Epilepsy ... the enemy of the great reveals more of his secrets

The Russian novelist “Dostoevsky” described it as a “State between life and death.” The Greek physician Galen held him responsible for damaging the “Pure divine part inhabited by the brain” ... and it affects 2.4 million people annually around the world.

Fear, anxiety, loss of consciousness, and the cries of frightening sounds that ring the ears, followed by uncontrollable spasms in the arms and feet, numbness, dizziness, inability to control the bladder, and a strange overlap of bright lights in which the illusion is mixed with the truth, in a way that some societies' cultures attribute to what they call He should "touch the jinn", while science attributes it to "epilepsy", which affects about 50 million people around the world, according to WHO estimates.

One of them, who is forty years old and who works as a security employee, tells me his suffering with "epilepsy", which has spanned for more than 15 years, saying: I feel like an electric thunderstorm hit my head. I fell several times. In Cairo, which led to my deep wound to the head.

Epileptic seizures attack this person violently without warning, to wake up in a state of extreme fatigue without remembering anything of what happened, and despite his regular intake of anti-epileptic drugs, this disease has clearly affected his memory and concentration, according to his statements to "science".

Also, the famous Russian novelist Fyodor Dostoyevsky described "epilepsy" as "a state between life and death," as many claim that he had epilepsy at the same moment he learned of the death of his father.

Continuous scientific attempts

Between "inherited" popular cultures and philosophical perceptions about "epilepsy," which the Greek physician Galen gave a religious dimension, stressing that it "harms the pure divine part that the brain inhabits." all ages.

In the context, a study conducted by researchers from McGill University in Canada confirmed that "the lack of gray matter resulting from epilepsy increases in areas where there is intense activity from the exchange of signals between neurons of the neural network or communication with them."

Boris Bernhard - Assistant Professor of Neurology and Neurology at McGill University and a co-author of the study - said in statements to "Science": The study represents a major advance in understanding the mechanisms of "epilepsy" and the possibility of dealing with it, and shows that brain atrophy (measured by magnetic resonance imaging) in syndromes Common epilepsy is related to how nerve networks communicate in the brain For example, we found that areas of the brain with many axons show significantly more atrophy in epileptics than regions with few axes, and that these regions were different in focal epilepsy than in generalized epilepsy.

Epilepsy ... and shocking numbers

Epilepsy is defined as a "chronic disease that affects the nerves and results from an imbalance of electrical activity in the brain, which leads to a disturbance of the patient's consciousness that appears in the form of a seizure, and it is usually of unknown cause. It is a disorder in the central nervous system, in which the brain activity becomes abnormal, causing The occurrence of seizures or periods of unusual behaviors and sensations, and sometimes loss of consciousness, and anyone can develop epilepsy, and epilepsy affects both males and females of all races, backgrounds and ages.

Doctors generally classify epileptic seizures into "focal and generalized", based on the way in which the brain begins its abnormal activity. When focal seizures result from abnormal activity in only one part of the brain, then they are called focal (partial) seizures. These seizures are divided into two classes. Two, namely: focal seizures that do not cause loss of consciousness, and focal seizures that lead to loss of consciousness. As for generalized seizures, generalized seizures affect all parts of the brain.

According to the World Health Organization report issued in 2019, "The proportion of the general population affected by active epilepsy (that is, continued seizures or the need for treatment) ranges between 4 and 10 persons per 1000 population. However, some studies conducted in low and middle income countries indicate Indicates that the rate is higher, as it ranges between 7 and 14 people per 1000 people. "

Globally, an estimated 2.4 million people are diagnosed with epilepsy each year, and in high-income countries, the number of new cases is between 30 and 50 per 100,000 in the general population, and in low and middle-income countries, the number is doubled.

Negative effect on brain structure

The study team, published in Science Advances, used data from 1,021 people with epilepsy and 1,564 controls (a control group whose members do not suffer from epilepsy) from 19 sites around the world taken from the ENIGMA database, the database. Neuroimaging data are available to researchers within the framework of open science principles. These data have enabled researchers to map gray matter atrophy areas in the brain in people with epilepsy.

The researchers also used data provided by the Human Connectome Project, a project that was launched in July 2009, and contains data on the neuronal network of a large number of healthy people. With the aim of tracking key brain pathways and providing an unparalleled set of neural data, allowing researchers to move between and analyze this data and learn about the secrets of the living human brain.

