Increased effect of physiological respiratory brain pulsations in focal-onset epilepsy

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu University Hospital, lecture room 7. Remote access: https://oulu.zoom.us/j/66738570551

Topic of the dissertation

Increased effect of physiological respiratory brain pulsations in focal-onset epilepsy

Doctoral candidate

Licentiate of Medicine, Master of Science (Technology) Janne Kananen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology (MIPT), Oulu Functional Neuroimaging (OFNI)

Subject of study

Radiology and neurology

Opponent

Professor Risto Kauppinen, University of Bristol

Custos

Professor Vesa Kiviniemi, University of Oulu, Oulu University Hospital

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Increased effect of physiological respiratory brain pulsations in focal-onset epilepsy

Epilepsies are one of the most common neurological diseases globally. While seizure-freedom is achieved in a majority of patients with proper treatment, epilepsy can still be refractory to antiepileptic medication and can cause impaired quality of life and premature death compared to the general population. In clinical diagnostic work-up, the unpredictable and temporary nature of epileptic activity in the brain with several different specified and still unknown etiologies can make the precise localization of the epileptic foci difficult.

In this thesis, alterations of respiratory brain pulsations between patients with focal-onset epilepsy and healthy controls were studied with functional magnetic resonance imaging. Functional magnetic resonance imaging measures changes in brain metabolism. However, it has been constrained by a relatively low temporal resolution. Recently developed fast functional methods can be used to study whether pulsations maintaining this homeostasis are disturbed in patients with focal-onset epilepsy.

In this thesis, a novel method was developed to study brain function in focal-onset epilepsy, offering a novel hypothesis of mechanisms behind the disease. Additionally, these pulsations were increased only at an individual level in epilepsy patients, creating a new possibility for a new diagnostic test in the future.

A deeper understanding of brain physiology offers crucial knowledge of changes in focal-onset epilepsy. These results could be explained by the transition in brain glymphatic water convection, which reciprocally affects potassium channels and, thus, brain electrophysiological homeostasis. This finding might at least partly explain the incomplete response to treatment in intractable epilepsy
Last updated: 28.10.2021