High-Frequency Oscillations (HFOs) as Biomarkers of Epileptogenicity in Children with Epilepsy

Pathological High Frequency Oscillations (HFOs) (80-250 Hz) have emerged over the last decade as potential biomarkers of epileptogenicity: recent studies have provided evidence of correlation between the surgical removal of HFO generating tissue and good post-surgical outcome, proving that HFOs occur reliably in brain tissue generating seizures. However, despite the promising findings, HFOs are not yet used for the diagnosis or monitoring of epilepsy in clinical practice. To be useful for most of the clinical applications of biomarkers, it is necessary to record HFOs noninvasively through scalp recordings. Additionally, it is important to investigate HFOs in combination with interictal spikes as this could reveal key insights into epileptogenicity mechanisms. Eleonora has helped develop a unique software tool to automatically detect HFOs in EEG and MEG signals with a high specificity to reject possible artifacts, combining information from both amplitude and time-frequency content. The current software detects interictal HFOs and spikes from simultaneous high-density scalp EEG and MEG data of pediatric epilepsy patients. Thus far, the team has discovered spikes with HFOs are localized in an area that is more closely related to the SOZ (seizure onset zone), as defined by the epileptologists, than the area localized by spikes without HFOs.

Anatomical and Functional Deficits in the Brain of Children with Cerebral Palsy

Although cerebral palsy is among the most common causes of physical disability in early childhood, we know little about the functional and structural changes of this disorder in the developing brain. We investigate with different neuroimaging modalities whether spastic cerebral palsy is associated with functional and anatomical abnormalities in the sensorimotor network. This research has important implications for the diagnosis and the rehabilitation of patients with spastic cerebral palsy. Such interventions should be applied early in life when the brain demonstrates the ability to plasticity, allowing it to readily reorganize in the face of injury.

Quantitative Assessment of Nutritive Sucking for the Early Diagnosis of Brain Injury in Newborns

Major advances in maternal-fetal medicine, neonatology and technological development have resulted in unprecedented survival rates for extremely preterm or low birth weight infants. However, preventing or predicting later adverse neurodevelopmental outcomes for these high-risk survivors remains a major challenge. The successful initiation of oral feeding and attainment of nutritive sucking competence appears to be the primary determinant of hospital discharge readiness for high-risk infants. The assessment of the sucking patterns during feeding represents one the earliest noninvasive ways to evaluate the newborns’ well-being and neuromotor status. Dr. Tamilia has designed and developed both the hardware and software tools for the signal acquisition and data analysis, and collected data from newborns in a clinical setting. The promising results from such studies provide the medical community with a new reliable and non-invasive tool for the assessment of the infants’ neuro-motor status and of their readiness for discharge, and advance the current knowledge of one of the most common and crucial problems faced by infants right after birth, which is oral feeding.

Innovative Functional Neuro-monitoring to Assess Pain and Stress in the NICU

Infants in the neonatal intensive care unit (NICU) experience pain and agitation for a multitude of reasons from the discomfort of mechanical ventilation to the minor pain of frequent procedures such as phlebotomy and IV placements, to the moderate pain of endotracheal intubation or chest tube insertion, to the more major pain of surgery. Recognition that both premature and full term infants experience pain has led to increasing appreciation of the prevalent problem of under-treatment of pain of infants in the NICU setting. Dr. Papadelis is working with experienced doctors in the NICU at BCH to develop a method that reliably quantifies the level of pain induced from clinically-required noxious procedures to these infants. This method will use measures of neurophysiological, autonomic, and behavioral responses to non-noxious and clinically-required noxious stimuli in order to guide the pharmacological treatment of NICU patients with analgesic agents, sedatives and/or muscle relaxants.

 Involvement of Cerebellum in the Processing of Emotions

Despite findings that a wide variety of psychiatric disorders have been associated with abnormalities in the cerebellum, this brain structure is often overlooked as a contributor to the neural basis of emotion. Our goal is to examine the functional role of cerebellum in the processing of emotional stimuli. This kind of knowledge could aid in the development of novel therapies to detect and treat early manifestations of psychiatric disorders, such as those affecting mood and anxiety.