Sergiusz Jozwiak1,2, Albert Becker3, Carlos Cepeda4, Jerome Engel5, Vadym Gnatkovsky6, Gilles Huberfeld7,8, Mehmet Kaya9, Katja Kobow10, Michele Simonato11,12, Jeffrey A Loeb13. 1. Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland. 2. Department of Child Neurology, The Children's Memorial Health Institute, Warsaw, Poland. 3. Section for Translational Epilepsy Research, Department of Neuropathology, University of Bonn Medical Center, Bonn, Germany. 4. IDDRC, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, California, U.S.A. 5. Departments of Neurology, Neurobiology, and Psychiatry & Biobehavioral Sciences and the Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A. 6. Unit of Epilepsy and Experimental Neurophysiology, The Foundation of the Carlo Besta Neurological Institute, Milan, Italy. 7. AP-HP, Department of Neurophysiology, UPMC and The Pitié-Salpêtrière Hospital, Sorbonne and UPMC University, Paris, France. 8. INSERM U1129, PRES Sorbonne Paris, Cité, CEA, Paris Descartes University, Paris, France. 9. Department of Physiology, Koc University School of Medicine, Istanbul, Turkey. 10. Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany. 11. Department of Medical Sciences, University of Ferrara, Ferrara, Italy. 12. Division of Neuroscience, University Vita-Salute San Raffaele, Milan, Italy. 13. Department of Neurology and Rehabilitation, The University of Illinois at Chicago, Chicago, Illinois, U.S.A.
Abstract
OBJECTIVE: Current medications for patients with epilepsy work in only two of three patients. For those medications that do work, they only suppress seizures. They treat the symptoms, but do not modify the underlying disease, forcing patients to take these drugs with significant side effects, often for the rest of their lives. A major limitation in our ability to advance new therapeutics that permanently prevent, reduce the frequency of, or cure epilepsy comes from a lack of understanding of the disease coupled with a lack of reliable biomarkers that can predict who has or who will get epilepsy. METHODS: The main goal of this report is to present a number of approaches for identifying reliable biomarkers from observing patients with brain disorders that have a high probability of producing epilepsy. RESULTS: A given biomarker, or more likely a profile of biomarkers, will have both a quantity and a time course during epileptogenesis that can be used to predict who will get the disease, to confirm epilepsy as a diagnosis, to identify coexisting pathologies, and to monitor the course of treatments. SIGNIFICANCE: Additional studies in patients and animal models could identify common and clinically valuable biomarkers to successfully translate animal studies into new and effective clinical trials. Wiley Periodicals, Inc.
OBJECTIVE: Current medications for patients with epilepsy work in only two of three patients. For those medications that do work, they only suppress seizures. They treat the symptoms, but do not modify the underlying disease, forcing patients to take these drugs with significant side effects, often for the rest of their lives. A major limitation in our ability to advance new therapeutics that permanently prevent, reduce the frequency of, or cure epilepsy comes from a lack of understanding of the disease coupled with a lack of reliable biomarkers that can predict who has or who will get epilepsy. METHODS: The main goal of this report is to present a number of approaches for identifying reliable biomarkers from observing patients with brain disorders that have a high probability of producing epilepsy. RESULTS: A given biomarker, or more likely a profile of biomarkers, will have both a quantity and a time course during epileptogenesis that can be used to predict who will get the disease, to confirm epilepsy as a diagnosis, to identify coexisting pathologies, and to monitor the course of treatments. SIGNIFICANCE: Additional studies in patients and animal models could identify common and clinically valuable biomarkers to successfully translate animal studies into new and effective clinical trials. Wiley Periodicals, Inc.
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