Yale Clinical Neuroscience Neuroanalytics

Transcript

• 00:06- Epilepsy in the past
• 00:0920 years increasingly has been thought of as a network disease,
• 00:13and that's important because our brain works
• 00:18on the basis of networks,
• 00:19and so how do you solve the problem of a disease
• 00:24that is mitigated by a network?
• 00:28Well, it needs a multidisciplinary team.
• 00:34- Yale Clinical Neuroscience Neuroanalytics Research Group or YNN,
• 00:38is focused on the study of network brain disorders,
• 00:42primarily epilepsy.
• 00:45- So we have basically three different disciplines.
• 00:47One part of the group studies the structure or brain anatomy,
• 00:52then the other groups studies the electrical activity in the brain,
• 00:56and then my part is to study the chemistry of certain brain regions,
• 01:00and then we will integrate it in order to find better biomarkers.
• 01:05- We draw on neurology,
• 01:09neurosurgery, neuroscience, computer science,
• 01:13electrical engineering, computer engineering, mathematics
• 01:16to try and understand the complex phenomenon that we are studying,
• 01:19the signals that we are studying, and then to be able to monitor
• 01:23and modulate them and build the devices that will control the brain networks.
• 01:32- My role primarily has been
• 01:34in defining the structure through our Yale Brain Atlas.
• 01:38It divides the brain into 690 parcels.
• 01:41Each parcel is enumerated and named.
• 01:44But once you have partially the brain,
• 01:48then you can take each of those parcels and superimpose a function.
• 01:54- One example of a device that we built using this
• 01:57is the neuroprobe, an award winning device that we built in the lab
• 02:02that monitors intracranial pressure, intracranial temperature,
• 02:07brain tissue, oxygen, and intracranial EEG,
• 02:10all within a single multimodal probe,
• 02:13and which is meant for use for traumatic brain injury in the neuro-ICU.
• 02:18- To put together electrophysiology
• 02:21structure and function from the atlas and then the new field.
• 02:26It's not a new field, but it's a new application of that field,
• 02:30the biochemistry of the brain that Dr. Eid brings.
• 02:33You have a more complete picture of the brain structure, function, relationships.
• 02:39- What I use is a method called mass spectrometry
• 02:42is a really advanced method that is very sensitive.
• 02:46You can detect really low levels of chemicals in any kind of body fluid.
• 02:50So the way we use it is we have samples from the patients.
• 02:54These are brain samples, saliva samples, sweat samples with an analyst
• 02:59with this mass spectrometry,
• 03:01and the advantage is it really allows us to analyze
• 03:05many chemicals all at once in many, many samples from the same patients.
• 03:11We have analyzed some patients.
• 03:14We are still in the early stages, but we are seeing chemicals
• 03:18that may be increased when the patient is at high risk for having a seizure.
• 03:23- Seizures are modulated by the time of day and by cycles,
• 03:29and these cycles may be 20 days or 30 days of integration.
• 03:34We are trying to better understand what motivates these cycles.
• 03:39- By combining the electrical signal with a chemical signal,
• 03:44We hope to have a much stronger predictor of when they will have a seizure.
• 03:48So we are using various methods - machine learning, AI - to identify groups
• 03:54of chemicals and of electrical signatures that will really forecast a seizure.
• 03:59- And then if we can understand them,
• 04:00then we could better treat the patient.
• 04:08- All of this is about therapeutics for the patient.
• 04:11Can we resect you know, can we identify the network?
• 04:15Can we modulate the network?
• 04:17How can we decide which of the chemistry electrophysiology
• 04:23functional issues are most important, or how do they interact together
• 04:28in a single patient at a single time to optimize therapy for that patient?
• 04:34- So the big picture is to take what we're learning from epilepsy
• 04:39and to translate it to other chronic diseases in people,
• 04:44and especially to cyclical or episodic diseases.
• 04:47There are many of them.
• 04:48You have migrant attacks, cluster headaches,
• 04:52mood disorders, even addiction that comes and goes.
• 04:58- In the longer term, we would like to create algorithms and devices
• 05:03that could forecast episodes
• 05:05in order to tailor the treatment for the individual.