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<h4> Specific Aims and Tasks </h4>
 
<h4> Specific Aims and Tasks </h4>
 
<h5>
 
<h5>
Identify patterns of physiological dysfunction (changes in blood pressure, heart rate, arrhythmia, breathing and EEG patterns) surrounding seizure periods and the underlying neural injury (focal structural brain changes identified through brain imaging including MRI) contributing to those patterns.
+
Sudden Unexpected Death in Epilepsy (SUDEP) affects ~3000 individuals with epilepsy in the
<ul> <li> Will provide insight into mechanisms of failure in SUDEP, and suggest pre-mortem characteristics that lead to a fatal scenario that are suitable for targeted intervention </ul>
+
USA annually. Death results from profound breathing and/or cardiovascular dysfunction, but
 +
mechanisms underlying failure, and risk factors identifying those most at risk are unknown. Our
 +
goal is to identify patterns of physiological dysfunction surrounding seizure periods and the
 +
underlying neural injury contributing to those patterns. We aim to identify patterns of physiological dysfunction (changes in blood pressure, heart rate, arrhythmia, breathing and EEG patterns) surrounding seizure periods and the underlying neural injury (focal structural brain changes identified through brain imaging including MRI) contributing to those patterns.
 +
<ul> <li> This project will provide insight into mechanisms of failure in SUDEP, and suggest pre-mortem characteristics that lead to a fatal scenario that are suitable for targeted intervention. </ul>
 
</h5>
 
</h5>
 
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       <h5>  
 
       <h5>  
 
       <ul>
 
       <ul>
              <li> <a href="investigators#sl" > Samden Lhatoo MD., FRCP.    </a> </li>
 
 
               <li> <a href="investigators#bd" > Beate Diehl, M.D., Ph.D.    </a> </li>
 
               <li> <a href="investigators#bd" > Beate Diehl, M.D., Ph.D.    </a> </li>
 
               <li> <a href="investigators#rh" > Ronald Harper, Ph.D.      </a> </li>
 
               <li> <a href="investigators#rh" > Ronald Harper, Ph.D.      </a> </li>
 +
              <li> <a href="investigators#sl" > Samden Lhatoo MD., FRCP.  (Contact PI)  </a> </li>
 
       </ul>
 
       </ul>
 
       </h5>
 
       </h5>
 
       <br><br>
 
       <br><br>
    
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      <h4> Core Personnel </h4> <h5>
  
      <h4> Citations </h4>
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<table class="table table-hover">
      <p>
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            <tbody>
      </p>
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                <tr>
      <br><br>
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                            <td id="az" class="col-md-1"> 
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                                      <a href="Nuria website link for image"> <img src="image"  width="64px" height="72px" alt="/images/7/72/Sample_image.jpg"> </a>  
 +
                            </td>
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                            <td class="col-md-11">
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                                      <h5 style="color:#93322d;"> <a href="">Nuria Lacuey-Lecumberri, MD </a> </h5>
 +
                                      <p> Dr. Lecumberri  is a Clinical Fellow in the  </p>
 +
                            </td>
 +
                </tr>
  
      <h4> Protocols and Manuals </h4>
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                <tr>
      <p>
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                            <td id="az" class="col-md-1"> 
      </p>
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                                      <a href="website link for image"> <img src="image"  width="64px" height="72px" alt="/images/7/72/Sample_image.jpg"> </a>  
      <br><br>
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                            </td>
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                            <td class="col-md-11">
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                                      <h5 style="color:#93322d;"> <a href="">Dr. Lhatoo, MD, FRCP </a> </h5>
 +
                                      <p>  Dr. Lhatoo is .</p>
 +
                            </td>
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                </tr>
  
      <h4> Publication Links </h4>
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                <tr>
      <p>
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                            <td id="az" class="col-md-1"> 
      </p>
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                                      <a href="Sandhya Rani"> <img src="image"  width="64px" height="72px" alt="/images/7/72/Sample_image.jpg"> </a>  
      <br><br>
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                            </td>
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                            <td class="col-md-11">
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                                      <h5 style="color:#93322d;"> <a href="">Sandhya Rani, PhD</a> </h5>
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                                      <p> Dr. Rani is the </p>
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                            </td>
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                </tr>
  
</div>
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                <tr>
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                            <td id="az" class="col-md-1"> 
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                                      <a href="Bilal Zonjy image file link"> <img src="image"  width="64px" height="72px" alt="/images/7/72/Sample_image.jpg"> </a>
 +
                            </td>
 +
                            <td class="col-md-11">
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                                      <h5 style="color:#93322d;"> <a href="">Bilal Zonjy, MD</a> </h5>
 +
                                      <p> Dr. Zonjy is a clinical epileptologist...</p>
 +
     
