Our research focuses on clinical and translational research in pediatric epilepsies. The main themes include research of high frequency oscillations in EEG and epileptogenic networks using functional MRI as well as clinical picture and treatment of rare, pharmacoresistant epilepsies. The group is also participating in several pharmaceutical clinical trials.

The Pediatric Epilepsy research group focusses on improving diagnostics and treatment in pediatric epilepsies. Most studies are tailored to improve the life of children with refractory epilepsies, but we are also interested in early diagnostics and interventions in patients at risk of developing seizures.

Two main methods for diagnostics are EEG, including intracranial EEG, and MRI studies.

Our group is specialized and has substantial expertise in the analysis of High-Frequency Oscillations (HFO) in EEG. These oscillations are biomarkers for epileptic activity. We work on technical improvements that enable HFO to be used as a precise biomarker for the definition of the seizure onset zone; this helps optimize outcome in epilepsy surgery.

We also evaluate the predictive value of HFO in children with early brain injury or in children with a first unprovoked seizure to assess their risk of developing epilepsy. Another important theme is the evaluation of HFO in the context of physiological processes as memory consolidation and sleep. Together with the Epilepsy Center for adults, we try to understand mechanisms of HFO generation by looking at single cell recordings.

In collaboration with the Department of Medical Physics we have used simultaneous EEG-fMRI to improve the understanding of epileptic networks in children with epilepsy. The main aim is to use fMRI to localize metabolic changes in patients with epilepsy. Our work groups focus on technical improvement, such as new methods of EEG and fMRI analysis.

In pediatric epilepsies we often face rare and difficult to treat epilepsies. Our group focusses on providing personalized and optimized treatment for some of these conditions. This includes improving understanding of clinical presentation with a special focus on comorbidities, as well as optimizing therapy options and outcome.

One focus in this context is the research of Hypothalamic hamartomas, a rare brain malformation that causes severe epilepsy and several comorbidities. We also participate with other pediatric epilepsy centers to gather data on conditions like Tuberous Sclerosis, Dravet syndrome and other rare genetic encephalopathies.

In recent years new anti-seizure treatment has become available for refractory epilepsies and our center focusses on making these treatments available for children. We have a dedicated research unit that allows participation in international pharmaceutical trials. Additionally, we have a special focus on using Cannabidiol (CBD) for refractory epilepsies. Interest in using CBD to epilepsies has grown over the last few years; our focus is on the open label use of CBD in childhood epilepsies as well as impact on cognition and quality of life.

Complete list of publications for Kerstin A. Klotz, Julia Jacobs, Jan Schönberger and Victoria San-Antonio Arce.

• Expectations and knowledge of cannabidiol therapy for childhood epilepsy – A German caregiver survey. Klotz KA, Schönberger J, Nakamura L, San Antonio-Arce V, Bast T, Wiemer-Kruel A, Schubert-Bast S, Borggraefe I, Syrbe S, Jacobs J. Epilepsy Behav, 2020 Jul 6;111:107268. doi: 10.1016/j.yebeh.2020.107268.
• Efficacy and tolerance of synthetic cannabidiol for treatment of drug resistant epilepsy. Klotz KA, Grob D, Hirsch M, Metternich B, Schulze-Bonhage A, Jacobs J. Front Neurol, 2019 Dec 10;10:1313. doi: 10.3389/fneur.2019.01313.
• High-frequency oscillations mirror severity of human temporal lobe seizures. Schönberger J, Birk N, Lachner-Piza D, Dümpelmann M, Schulze-Bonhage A, Jacobs J. Ann Clin Transl Neurol, 2019 Dec;6(12):2479-2488. doi: 10.1002/acn3.50941.

• Removing high-frequency oscillations: A prospective multicenter study on seizure outcome. Jacobs J, Wu JY, Perucca P, Zelmann R, Mader M, Dubeau F, Mathern GW, Schulze-Bonhage A, Gotman J. Neurology, 2018 Sep 11;91(11):e1040-e1052. doi: 10.1212/WNL.0000000000006158.

• Cognitive and behavioral comorbidities in Rolandic epilepsy and their relation with default mode network’s functional connectivity and organization. Ofer I, Jacobs J, Jaiser N, Akin B, Hennig J, Schulze-Bonhage A, LeVan P. Epilepsy Behav, 2018 Jan;78:179-186. doi: 10.1016/j.yebeh.2017.10.013.

Kerstin A. Klotz and Jan Schönberger are Fellows in the Berta-Ottenstein Programme for Clinician Scientists (Freiburg University Medical Center)

DFG 1725/4-1: Spontaneous and electrically-induced cortical excitability changes of epileptic networks after radio-frequency thermo-coagulation

CSC Grant: Investigation local sleep phenomena in pediatric epileptic encephalopathy