WP 2.6: Epilepsies: Cognition et comportements

Coordonnateurs: Edouard Hirsch/Louise Tyvaert

Co-coordonnateur: Jamel Chelly/Anne de Saint-Martin, Emmanuel Raffo, Louis Maillard

General scopes and previous achievements:

Epilepsies are a group of cerebral diseases characterized by an enduring predisposition to generate epileptic seizures and having major cognitive, psychological and social consequences. Such complexity needs a global approach in order to understand the underlying pathophysiology. The cognitive impairment associated with epilepsies is a major factor of handicap. Epileptic activity itself may contribute to cognitive and behavioural impairments and in fact fare beyond what is expected from the underlying pathology alone (e.g; cortical malformation…), thus defining the concept of epileptic encephalopathy. The general idea is that suppressing or preventing the epileptic activity (by medical treatment or epilepsy surgery), may improve the cognitive and behavioural outcome of the disorder. The interaction between cognitive processes and epileptic activity is still poorly understood and requires a multidisciplinary approach combining genetics, clinical expertise, neurophysiology, functional and structural imaging (high resolution EEG, intracerebral EEG, combined EEG-fMRI, electrical source imaging). Understanding the interactions between cognitive processes and epileptic activity is crucial to develop and promote new therapeutic strategies for rare and/or severe epilepsies.

Future projects in NEUROGENYCS:

1) Understand how genetic factors combined with other factors might influence the development of epileptogenesis and cognitive-behavioral deficits. We will pursue efforts based on large scale complementary genomic studies in order to improve diagnosis and identification of genetic causes of epileptic encephalopathies. We will also develop in vitro and in vivo functional studies, including investigation of animal models.

2) Characterize cognitive and behavioral deficits in children and adults with rare and/or severe epilepsies.

3) Characterize the interactions between cognitive (visual recognition, memory, language, attention) and the epileptic networks.

4) Identify biomarkers, predictive of cognitive deficits and behavioral dysfunction.

5) Design and test new therapeutic approaches (drug, functional neurosurgery, remediation) in order to prevent and treat cognitive-behavioral deficits in epilepsies.