Presurgical video-EEG monitoring with foramen ovale and epidural peg electrodes: a 25-year perspective

Background: Epilepsy surgery cases are becoming more complex and increasingly require invasive video-EEG monitoring (VEM) with intracranial subdural or intracerebral electrodes, exposing patients to substantial risks. We assessed the utility and safety of using foramen ovale (FO) and epidural peg electrodes (FOP) as a next step diagnostic approach following scalp VEM. Methods: We analyzed clinical, electrophysiological, and imaging characteristics of 180 consecutive patients that underwent FOP VEM between 1996 and 2021. Multivariate logistic regression was used to assess predictors of clinical and electrophysiological outcomes. Results: FOP VEM allowed for immediate resection recommendation in 36 patients (20.0%) and excluded this option in 85 (47.2%). Fifty-nine (32.8%) patients required additional invasive EEG investigations; however, only eight with bilateral recordings. FOP VEM identified the ictal onset in 137 patients, compared to 96 during prior scalp VEM, p = .004. Predictors for determination of ictal onset were temporal lobe epilepsy (OR 2.9, p = .03) and lesional imaging (OR 3.1, p = .01). Predictors for surgery recommendation were temporal lobe epilepsy (OR 6.8, p < .001), FO seizure onset (OR 6.1, p = .002), and unilateral interictal epileptic activity (OR 3.8, p = .02). One-year postsurgical seizure freedom (53.3% of patients) was predicted by FO ictal onset (OR 5.8, p = .01). Two patients experienced intracerebral bleeding without persisting neurologic sequelae. Conclusion: FOP VEM adds clinically significant electrophysiological information leading to treatment decisions in two-thirds of cases with a good benefit-risk profile. Predictors identified for electrophysiological and clinical outcome can assist in optimally selecting patients for this safe diagnostic approach

Transcriptional response to interferon beta-1a treatment in patients with secondary progressive multiple sclerosis

Background: Interferon (IFN) beta-1a is an approved treatment for relapsing remitting multiple sclerosis (RRMS) and has been examined for use in secondary progressive multiple sclerosis (SPMS). However, no information regarding blood transcriptional changes induced by IFN treatment in SPMS patients is available. Our aim was to identify a subgroup of SPMS patients presenting a gene expression signature similar to that of RRMS patients who are clinical responders to IFN treatment. Methods: SPMS patients (n = 50, 20 IFN treated and 30 untreated) were classified using unsupervised hierarchical clustering according to IFN inducible gene expression profile identified in RRMS clinical responders to treatment. IFN inducible gene expression profile was determined by finding differentially expressed genes (DEGs) between IFN treated (n = 10) and untreated (n = 25) RRMS patients. Validation was performed on an additional independent group of 27 SPMS IFN treated patients by qRT-PCR. Results: One hundred and four DEGs, enriched by IFN signaling pathway (p = 7.4E-08), were identified in IFN treated RRMS patients. Classification of SPMS patients based on these DEGs yielded two patient groups: (1) IFN transcriptional responders (n = 12, 60 % of SPMS treated patients) showing gene-expression profile similar to IFN treated RRMS patients; (2) IFN transcriptional non-responders (n = 8) showing expression profile similar to untreated patients. IFN transcriptional responders were characterized by a more active disease, as defined by higher EDSS progression and annual relapse rate. Conclusion: Within the IFN treated SPMS population, 60 % of patients have a transcriptional response to IFN which is similar to that of RRMS patients who are IFN responders to treatment

The scientific payload of the Ultraviolet Transient Astronomy Satellite (ULTRASAT)

The Ultraviolet Transient Astronomy Satellite (ULTRASAT) is a space-borne near UV telescope with an unprecedented large field of view (200 sq. deg.). The mission, led by the Weizmann Institute of Science and the Israel Space Agency in collaboration with DESY (Helmholtz association, Germany) and NASA (USA), is fully funded and expected to be launched to a geostationary transfer orbit in Q2/3 of 2025. With a grasp 300 times larger than GALEX, the most sensitive UV satellite to date, ULTRASAT will revolutionize our understanding of the hot transient universe, as well as of flaring galactic sources. We describe the mission payload, the optical design and the choice of materials allowing us to achieve a point spread function of ~10arcsec across the FoV, and the detector assembly. We detail the mitigation techniques implemented to suppress out-of-band flux and reduce stray light, detector properties including measured quantum efficiency of scout (prototype) detectors, and expected performance (limiting magnitude) for various objects.Comment: Presented in the SPIE Astronomical Telescopes + Instrumentation 202