Epilepsy Surgery and SEEG

Dr. Vadym Gnatkovsky, MD, PhD

Workgroup leader

Tel.: 0228 287-10378

Vadym Gnatkovsky studied human medicine at the Medical University of Odessa from 1992 to 1998 and completed his doctorate in 2002. In 2012, he obtained his medical license from the Università degli Studi di Milano, Facoltà di Medicina e Chirurgia. From 2002 to 2020, he worked as a clinical scientist at the C. Besta Neurological Institute in Milan (Dr. Marco de Curtis), where he researched the fundamental mechanisms of epileptic seizure development in experimental and human epilepsy, as well as the identification and quantification of EEG biomarkers of the epileptogenic zone. Since 2020, he has held a position as a project leader at the University Hospital Bonn. His workgroup is supported by the Department of Epileptology (Prof. Rainer Surges).

One-third of patients with pharmacoresistant focal epilepsy are potential candidates for therapeutic surgery. The objective of epilepsy surgery is to eliminate, disconnect, or deactivate the epileptogenic cortex to achieve freedom from seizures. Precise preoperative identification of the epileptogenic zone (EZ) has significant implications for postoperative outcomes. In 20–50% of eligible patients for surgery, invasive recordings using intracerebral stereoelectroencephalographic (SEEG) electrodes are necessary for identifying the boundaries of the EZ. The Epilepsy Surgery and SEEG Group was established to explore, develop, and implement new technological approaches to facilitate this process. A comprehensive range of techniques (Video-EEG, MRI, PET, SPECT, SEEG) is employed to identify biomarkers for the epileptogenic network during preoperative evaluation and SEEG implantation planning.

The primary focus of the group is on developing computer-assisted tools for SEEG analysis, seizure detection, and surgical planning. This demands robust interdisciplinary expertise and collaboration. We invite motivated individuals who wish to join us on this exciting journey.

Methods and Expertise:

Intracranial SEEG- and Einheitsaufzeichnungen
Video-EEG
HD-EEG
ESI
MRI-Nachverarbeitung
PET
SPECT
E-Stimulation
Thermocoagulation

Staff:

Dr. med. Karmele Olaciregui
Ekaterina Poguzhelskay

Publications (selection):