 +
                                      <p> </p>
 +
                            </td>
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                </tr>
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      <h4> Publication Links </h4> <h5>
 +
</html>
 +
<ul class="text-justify">
 +
<li> Wandschneider B, Koepp M, Scott C, Micallef C, Balestrini S, Sisodya S, Thom M, Harper R, Sander J, Vos S, Duncan J, Lhatoo S, Diehl B.
 +
Structural imaging biomarkers of sudden unexpected death in epilepsy (Accepted, Brain 2015).
 +
<li>Ryvlin P, Nashef L, Lhatoo SD, Bateman LM et al. Incidence and mechanisms of cardiorespiratory arrests
 +
in epilepsy monitoring units (MORTEMUS): a retrospective study. [http://www.ncbi.nlm.nih.gov/pubmed/24012372 PMID 24012372].
 +
<li>Bozorgi A, Chung S, Kaffashi F, Loparo KA, Sahoo SS, Zhang GQ, Kaiboriboon K, Lhatoo SD.
 +
Significant peri-ictal hypotension: Expanding the spectrum of seizure induced autonomic dysregulatory
 +
phenomena with polygraphy. [http://www.ncbi.nlm.nih.gov/pubmed/23758665 PMID 23758665].
 +
<li>Lhatoo SD, Faulkner HJ, Dembny K, Trippick K, Johnson C, Bird JM (2010). An electroclinical case-control
 +
study of sudden unexpected death in epilepsy. [http://www.ncbi.nlm.nih.gov/pubmed/20882604 PMID 20882604].
 +
<li> Lhatoo SD, Johnson AL, Goodridge DM, MacDonald BK, Sander JW, Shorvon SD. Mortality in
 +
epilepsy in the first 11 to 14 years after diagnosis: Multivariate analysis of a long-term, prospective,
 +
population-based cohort.
 +
[http://www.ncbi.nlm.nih.gov/pubmed/11261508 PMID 11261508].
 +
 
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                 <a href="#">
 
                 <a href="#">
                     <img class="img-responsive" src="http://placehold.it/700x400" alt="">
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                     <img class="img-responsive" src="http://csr.case.edu/images/b/b4/SUDEP_fig.jpg" alt="">
 
                 </a>
 
                 </a>
 
                 <h3>
 
                 <h3>
                     <a href="#">Highlight 1</a>
+
                     <a href="#">Regional grey matter volume differences between SUDEP,  people at high risk and controls</a>
 
                 </h3>
 
                 </h3>
                 <p>Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam viverra euismod odio, gravida pellentesque urna varius vitae.</p>
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                 <p>Figure modified from:
 +
Structural imaging biomarkers of sudden unexpected death in epilepsy:
 +
Britta Wandschneider et al., Brain 2015, in press
 +
</p>
 
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                 <p>Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam viverra euismod odio, gravida pellentesque urna varius vitae.</p>
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Latest revision as of 09:54, 1 July 2015


The Autonomic and Imaging Biomarkers of SUDEP (NS090407)


Specific Aims and Tasks

Sudden Unexpected Death in Epilepsy (SUDEP) affects ~3000 individuals with epilepsy in the USA annually. Death results from profound breathing and/or cardiovascular dysfunction, but mechanisms underlying failure, and risk factors identifying those most at risk are unknown. Our goal is to identify patterns of physiological dysfunction surrounding seizure periods and the underlying neural injury contributing to those patterns. We aim to identify patterns of physiological dysfunction (changes in blood pressure, heart rate, arrhythmia, breathing and EEG patterns) surrounding seizure periods and the underlying neural injury (focal structural brain changes identified through brain imaging including MRI) contributing to those patterns.
  • This project will provide insight into mechanisms of failure in SUDEP, and suggest pre-mortem characteristics that lead to a fatal scenario that are suitable for targeted intervention.

Principal Investigators



Publication Links

  • Wandschneider B, Koepp M, Scott C, Micallef C, Balestrini S, Sisodya S, Thom M, Harper R, Sander J, Vos S, Duncan J, Lhatoo S, Diehl B. Structural imaging biomarkers of sudden unexpected death in epilepsy (Accepted, Brain 2015).
  • Ryvlin P, Nashef L, Lhatoo SD, Bateman LM et al. Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. PMID 24012372.
  • Bozorgi A, Chung S, Kaffashi F, Loparo KA, Sahoo SS, Zhang GQ, Kaiboriboon K, Lhatoo SD. Significant peri-ictal hypotension: Expanding the spectrum of seizure induced autonomic dysregulatory phenomena with polygraphy. PMID 23758665.
  • Lhatoo SD, Faulkner HJ, Dembny K, Trippick K, Johnson C, Bird JM (2010). An electroclinical case-control study of sudden unexpected death in epilepsy. PMID 20882604.
  • Lhatoo SD, Johnson AL, Goodridge DM, MacDonald BK, Sander JW, Shorvon SD. Mortality in epilepsy in the first 11 to 14 years after diagnosis: Multivariate analysis of a long-term, prospective, population-based cohort. PMID 11261508.




Regional grey matter volume differences between SUDEP, people at high risk and controls

Figure modified from: Structural imaging biomarkers of sudden unexpected death in epilepsy: Britta Wandschneider et al., Brain 2015, in press