Since the development of the 2007 Epilepsy Research Benchmarks, remarkable strides have been made toward understanding the causes of epilepsy and epileptogenesis, developing new and improved treatments, and delineating factors that contribute to comorbidities associated with epilepsy. The Epilepsy Research Benchmarks Stewards have selected the following research advances from 2007-2009 as examples of important progress toward meeting goals within the 2007 Epilepsy Research benchmarks. (Stewards and other researchers who contributed to this report are acknowledged below.) These advances resulted from research conducted in the U.S. and abroad and include numerous findings reported by the Stewards themselves. Financial and other support for the investigators and projects that made these advances was provided by NINDS, other NIH institutes, and additional U.S. government partners; as well as by nongovernmental organizations including the Epilepsy Foundation, Citizens United for Research in Epilepsy, the Tuberous Sclerosis Alliance, the Epilepsy Therapy Project, and the American Epilepsy Society, among many others.
Although the findings in these summaries hold much promise for reducing the burden of the epilepsies, many research needs remain unmet. In particular, biomarkers and new and improved animal models are needed to aid the search for strategies to prevent epilepsy and to treat epilepsies that remain intractable to currently available interventions. The comorbid conditions common in people with epilepsy were a new focus for the Epilepsy Benchmarks in 2007, and many questions have yet to be answered about the interplay between these conditions, seizures, and the underlying causes of epilepsy. Moving forward, NINDS and the Benchmarks Stewards will continue to monitor research across all Benchmarks areas and to promote further progress in areas of need. Among current opportunities, continued advances in technologies for genetics research and brain imaging and electrophysiological recording stand to accelerate the pace of discovery. New resources and infrastructure for collaborative approaches also present research opportunities, as do recent insights from other disorders that share features with the epilepsies.
Area I: Prevent epilepsy and its progression
A. Identify as yet unrecognized causes of epilepsy (e.g., genetic, autoimmune and infectious).
B. Identify underlying mechanisms of epileptogenesis.
C. Identify biomarkers for epileptogenesis.
D. Identify approaches to prevent epilepsy or its progression.
E. Develop new animal models to study epileptogenesis.
F. Test the efficacy of prevention strategies.
Area II: Develop new therapeutic strategies and optimize current approaches to cure epilepsy
A. Identify basic mechanisms of seizure generation (ictogenesis) that will lead to the development of cures.
B. Develop tools that facilitate the identification and validation of a cure.
C. Optimize existing therapies and develop new therapies and technologies for curing epilepsy.
Area III: Prevent, limit, and reverse the co-morbidities associated with epilepsy and its treatment
A. Identify and characterize the full range and age specificity of comorbidities in people with epilepsy.
B. Identify predictors and underlying mechanisms that contribute to co-morbidities.
C. Determine the optimal treatments for the neuropsychiatric and cognitive co-morbidities in people with epilepsy.
D. Prevent or limit other adverse consequences occurring in people with epilepsy.
E. Develop effective methods for diagnosis, treatment and prevention of non-epileptic seizures (NES).
Contributors
NINDS gratefully acknowledges the contributions of the following Epilepsy Benchmarks Stewards and other investigators to the content and preparation of this progress summary:
Area I, contributing Stewards:
Daniel H. Lowenstein, MD, University of California, San Francisco (Benchmarks Chair)
Jocelyn F. Bautista, MD, Cleveland Clinic
Ray Dingledine, PhD, Emory University School of Medicine
Jerome Engel, Jr., MD, PhD, University of California, Los Angeles
Solomon Moshé, MD, Albert Einstein College of Medicine
Carl Stafstrom, MD, PhD, University of Wisconsin
H. Steve White, PhD, University of Utah
Additional input:
Aristea S. Galanopoulou, MD, PhD, Albert Einstein College of Medicine
Annapurna Poduri, MD, MPH, Harvard Medical School
Michael Wong, MD, PhD, Washington University
Area II, contributingStewards:
Edward Bertram, MD, PhD, University of Virginia
Jacqueline A. French, MD, New York University
Karen Wilcox, PhD, University of Utah
Additional input:
Chad Carlson, MD, New York University
Greg Worrell, MD, Mayo Clinic
Area III, contributingStewards:
Anne Berg, PhD, Northern Illinois University
Amy Brooks-Kayal, MD, University of Colorado, Denver
Bruce P. Hermann, PhD, University of Wisconsin
W. Curt LaFrance, Jr., MD, MPH, Brown Medical School
John W. Swann, PhD, Baylor College of Medicine
Additional input:
Miya Asato, MD, Children's Hospital of Pittsburgh
Timothy A. Benke, MD, PhD, University of Colorado, Denver
Robert C. Doss, PsyD, LP, ABPP-CN, Minnesota Epilepsy Group
Daniel L. Drane, PhD, ABPP-CN, Emory University School of Medicine
Alica Goldman, MD, PhD, Baylor College of Medicine
Molly Huntsman, PhD, Children’s National Medical Center
Jack J. Lin, MD, University of California, Irvine
Alison Pack, MD, Columbia University Medical Center
Page Pennell, MD, Brigham and Women's Hospital
Elson So, MD, Mayo Clinic
Mark Stewart, MD, PhD, SUNY Downstate Medical Center
Tanvir Syed, MD, MPH, Case Western Reserve University
David Thurman, MD, MPH, Centers for Disease Control and Prevention
References Cited
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