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3. Issues related to development of new antiseizure treatments

Author

Wilcox, Karen S, Dixon‐Salazar, Tracy, Sills, Graeme J, Ben‐Menachem, Elinor, White, H Steve, Porter, Roger J, Dichter, Marc A, Moshé, Solomon L, Noebels, Jeffrey L, Privitera, Michael D, and Rogawski, Michael A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Neurodegenerative, Epilepsy, Brain Disorders, Neurological, Adult, Animals, Anticonvulsants, Child, Disease Models, Animal, Drug Discovery, Drug Evaluation, Drug Industry, Drugs, Investigational, Humans, Research Support as Topic, Translational Research, Biomedical, Antiseizure drug, Pharmacoresistant epilepsy, Animal models of epilepsy, Translational Medical Research, Neurology & Neurosurgery, Clinical sciences
Abstract

This report represents a summary of the discussions led by the antiseizure treatment working group of the International League Against Epilepsy (ILAE)/American Epilepsy Society (AES) Working Groups joint meeting in London (London Meeting). We review here what is currently known about the pharmacologic characteristics of current models of refractory seizures, both for adult and pediatric epilepsy. In addition, we address how the National Institute of Neurological Disorders and Stroke (NINDS)-funded Anticonvulsant Screening Program (ASP) is evolving to incorporate appropriate animal models in the search for molecules that might be sufficiently novel to warrant further pharmacologic development. We also briefly address what we believe is necessary, going forward, to achieve the goal of stopping seizures in all patients, with a call to arms for funding agencies, the pharmaceutical industry, and basic researchers.

Published
2013

14. Genetic Variation in PADI6-PADI4 on 1p36.13 Is Associated with Common Forms of Human Generalized Epilepsy

Author

Buono, Russell J., primary, Bradfield, Jonathan P., additional, Wei, Zhi, additional, Sperling, Michael R., additional, Dlugos, Dennis J., additional, Privitera, Michael D., additional, French, Jacqueline A., additional, Lo, Warren, additional, Cossette, Patrick, additional, Schachter, Steven C., additional, Basehore, Heather, additional, Lohoff, Falk W., additional, Grant, Struan F. A., additional, Ferraro, Thomas N., additional, and Hakonarson, Hakon, additional

Published
2021
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18. Genetic variation in PADI6-PADI4 on 1p36.13 is associated with common forms of human generalized epilepsy

Author

Buono, Russell J., Bradfield, Jonathan P., Wei, Zhi, Sperling, Michael R., Dlugos, Dennis J., Privitera, Michael D., French, Jacqueline A., Lo, Warren, Cossette, Patrick, Schachter, Steven C., Basehore, Heather, Lohoff, Falk W., Grant, Struan F.A., Ferraro, Thomas N., Hakonarson, Hakon, Buono, Russell J., Bradfield, Jonathan P., Wei, Zhi, Sperling, Michael R., Dlugos, Dennis J., Privitera, Michael D., French, Jacqueline A., Lo, Warren, Cossette, Patrick, Schachter, Steven C., Basehore, Heather, Lohoff, Falk W., Grant, Struan F.A., Ferraro, Thomas N., and Hakonarson, Hakon

Abstract

We performed a genome-wide association study (GWAS) to identify genetic variation associated with common forms of idiopathic generalized epilepsy (GE) and focal epilepsy (FE). Using a cohort of 2220 patients and 14,448 controls, we searched for single nucleotide polymorphisms (SNPs) associated with GE, FE and both forms combined. We did not find any SNPs that reached genome-wide statistical significance (p ≤ 5 × 10−8) when comparing all cases to all controls, and few SNPs of interest comparing FE cases to controls. However, we document multiple linked SNPs in the PADI6-PADI4 genes that reach genome-wide significance and are associated with disease when comparing GE cases alone to controls. PADI genes encode enzymes that deiminate arginine to citrulline in molecular pathways related to epigenetic regulation of histones and autoantibody formation. Although epilepsy genetics and treatment are focused strongly on ion channel and neurotransmitter mechanisms, these results suggest that epigenetic control of gene expression and the formation of autoantibodies may also play roles in epileptogenesis.

Published
2021

43. Introduction

Author

Privitera, Michael D. and Brenner, Richard P.

Published
2002

44. Introduction

Author

Privitera, Michael D.

Published
2001

47. Reply to

Author

Alsherbini, Khalid A., primary, Metter, E. Jeffrey, additional, Foreman, Brandon P., additional, and Privitera, Michael D., additional

Published
2019
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50. Secondary epileptogenesis in cerebral arteriovenous malformations

Author

Yeh, Hwa-shain and Privitera, Michael D.

Subjects
Cerebral arteriovenous malformations -- Complications, Epilepsy -- Causes of, Seizures (Medicine) -- Case studies, Health
Abstract

Epilepsy is characterized by the sudden appearance of motor or sensory phenomena, or an alteration in the state of consciousness. The most common phenomenon is convulsive seizures. The origin of seizures is poorly understood, but they are generally considered to begin as abnormal electrical activity in some part, or parts, of the brain which then kindles a reaction that spreads to other brain regions. There is some controversy about whether epilepsy is always a primary disorder in humans or whether it may sometimes by a secondary consequence of some other abnormal physiological process. There is frequently an association between epilepsy and cerebral arteriovenous malformations (AVMs), abnormal structures in the blood vessels of the brain. While these AVMs often lead to intracranial hemorrhages and complications thereof, there is no indication that an AVM must bleed to cause epilepsy. It is estimated that from 17 to 40 percent of people with nonhemorrhagic AVMs are likely to have epileptic seizures. The authors present two cases that illustrate a curious relation between arteriovenous malformations and epilepsy. The two men, one 20 and one 30, had generalized seizures that began without a warning period or ''aura''. In one case, an arteriovenous malformation was revealed by CT scan; in the other, by angiography. In both cases, electroencephalography (EEG) revealed electrical activity consistent with epilepsy in the region of the cerebral cortex near the AVM, and in both cases both the AVM and the epileptic cortex were surgically removed. This resulted in complete freedom from generalized seizures in both patients. However, both patients subsequently developed partial seizures, which caused confusion and automatisms in one patient and hallucinatory smells in the other. Further EEG examination revealed a temporal lobe source for epileptic activity in both patients, an area distant from the original malformation. Second procedures were performed to extirpate these brain regions, which freed the patients from epileptic activity. The present cases are unique in that the surgical treatment of the AVMs resulted in the disappearance of generalized seizure activity, but apparently unmasked a second focus of epileptic activity causing partial seizures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

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