2022
Factors Predicting Outcome After Intracranial EEG Evaluation in Patients With Medically Refractory Epilepsy
Sivaraju A, Hirsch L, Gaspard N, Farooque P, Gerrard J, Xu Y, Deng Y, Damisah E, Blumenfeld H, Spencer DD. Factors Predicting Outcome After Intracranial EEG Evaluation in Patients With Medically Refractory Epilepsy. Neurology 2022, 99: e1-e10. PMID: 35508395, PMCID: PMC9259091, DOI: 10.1212/wnl.0000000000200569.Peer-Reviewed Original ResearchMeSH KeywordsDrug Resistant EpilepsyElectrocorticographyElectroencephalographyHumansMagnetic Resonance ImagingRetrospective StudiesTreatment OutcomeConceptsTemporal lobe onsetSeizure freedomResective surgeryIndependent predictorsLesional MRIUnfavorable predictorRefractory epilepsyContinued medical treatmentEpilepsy surgical evaluationFactors Predicting OutcomeIntracranial EEG evaluationNonlesional extratemporal epilepsySubsequent seizure freedomSustained seizure freedomThorough presurgical evaluationSeizure-free outcomeClass II evidenceMedically Refractory EpilepsyRetrospective chart reviewKaplan-Meier curvesSelect clinical scenariosMultivariable regression analysisBest multivariable modelIntracranial EEGSeizure onset localization
2021
Patient‐detectable responsive neurostimulation as a seizure warning system
Quraishi IH, Hirsch LJ. Patient‐detectable responsive neurostimulation as a seizure warning system. Epilepsia 2021, 62: e110-e116. PMID: 34018182, PMCID: PMC8629031, DOI: 10.1111/epi.16933.Peer-Reviewed Original ResearchConceptsResponsive neurostimulation systemFocal impaired awareness seizuresProportion of patientsQuality of lifeSeizure warningTolerable symptomsClinical seizuresLatter therapySelect patientsAwareness seizuresEpileptiform activityEarly recognitionResponsive neurostimulationEpileptiform patternsCognitive impairmentPatientsNeurostimulation systemSymptomsSeizuresTherapyTreatment of clustersStimulationSeizure warning systemSeizure recognitionEpilepsy
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 dataYearsMesial 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
Early detection rate changes from a brain‐responsive neurostimulation system predict efficacy of newly added antiseizure drugs
Quraishi IH, Mercier MR, Skarpaas TL, Hirsch LJ. Early detection rate changes from a brain‐responsive neurostimulation system predict efficacy of newly added antiseizure drugs. Epilepsia 2019, 61: 138-148. PMID: 31849045, PMCID: PMC7003822, DOI: 10.1111/epi.16412.Peer-Reviewed Original ResearchConceptsPositive predictive valueEpisode startsLonger episodesSystem patientsPredictive valueFirst weekLong-term treatment trialsBrain-responsive neurostimulationSingle epilepsy centerSingle-center cohortRefractory focal epilepsyGreater reductionMedication adjustmentsClinical improvementClinical responseSeizure frequencyAntiseizure drugsCenter cohortMulticenter cohortEpilepsy centersMedication trialsEffective medicationsEfficacy measuresTreatment trialsFocal epilepsy
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 timeHospitalBilateral independent periodic discharges are associated with electrographic seizures and poor outcome: A case-control study
Osman G, Rahangdale R, Britton JW, Gilmore EJ, Haider HA, Hantus S, Herlopian A, Hocker SE, Woo Lee J, Legros B, Mendoza M, Punia V, Rampal N, Szaflarski JP, Wallace AD, Westover MB, Hirsch LJ, Gaspard N. Bilateral independent periodic discharges are associated with electrographic seizures and poor outcome: A case-control study. Clinical Neurophysiology 2018, 129: 2284-2289. PMID: 30227348, PMCID: PMC6785981, DOI: 10.1016/j.clinph.2018.07.025.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain Injuries, TraumaticBrain WavesCase-Control StudiesElectrocorticographyFemaleHumansMaleMiddle AgedPeriodicityPrognosisSeizuresConceptsBilateral independent periodic dischargesCase-control studyElectrographic seizuresPoor outcomePeriodic dischargesLPD groupBrain injuryRetrospective case-control studyAcute brain injuryAnoxic brain injuryCNS infectionsFrequent etiologyCerebral injuryIll patientsClinical managementPD groupLevel of alertnessHigh riskBetter outcomesPatientsMultivariate analysisSeizuresInjuryPotential important implicationsOutcomes
2015
Delta 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 Research