The study team hypothesized that gray matter atrophy may occur more often in areas of the brain that experience intense nerve activity, that is, in "axons", which are extensions of nerve cells that transmit electrical impulses away from the cell body. By analyzing the results of the research, the model showed Designed by researchers, it is possible to predict the damage to gray matter due to epilepsy over time.

Bernhard says: The axons contribute to the transmission of nerve signals and have high flexibility and metabolic activity, which makes them vulnerable to atrophy due to epilepsy. Epilepsy consumes nerve connections in the brain, and our results - in which we consulted with data from multiple sites - indicate that brain connections may contribute to the effect of epilepsy on the entire brain structure.

Epilepsy of the great

Surprisingly, the potential link between epilepsy and osteopathy has fascinated many biographers and physicians for centuries. In his treatise on epilepsy, the French doctor Jean Taxelle notes that the list of great people with epilepsy included Aristotle, Heracles, Bellerophon, Socrates, Plato, Empedocles, Maracus, and other philosophy, as well as military leaders such as Julius Caesar and Napoleon, and included great artists such as the Italian painter. The famous Michelangelo and German musician George Friedrich Handel, as well as the scientist Alfred Nobel, were all suddenly suffering from epileptic seizures that were suddenly plaguing them, according to Taxil.

A professor of physiological psychology says: The recent period has witnessed the emergence of many studies that represent cognitive and scientific advances in the field of identifying epilepsy, and their results can pave the way for new treatments.

He added: In 2020, a study based on brain imaging using "magnetic resonance imaging" and published in the journal "Brain", stated that "epilepsy is accompanied by abnormalities spread in the white matter in the brain, which provides more detailed insights into the pathological basis through which the imbalances can be explained The cognitive and psychological aspects associated with epilepsy can also guide genetic research and biological marker studies for treatment outcomes.

He continues: The new study is very important. Because she not only looked at the anatomical part of the brain, but she made use of magnetic resonance imaging techniques, which helped the researchers monitor communication patterns within the brain as well.

An important step

Bernhard comments, saying: Despite the progress of scientific research in recent years in uncovering the possible role of communication processes within the brain and its relationship to some disorders such as epilepsy, there are still many unknown things, such as how disorders - such as epilepsy - affect the structure of the brain, Which appear very complex, even in "epileptic syndromes" such as temporal lobe epilepsy (one of the most common drug-resistant types of epilepsy in adults), brain structures outside the temporal lobe are often compromised, and in the current work, we have shown that mapping human brain communication can It helps in understanding the effect of various epileptic syndromes on brain structure.

Therefore, there is an urgent need to gain new insights into the characteristics of the brain's neural networks associated with epileptic seizures that include more than one region of the brain, and to accurately identify the epileptogenic region as a target for the surgery that 30% of people with epilepsy may need.

The study stresses that "there is an urgent need to develop more efficient techniques capable of processing the increasing volume of electrical signal data to identify - more closely - the area of ​​the onset of epileptic seizures."

Despite the new additions made by researchers to unravel more mysteries about epilepsy, "Bernhard" is looking forward to more global cooperation in initiatives such as ENIGMA to draw a powerful map of the impact of diseases such as epilepsy on the structure of the brain.

Bernhard says: These maps of the structure of the neural networks in the brain can help us understand how the different epileptic syndromes affect the brain, and the insights drawn from research that rely on big data can also become useful in ultimately studying each patient’s case. In future research, we may need to conduct longitudinal studies. In order to assess how the brain structure of people with epilepsy changes over time, and how these effects are related to seizure control and cognitive functions of the brain.

For his part, a doctor in neurosurgery from Paul Sabatier University in France comments on the results of the study, saying: According to this study, the older the patient gets, and the longer the disease history, this led to more atrophy in multiple areas of the brain, such as the temporal lobe and the lobe. Parietal cerebrum, movement and sense regions and thalamus.

And he adds: These areas are all high communication networks, which can be compared, for example, to a major train station, in which there is heavy movement compared to other train stations in the provinces, and although there are many networks in the brain, but these areas are like the main stations of the train, and therefore we call these areas The term "interlocutor"; Because of its high communication networks.