Taking people in FranceNo phase

Mapping brain areas that control breathing in adults with epilepsy

Studies how brain regions help breathing during stress in adults with epilepsy.

Key facts

Who runs it: Hospices Civils de Lyon
Where: Bron, FranceSee the site
Trial code: NCT07599150
Registry title: Intracranial CArtography of Cortical Contribution to Respiratory Load Compensation in Epilepsy
Status: Recruiting
People taking part: 20 people, planned
Started: 17 Sept 2026
Expected to end: 17 Sept 2028
Type of study: Interventional
Treatments tested: SEEG monitoring
Comprehensive respiratory monitoring
Cardio-respiratory monitoring
Expiratory load compensation
Hypercapnic challenge
Questionnaires
Record updated: 23 September 2026

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults aged 18 to 55 with drug-resistant focal epilepsy who are having SEEG (electrodes placed in the brain) as part of a pre-surgery work-up.

Age: 18 to 55 years
Sex: All sexes
Disease stage: Drug-resistant focal epilepsy, as defined by the International League Against Epilepsy
Earlier treatment: Must be undergoing SEEG as part of the evaluation before surgery.
Biomarker or test result: At least one SEEG electrode in the perisylvian cortex and at least one in the premotor cortex.

Main reasons for not taking part

Ongoing or long-term breathing or heart failure, or ischemic heart disease
Stroke in the last 5 years
Raised pressure in the skull from a space-occupying lesion in the brain
Pregnant, giving birth, or breastfeeding women
People receiving psychiatric care

The registry criteria, word for word

Show all 7 criteriaShow less

Who can take part

Written informed consent obtained from study subject and ability for study subject to comply with the requirements of the study
Aged 18 to 55 years old
Diagnosis of drug-resistant focal epilepsy, as defined by the International League Against Epilepsy 20
Patients undergoing SEEG as part of presurgical evaluation
At least one SEEG electrode localized in the perisylvian cortex
At least one SEEG electrode localized in the premotor cortex

Who cannot take part

Ongoing or chronic respiratory and/or cardiac insufficiency and/or ischemic cardiac disease 2. History of stroke in the last 5 years 3. Intracranial hypertension related to space-occupying lesion in the brain 4. Pregnant, parturient, or breastfeeding women 5. Individuals receiving psychiatric care 6. Individuals deprived of their liberty by judicial or administrative decision 7. Adults subject to legal protection measures (guardianship, curatorship) 8. Individuals not affiliated with a social security scheme or beneficiaries of a similar scheme; -

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

Are you between 18 and 55 years old?

Where in France

Service de Neurologie Fonctionne et d'Epileptologie Hôpital Neurologique Pierre WERTHEIMERBron, FranceContact: sylvain RHEIMS, PrTaking people

About the trial

What the trial wants to find out

30% of patients with epilepsy suffer from drug-resistant seizures and have a greater risk of premature mortality than the general population. Among all causes of death, the most frequent is SUDEP, for sudden and unexpected death in epilepsy patients. SUDEP typically occurs after a nocturnal seizure, and primarily results from a postictal central respiratory dysfunction in patients with generalized convulsive seizure (GCS), suggesting the critical role of seizure-related impairment of breathing control, and underscoring the importance of monitoring and preventive interventions during the post-ictal phase. Most of patients with drug-resistant seizures demonstrate transient peri-ictal apnea and hypoxemia especially in the aftermath of a GCS. Experimental and clinical data suggest that most SUDEP primarily result from a fatal seizure-related respiratory arrest 5. Apnea was the primary cause of death in several epilepsy models. In patients whose SUDEP had occurred during long-term video-EEG monitoring, we observed fatal postictal central apnea after a nocturnal GCS in all SUDEP. Accordingly, it is currently hypothesized that in a subgroup of patients, repetition of seizures may contribute to chronic alteration of respiratory regulation which may increase the risk of fatal postictal central respiratory arrest.

Read full original descriptionShow less

Central regulation of autonomic function is ensured by the so-called Central Autonomic Network (CAN), which anatomy in humans has primarily been investigated in neuroimaging studies or using intraEEG (iEEG) data in patients with drug-resistant focal epilepsy undergoing presurgical evaluation with intracerebral electrodes. Central regulation of breathing primarily rely on brainstem, especially the preBötzinger complex for rhythm generation and the retrotrapezoid nucleus and dorsal raphe for chemoreception, especially ventilatory response to hypercapnia. However, through an intricated structures connecting these regions, this respiratory signal projects to a network of cortical and subcortical regions mainly including the limbic and sensorimotor cortical areas. Studies in patients undergoing iEEG reinforced the role of limbic and paralimbic structures, with transient central apnea elicited by direct electrical stimulation of amygdala, hippocampus, anterior parahippocampal, and antero-mesial fusiform gyri. However, our group also reported transient hypoxemia could be elicited by cortical direct electrical stimulation outside the temporo-limbic structures, most commonly after stimulation of the perisylvian cortex. Importantly, our group recently showed that involvement of this perisylvian cortex in the epileptogenic zone is a strong risk factor of SUDEP, reinforcing the importance of further studying its integration in the cortical control of respiration.

The involvement of cortical control of ventilation is particularly important to ensure expiratory load compensation, a typical situation after GCS, which is associated with airway obstruction, especially when the face is positioned into the pillow. This cortical component of the physiological response to experimental expiratory loads was investigated in healthy subjects through the study of EEG activity during an expiratory load compensation protocol. Accordingly, EEGs were processed by ensemble averaging expiratory time-locked segments and examined for pre-expiratory EEG potentials, defined as a slow negative shift from the baseline signal preceding expiration, and suggestive of cortical preparation of expiration. Expiratory load compensation was associated with EEG premotor potential presumably involving the supplementary motor area. However, because of the limited spatial resolution of scalp EEG, the organization of cortical neural sources involved in this expiratory load compensation or during response to hypercapnia, especially the interaction between the premotor cortex, the sensorimotor cortical areas and the perisylvian cortex is unknown.

The group in the trial

Patients with drug-resistant epilepsyTreatment being tested
Patients with drug-resistant focal epilepsy, as defined by the International League Against Epilepsy, who undergo SEEG as part of presurgical evaluation of epilepsy. In addition to SEEG monitoring, the following procedures will be carried out as part of the research: * Comprehensive respiratory monitoring * Cardio-respiratory monitoring * Expiratory load compensation * Hypercapnic challenge * Questionnaires completion.
Treatment: SEEG monitoring, Comprehensive respiratory monitoring, Cardio-respiratory monitoring, Expiratory load compensation, Hypercapnic challenge, and Questionnaires