University of Iowa neuroscientists led by George Richerson, chair and department executive officer of neurology in the UI Carver College of Medicine, have joined eight other research groups across the world that will work together on increasing the understanding of sudden unexpected death in epilepsy (SUDEP), the leading cause of death from epilepsy.

This consortium of scientists forms the Center for SUDEP Research and will receive funding totaling $5.9 million in 2014 from the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health. The NINDS grant will be funded for five years with similar annual funding expected each year.

The Center for SUDEP Research is made up of related projects with the common goal of quickly taking SUDEP lab results into the clinic. It is NINDS' second "Center Without Walls," an initiative to speed the pace of research on difficult problems in epilepsy by promoting collaborative research.

“We hope that by encouraging scientists with expertise in a variety of areas to join forces in the Centers Without Walls initiative for SUDEP research, we may learn how to prevent the tragic death of as many as 3,000 children and adults each year in the United States,” says Walter Koroshetz, acting director of NINDS.

Seizures are common, affecting almost 1 in 20 people. Each year, SUDEP occurs in 1 out of 1,000 people with epilepsy, often in people between 20 to 40 years old. SUDEP refers to deaths with no known causes in individuals with epilepsy; there are no strategies for preventing it.

Richerson will lead the “Center for SUDEP Research: Respiratory and Arousal Mechanisms,” at the UI, which will focus on understanding how seizures can disrupt the brain mechanisms involved in breathing. Research from Richerson’s lab suggests that dysfunction in brainstem pathways involved in controlling breathing and arousal may be involved in a significant percentage of SUDEP cases. By studying individuals with epilepsy as well as mouse models, Richerson and his colleagues will investigate these pathways and look for biomarkers that may be used to screen individuals most at risk of developing SUDEP.

“Just knowing that breathing is affected by seizures changes how we communicate with patients and physicians,” Richerson says. “I want physicians to know that if they have a patient whose seizures are not being well controlled with multiple medications, they should try a different treatment strategy, because that patient is at risk for SUDEP.”

Richerson adds that there are now many options available for patients with refractory (uncontrolled) epilepsy, and it is important that these patients be evaluated at a comprehensive epilepsy center like the one in the UI Department of Neurology.

Richerson's colleagues involved in SUDEP research belong to the UI Departments of Neurology, Psychiatry, Neurosurgery, and Internal Medicine, and include Brian Gehlbach, Mark Granner, Mary Ann Werz, LeBron Paige, Rup Sainju, Gordon Buchanan, Nandakumar Narayanan, Brian Dlouhy, Hiroto Kawasaki, Matthew Howard, and John Wemmie. UI graduate students Cory Massey, YuJaung Kim, and Katherine Proch, all in Richerson's lab, are also part of the research team.

To learn more about SUDEP research at the UI, visit medcom.uiowa.edu/medicine/eyes-on-the-storm/.

A full list of the projects funded through the NINDS Center for SUDEP Research grant is available at csr.case.edu/csr/index.php/Main_Page.