The Targeted Research Initiative for Morbidity and Mortality supports research that generates initial data leading to more extensive projects that will generate knowledge that will ultimately improve the lives of persons with epilepsy. This initiative recognizes the need for research and new insights into these scientific areas.

The broad focus of the morbidity portion of this program includes: identification of somatic comorbidities in epilepsy that occur more than expected among controls, including but not limited to diabetes, gastrointestinal bleeding, chronic lung disease, congenital cardiac abnormalities, heart failure, and pneumonia; and associations between somatic comorbidities in epilepsy and epilepsy outcomes, including quality of life in epilepsy, seizure remission, stigma and other outcomes.

The mortality portion of the program is focused upon potentially preventable causes of death in epilepsy, such as accidents, suicide and SUDEP. Applicants are encouraged to examine risk factors for these causes of death in epilepsy; as well as interventions to decrease the presence of risk factors for these causes of death where risk factors have been identified. 


Susanne Mueller MD
The Regents of the University of California, San Francisco
Brainstem Atrophy: A SUDEP Biomarker

The goal of this project is to demonstrate that patients with difficult to control temporal lobe epilepsy (TLE) have atrophy in brainstem regions involved in cardio respiratory control and seizure inhibition using MR imaging. Consequently these patients have more severe seizures that are more often associated with respiratory and cardiac disturbances severe enough to cause hypoxia. The repetitive hypoxia leads to more brainstem damage and further aggravation of the cardiac and respiratory disturbances until they reach a critical point after which cardio respiratory control becomes unstable during heightened demand and results in a heightened SUDEP risk.

This hypothesis will be investigated by demonstrating brainstem damage in 10 TLE patients and correlating its extent with that of the cardiac/respiratory dysfunction (reduced heart rate variability) between seizures. In addition, the MRI of 5 patients who died of SUDEP will be investigated in the same way with the aim to demonstrate that they had more severe brainstem atrophy in the same regions. If successful, this project could lead to a biomarker to identify patients at risk for SUDEP and thus in need of rigorous seizure control and increased surveillance during seizures.