rhody said:
On reflection of this finding, the thought occurred to me, the only way to see a rEEG evidence of a seizure (without actually waiting for one to happen, then try to get the equipment on and test for it) would be to look for warning signs in the scan and real time analysis (like tremors before an earthquake). Or, God forbid find a way to induce one. I don't believe that scenario either. So how did she, Dr Shankardass, pull this off ?
nismaratwork, zooby, aperion, SW VandeCarr ?
Rhody...
When you think of a seizure, most people think of the "grand mal" or Tonic-Clonic seizure; a massive event preceded by aura or other signs. In this case, what I'm hearing sounds like a nearly constant abnormal activity. In her website she describes this as "epileptiform" activity, which is just what is sounds like. This is not a new concept, but that it could be a factor in childhood developmental disorders is much broader application of the concept.
I'm going to assume that you have a functional knowledge of epilepsy, and if not the wikipedia article is not terrible. Because of the nature of this activity, it presents very regularly, in what I would describe as advancing and retreating waves of abnormal firing throughout the cortex. Consider this work in '99 which used EEG's sensing this activity to trigger the (then even more expensive to use) fMRI and capture the activity in real time.
http://brain.oxfordjournals.org/cgi/content/abstract/122/9/1679
This is only of interest to the researchers at the time as a test of fMRI, but it shows how what Dr. Shankardass doesn't require unethical means:
OxfordJournals said:
We have systematically studied and resolved the issues of patient safety and pulse artefact and now report the application of the technique in 24 experiments in 10 consecutive patients with localization-related epilepsy and frequent interictal epileptiform discharges (spikes or spike wave). At least two experiments were performed for each patient. In each experiment, 10- or 20-slice snapshot gradient-echo planar images were acquired ~3.5 s after a single typical epileptiform discharge (activation image) and in the absence of discharges (control image). Between 21 and 50 epileptiform discharges were sampled in each experiment. The significance of functional activation was tested using the t test at 95% confidence on a pixel-by-pixel basis. Six of the 10 patients showed reproducible focal changes of the blood oxygen level-dependent (BOLD) signal, which occurred in close spatial relationship to the maximum of the epileptiform discharges in the concurrent EEG.
Now, for seizure activity that doesn't kindly pop up ever few minutes or more, such as the afformentioned tonic-clonic seizure, there are animal models http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WNP-4Y5BMD4-3&_user=10&_coverDate=04%2F15%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1389850943&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6fcb459d5c61c2c52407d0d9037cf3ae
and "happy" accidents.
http://www.ncbi.nlm.nih.gov/pubmed/12153004
Generally speaking, inducing this kind of seizure is no more extreme than inducing someone with schizophreniform disorder(s?) to show symptoms; it is nearly if not entirely constant. This is why I am struck by the brilliance of this approach, which while it probably doesn't account for the majority of people with developmental disorders, is still clearly a useful tool in an generally arcane arsenal.
Keep in mind, that anti-seizure medications are often perscribed off-label, in fact we have a member here who mentioned taking Gabapentin for neuropathic joint pain, and that is in fact a powerful anti-seizure drug. Autistic children are often given benzodiazapines on occasion, and again, rarely do you see a dramatic improvement. In the end, I doubt that this will prove to be the answer to most, but if it accounts for only a tiny percentage it will be a nearly miraculous breakthrough in the clinical side of this problem, and open new avenues of research into other dysfunction.
This is a study from 2009 regarding schizophrenia and the role the DMN (Default Mode Network) seems to play (or reflect?) in it. http://www.pnas.org/content/106/4/1279.full.pdf
It is in my view, an excellent piece of work, and personally knowing several of the study authors, we've discussed the wide range of roles the DMN seems to play in everything from schizophrenia, to ADHD. Everyone is still scratching their heads a bit and trying to understand if this represents a cause, or something like encoding information in the event horizon of a black hole. Once again, in this case, there is no need to induce anything, but rather it is the constant activity under various circumstances which creates the opportunity for study in such depth.
Now, this is not epileptiform, but the notion of a constant failure in the regulation of signaling across a large area is common between the two. It is, in my view, too soon to know what this means. It is soon enough to conclude that there are people out there who may be considered eccentric and are simply like those 1st degree relatives, and children who are believed to be autistic or otherwise "damaged" who are suffering from something along the lines of what Dr. Shankardass describes.
It's known that epilepsy and other seizure activity can cause damage, so the trick here was in finding what would not have been otherwise detected. The range that falls into clinically defined seizures is already covered, but this... is very interesting. This, like the exploration of the role of the DMN, represents another increase in "resolution" when looking at the picture of the brain and just how it does that voodoo... you get the idea.
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