Ongoing studies, The Epilepsy Research Group

Can the brain's glial cells be a point of attack for novel AED treatments? This is a major project within the ERGO network in which, among other approaches, a mouse model is being used to investigate how epilepsy arises and evolves over time. Neurophysiological changes, especially related to calcium signalling in glial cells versus neurons are studied in detail. Both immediate effects related to acute seizures to study the processes of transition from the interictal state to a seizure (ictogenesis) and studies on the development of epilepsy over time (epileptogenesis) are investigated. The main question is how glia cells behave during the development and worsening of epilepsy, and whether these changes can be affected by various drugs such as AEDs, anti-inflammatory drugs, drugs that affect intracellular cell signalling etc. The work is being done in close collaboration with the GliaLab/Letten Center, Institute of Basic Medical Sciences, UiO, led by Ass. Prof. Rune Enger. We also investigate possible epigenetic regulation of epileptogenesis. This is done in collaboration with several research groups at UiO and OUH.

Studying possible mechanisms involved in epileptogenesis may open new treatment strategies to prevent epilepsy after i.e. traumatic brain injuries or stroke.

Is epilepsy a progressive disease? This is a long-term project that focuses on changes in the clinical, radiological, and neuropsychological changes in patients with temporal lobe epilepsy (Pro-TLE). Comprehensive investigations are conducted on patients with newly diagnosed temporal lobe epilepsy at various time points over a 10-year period.

We are also performing a retrospective study (Retro-TLE) investigating MR changes over time before operation in patients with surgically verified hippocampal sclerosis.

Long-term effects of AEDs. Patients starting treatment with the AEDs levetiracetam and lamotrigine will be followed prospectively for 2-years in terms of immunological, hormonal, and haematological adverse reactions, and possible changes in bone health. The data will be collected through interviews, questionnaires, blood tests, and bone density measurements. This project is supported with a 50 % PhD student from Østfold Hospital.

As part of this project, studies in zebrafish on the effect of AEDs on gene expression related to immune genes have been performed in collaboration with NMBU (Norwegian University of Life Sciences).

In addition, a human study on the effect of AEDs on different markers for inflammation in humans with epilepsy is under way together with collaborators in OUH.

Epilepsy and cardiology. It has become increasingly clear that several epilepsies are channelopathies, as are many cardiac arrhythmias and they are both associated with many of the same channels and ions. This is also of central importance for understanding sudden unexpected death in epilepsy (SUDEP).

We are performing clinical studies on the impact of several years of active epilepsy on cardiac function. We have also recently finished experimental studies in mice experiencing status epilepticus to investigate possible deleterious effects on the heart using mouse MR, ecco-cor and ECG. This has been done in collaboration with prof Ivar Sjåstad and his group in Institute for Experimental Medical Research, OUH – Ullevål.
Status epilepticus. Studies focus especially on possible predictors for outcome based on EEG are under way as part of a phd project. We also collaborate in an international network studying long term survival after status epilepticus.
National registration of refractory status epilepticus. We are collating national experiences on how patients with this condition are treated in Norway and how this can be improved. As there are only a few such patients at each centre, joint exchange of experiences is essential. A national reference group is now being established.
Traumatic brain injury and posttraumatic epilepsy. This has over the last one to two years become one of the most active areas of research within our group focusing on biomarkers for posttraumatic epilepsy. Both national and international collaborative studies are ongoing with special emphasis on inflammation markers and selected genetic markers. Main collaborators are in Italy and USA.
Deep brain stimulation (DBS) in epilepsy. In this study patients with hard-to-treat epilepsy are treated with DBS using a blinded study design. The clinical work is now completed, and the first results published. The project will end in 2023.
Ketogenic diet and endocrinology. In collaboration with the National Center for Epilepsy we have participated in a study on ketogenic diet (modfied Atkins diet) in adults with epilepsy. As part of this study, we are now investigating possible endocrine side effects of the diet.