Our Mission
Research in the Wilder Center follows the interests of our members and affiliates in the science of, and around, the subject of epilepsy. Epilepsy is a neurological condition that can be studied at many levels, all of which feature important unanswered questions. As physicians, we deal with patient groups, with individual patients and their particular biology, and with data from the technology used for patient tests. As scientists, we ask questions about the behavior of epilepsy and seizures within the brain, and about the brain itself. As educators and citizens, we also research questions about higher medical training and the societal impact of epilepsy and healthcare service models.
Case Reports and Series
Clinical practice in our large tertiary center often presents opportunity to see unusual presentations, rare syndromes, and under-recognized patterns of symptoms and signs. To stay alert to these is to practice the original tradition of clinical neurology: observation, deduction and pathophysiological correlation. Our collection offers clinical insight or pedagogical value into disease manifestations and diagnostic challenges in the practice of epilepsy.
Neurophysiology of Critical Illness
Long-term EEG monitoring has assumed the standard of care in many situations of acute neurological and systemic illness. Several characteristic EEG wave patterns accompanying critical illness are now recognized but their basis in the underlying neuropathobiology is less well understood. Our work seeks to better understand and correlate EEG and clinical phenotypes.
Network Dynamics of Epilepsy
Epilepsy is increasingly seen as a disorder of brain networks, where brain regions (nodes) and their connections (edges) interface in abnormal ways to generate seizures. Yet, fundamental questions remain regarding epilepsy networks: how does the network birth seizures? What nodes and connections are essential to the diagnosis of an abnormal network? Our research program asks these and other questions to uncover systems-level insights into epilepsy.
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Deep Brain Neurophysiology
There is increasing interest in identifying relationships between the cerebral cortex and deep brain structures, such as the thalamus, in the genesis and maintenance of seizures. Deep brain stimulation (DBS) seeks to exploit these relationships to treat epilepsy. Our current research investigates deep brain signals from the anterior (ANT) and centromedian (CM) thalamus along with simultaneously recorded scalp EEG to better understand thalamic-cortical interactions.
Applications of MEG
Magnetoencephalography (MEG) measures the magnetic field associated with brain electrical activity. MEG identifies seizure-generating regions through magnetic signals from neural discharges and maps critical brain functions such as language, movement, and sensation. These insights guide safer, more effective surgical planning and support personalized treatment strategies.
Data Science of Epilepsy
Clinical care in epilepsy is significantly influenced by data: information accruing from investigations. EEG investigations in particular studies produce large, complex datasets that are only partly parsed by clinical empiricisms and protocols of nomenclature. Our research in this field applies analytic and algorithmic to organize and process EEG with a view to developing data-handling methods and deeper insight into relationships between the data and the biology.
Epilepsy and Cognition
Through disruption of cellular architecture and their connections, epilepsy impacts integrated brain function such as language, memory, and attention in complex ways. Reciprocally, seizure onsets and propagation can recapitulate modes of normal brain function. Our current work focuses on functional mapping, where we aim to understand the representation of higher cognitive processes in the gross anatomy of the brain.
Surveys and Reviews
Complementary to formal research is the process of survey and review, that allows broader reflection on the principles underlying epilepsy care. The appraisal of accumulated evidence, recurring clinical patterns and emerging trends leads to synthesis and new knowledge that eventually guide evidence-based practice.
Pedagogical Methods
Essential to our mission is training the next generation. Postgraduate medical education remains rooted in the classical tradition of apprenticeship. However, the arrival of new technologies and healthcare models demand a similar evolution in training methods and content. Our work in this area examines some of these emerging trends.
