, Hirsch LJ, Spencer DD, Zaveri HP. Delta rhythm in wakefulness: evidence from intracranial recordings in human beings. Journal Of Neurophysiology 2015, 114: 1248-1254. PMID: 26084904, PMCID: PMC4725112, DOI: 10.1152/jn.00249.2015.Peer-Reviewed Original ResearchEffects of site-specific infusions of methionine sulfoximine on the temporal progression of seizures in a rat model of mesial temporal lobe epilepsy
Dhaher R, Wang H, Gruenbaum SE, Tu N, Lee TS, Zaveri HP, Eid T. Effects of site-specific infusions of methionine sulfoximine on the temporal progression of seizures in a rat model of mesial temporal lobe epilepsy. Epilepsy Research 2015, 115: 45-54. PMID: 26220375, PMCID: PMC4677790, DOI: 10.1016/j.eplepsyres.2015.05.005.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyTemporal lobe epilepsyRecurrent seizuresLateral ventricleLobe epilepsyDentate gyrusEntorhinal cortexDeep entorhinal cortexEntorhinal-hippocampal areaWeek recording periodSite-specific infusionPhosphate-buffered salineDays of infusionAdult laboratory ratsRecording periodMethionine sulfoximineSeizure severitySeizure activitySevere seizuresMetabolism of glutamateRat modelSynaptic transmissionAnatomical distributionHippocampal formationAngular bundle
2014
5-Aminovaleric acid suppresses the development of severe seizures in the methionine sulfoximine model of mesial temporal lobe epilepsy
Dhaher R, Damisah EC, Wang H, Gruenbaum SE, Ong C, Zaveri HP, Gruenbaum BF, Eid T. 5-Aminovaleric acid suppresses the development of severe seizures in the methionine sulfoximine model of mesial temporal lobe epilepsy. Neurobiology Of Disease 2014, 67: 18-23. PMID: 24632421, PMCID: PMC4035438, DOI: 10.1016/j.nbd.2014.03.006.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyTemporal lobe epilepsyNumber of seizuresLobe epilepsyHippocampal formationMesial temporal lobe seizuresSevere typeEntorhinal-hippocampal areaExpression of seizuresStages of seizuresTemporal lobe seizuresDorsal hippocampal formationLocalization-related epilepsyMale Sprague-DawleyPotential therapeutic targetSeizure frequencyAlzet pumpsRacine scaleSevere seizuresSecond surgerySprague-DawleyPump placementMethionine sulfoximineGlutamine-glutamateTherapeutic targetIctal spread of medial temporal lobe seizures with and without secondary generalization: An intracranial electroencephalography analysis
Yoo JY, Farooque P, Chen WC, Youngblood MW, Zaveri HP, Gerrard JL, Spencer DD, Hirsch LJ, Blumenfeld H. Ictal spread of medial temporal lobe seizures with and without secondary generalization: An intracranial electroencephalography analysis. Epilepsia 2014, 55: 289-295. PMID: 24417694, PMCID: PMC4103687, DOI: 10.1111/epi.12505.Peer-Reviewed Original ResearchConceptsSecondary generalizationTemporal lobe seizuresFocal seizuresTemporal cortexMedial temporal lobe seizuresCortical regionsLow-voltage fast activityProminent activationAnteromedial temporal lobe resectionTonic-clonic seizuresSeizure-onset patternsTemporal lobe resectionLateral temporal cortexQuality of lifePosterior lateral temporal cortexTemporal lobe areasIntracranial electroencephalography studyMedial temporal lobe areasMedial temporal lobePosterior lateral temporal regionsIctal spreadHippocampal sclerosisSeizure spreadLobe resectionTemporal lobe