Frauscher B, Mansilla D, Abdallah C, Astner-Rohracher A, Beniczky S, Brazdil M, Gnatkovsky V, Jacobs J, Kalamangalam G, Perucca P, Ryvlin P, Schuele S, Tao J, Wang Y, Zijlmans GJM, McGonigal A. Learn how to interpret and use intracranial EEG findings. Epileptic Disord. 2023 Dec 20. doi: 10.1002/epd2.20190
Jiruska P, Freestone D, Gnatkovsky V, Wang Y (2023) An update on the seizures beget seizures theory. Epilepsia. doi:10.1111/epi.17721
Pelliccia V, Villani F, Gozzo F, Gnatkovsky V, Cardinale F, Tassi L. Musicogenic epilepsy: A Stereo-electroencephalography study. Cortex. 2019 Nov;120:582-587. doi: 10.1016/j.cortex.2019.02.005
de Curtis M, Librizzi L, Uva L, Gnatkovsky V. GABAA receptor-mediated networks during focal seizure onset and progression in vitro. Neurobiol Dis. 2019 May;125:190-197. doi: 10.1016/j.nbd.2019.02.007
Gnatkovsky V, Pelliccia V, de Curtis M, Tassi L. Two main focal seizure patterns revealed by intracerebral electroencephalographic biomarker analysis. Epilepsia 2019;60(1):96-106
de Curtis M, Uva L, Gnatkovsky V, Librizzi L. Potassium dynamics and seizures: Why is potassium ictogenic? Epilepsy Res. 2018 Jul;143:50-59. doi: 10.1016/j.eplepsyres.2018.04.005
Rossini L, Garbelli R, Gnatkovsky V, Didato G, Villani F, Spreafico R, Deleo F, Lo Russo G, Tringali G, Gozzo F, Tassi L, de Curtis M. Seizure activity per se does not induce tissue damage markers in human neocortical focal epilepsy. Ann Neurol. 2017 Sep;82(3):331-341. doi: 10.1002/ana.25005
Andrzejak RG, David O, Gnatkovsky V, Wendling F, Bartolomei F, Francione S, Kahane P, Schindler K, de Curtis M. Localization of Epileptogenic Zone on Pre-surgical Intracranial EEG Recordings: Toward a Validation of Quantitative Signal Analysis Approaches. Brain Topogr. 2015 Nov;28(6):832-7. doi: 10.1007/s10548-014-0380-8
Bellistri E, Sartori I, Pelliccia V, Francione S, Cardinale F, de Curtis M, Gnatkovsky V. Fast Activity Evoked by Intracranial 50 Hz Electrical Stimulation as a Marker of the Epileptogenic Zone. Int J Neural Syst. 2015 Aug;25(5):1550022. doi: 10.1142/S0129065715500227
Boido D, Gnatkovsky V, Uva L, Francione S, de Curtis M. Simultaneous enhancement of excitation and postburst inhibition at the end of focal seizures. Ann Neurol. 2014 Dec;76(6):826-36. doi: 10.1002/ana.24193
Boido D, Kapetis D, Gnatkovsky V, Pastori C, Galbardi B, Sartori I, Tassi L, Cardinale F, Francione S, de Curtis M. Stimulus-evoked potentials contribute to map the epileptogenic zone during stereo-EEG presurgical monitoring. Hum Brain Mapp. 2014 Sep;35(9):4267-81. doi: 10.1002/hbm.22516
Gnatkovsky V, de Curtis M, Pastori C, Cardinale F, Lo Russo G, Mai R, Nobili L, Sartori I, Tassi L, Francione S. Biomarkers of epileptogenic zone defined by quantified stereo-EEG analysis. Epilepsia. 2014 Feb;55(2):296-305. doi: 10.1111/epi.12507
Gnatkovsky V, Francione S, Cardinale F, Mai R, Tassi L, Lo Russo G, de Curtis M. Identification of reproducible ictal patterns based on quantified frequency analysis of intracranial EEG signals. Epilepsia. 2011 Mar;52(3):477-88. doi: 10.1111/j.1528-1167.2010.02931.x
de Curtis M, Gnatkovsky V. Reevaluating the mechanisms of focal ictogenesis: The role of low-voltage fast activity. Epilepsia. 2009 Dec;50(12):2514-25. doi: 10.1111/j.1528-1167.2009.02249.x
Gnatkovsky V, Librizzi L, Trombin F, de Curtis M. Fast activity at seizure onset is mediated by inhibitory circuits in the entorhinal cortex in vitro. Ann Neurol. 2008 Dec;64(6):674-86. doi: 10.1002/ana.21519

All PubMed-listed publications of the Epilepsy Surgery and SEEG Workgroup are here

Third-Party Funding:

BMG (MOND, bis 2022)

Collaboration Partners / Research Consortia: (among others)

Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn (Valeri Borger)
Neuropathologisches Institut, Universitätsklinikum Erlangen (Katja Kobow)
Kognitive und Klinische Neurophysiologie AG, Universitätsklinikum Bonn (Florian Mormann)
Personalisierte Digitale Gesundheit und Telemedizin AG, Universitätsklinikum Bonn (Björn Krüger)
Pädiatrische Epilepsiechirurgie, Schön Klinik Vogtareuth (Till Hartlieb)
Epilepsy Unit, Fondazione Istituto Neurologico C. Besta, Milano (Marco de Curtis)
“Claudio Munari” Epilepsy Surgery Centre Niguarda, Milano (Laura Tassi)
EEG & Epileptologie , Hôpital Fondation Adolphe de Rothschild, Paris (Gill Huberfeld)
MOND Konsortium (LINK)