Eleonora Tamilia

Eleonora Tamilia
Harvard Medical School | HMS · Department of Pediatrics

PhD
Instructor of Pediatrics at Harvard Medical School, Boston Children's Hospital (HMS, BCH)

About

55
Publications
12,244
Reads
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522
Citations
Additional affiliations
September 2019 - present
Harvard Medical School
Position
  • Instructor
October 2015 - present
Boston Children's Hospital/Harvard Medical School
Position
  • PostDoc Position
July 2014 - December 2014
Harvard University
Position
  • Researcher

Publications

Publications (55)
Conference Paper
Full-text available
In this work a novel unobtrusive technologyaided system is presented and tested for the assessment of newborns’ oral-motor behavior and coordination during bottle feeding. A low-cost monitoring device was designed and developed in order to record Suction (S) and Expression (E) pressures from a typical feeding bottle. A software system was developed...
Article
Objective In patients with medically refractory epilepsy (MRE), interictal ripples (80‐250 Hz) are seen in large brain areas whose resection may be unnecessary for seizure‐freedom. This limits their utility as epilepsy biomarkers for surgery. We assessed the spatiotemporal propagation of interictal ripples on intracranial electroencephalography (iE...
Article
Full-text available
Objective: To evaluate the accuracy and clinical utility of conventional 21-channel EEG (conv-EEG), 72-channel high-density EEG (HD-EEG) and 306-channel MEG in localizing interictal epileptiform discharges (IEDs). Methods: Twenty-four children who underwent epilepsy surgery were studied. IEDs on conv-EEG, HD-EEG, MEG and intracranial EEG (iEEG)...
Article
Full-text available
Objective Intracranial EEG (icEEG) studies show that interictal ripples propagate across the brain of children with medically refractory epilepsy (MRE) and the onset of this propagation (ripple‐onset‐zone, ROZ) estimates the epileptogenic zone. It is still unknown whether we can map this propagation non‐invasively. The goal of this study is to map...
Article
Full-text available
About 30% of children with drug-resistant epilepsy (DRE) continue to have seizures after epilepsy surgery. Since epilepsy is increasingly conceptualized as a network disorder, understanding how brain regions interact may be critical for planning re-operation in these patients. We aimed to estimate functional brain connectivity using scalp EEG and i...
Article
Full-text available
Multimodal brain magnetic resonance imaging (MRI) can provide biomarkers of early influences on neurodevelopment such as nutrition, environmental and genetic factors. As the exposure to early influences can be separated from neurodevelopmental outcomes by many months or years, MRI markers can serve as an important intermediate outcome in multivaria...
Article
Full-text available
Delineation of resected brain cavities on magnetic resonance images (MRIs) of epilepsy surgery patients is essential for neuroimaging/neurophysiology studies investigating biomarkers of the epileptogenic zone. The gold standard to delineate the resection on MRI remains manual slice-by-slice tracing by experts. Here, we proposed and validated a semi...
Article
Full-text available
Objective Delineation of the seizure onset zone (SOZ) is required in children with drug resistant epilepsy (DRE) undergoing neurosurgery. Intracranial EEG (icEEG) serves as gold standard but has limitations. Here, we examine the utility of virtual implantation with electrical source imaging (ESI) on ictal scalp EEG for mapping the SOZ and predict s...
Conference Paper
Full-text available
Interictal epileptiform discharges (IEDs) serve as sensitive but not specific biomarkers of epilepsy that can delineate the epileptogenic zone (EZ) in patients with drug resistant epilepsy (DRE) undergoing surgery. Intracranial EEG (icEEG) studies have shown that IEDs propagate in time across large ar- eas of the brain. The onset of this propagatio...
Conference Paper
Full-text available
Studies on intracranial electroencephalography (icEEG) recordings of patients with drug resistant epilepsy (DRE) show that epilepsy biomarkers propagate in time across brain areas. Here, we propose a novel method that estimates critical features of these propagations for different epilepsy biomarkers (spikes, ripples, and fast ripples), and assess...
Conference Paper
Full-text available
Children with medically refractory epilepsy (MRE) require resective neurosurgery to achieve seizure freedom, whose success depends on accurate delineation of the epileptogenic zone (EZ). Functional connectivity (FC) can assess the extent of epileptic brain networks since intracranial EEG (icEEG) studies have shown its link to the EZ and predictive...
Article
Full-text available
Introduction Generalized tonic-clonic seizures (GTCS) are associated with elevated electrodermal activity (EDA) and postictal generalized electroencephalographic suppression (PGES), markers that may indicate sudden unexpected death in epilepsy (SUDEP) risk. This study investigated the association of GTCS semiology, EDA, and PGES in children with ep...
Article
Full-text available
Objective To assess whether ictal electric source imaging (ESI) on low-density scalp EEG can approximate the seizure onset zone (SOZ) location and predict surgical outcome in children with refractory epilepsy undergoing surgery. Methods We examined 35 children with refractory epilepsy. We dichotomized surgical outcome into seizure- and non-seizure...
Article
Full-text available
Objective To assess the utility of interictal magnetic and electric source imaging (MSI and ESI) using dipole clustering in magnetic resonance imaging (MRI)-negative patients with drug resistant epilepsy (DRE). Methods We localized spikes in low-density (LD-EEG) and high-density (HD-EEG) electroencephalography as well as magnetoencephalography (ME...
Article
Full-text available
A term neonate is born with the ability to suck; this neuronal network is already formed and functional by 28 weeks gestational age and continues to evolve into adulthood. Because of the necessity of acquiring nutrition, the complexity of the neuronal network needed to suck, and neuroplasticity in infancy, the skill of sucking has the unique abilit...
Article
Full-text available
Objectives Photoplethysmography (PPG) reflects variations of blood perfusion in tissues, which may signify seizure‐related autonomic changes. The aim of this study is to assess the variability of PPG signals and their value in detecting peri‐ictal changes in patients with focal impaired awareness seizures (FIASs). Methods PPG data were recorded us...
Article
Full-text available
Objective Photoplethysmography (PPG) is an optical technique measuring variations of blood perfusion in peripheral tissues. We evaluated alterations in PPG signals in relationship to the occurrence of generalized tonic‐clonic seizures (GTCSs) in patients with epilepsy to evaluate the feasibility of seizure detection. Methods During electroencephal...
Article
Full-text available
Objective: To assess the ability of high-density Electroencephalography (HD-EEG) and magnetoencephalography (MEG) to localize interictal ripples, distinguish between ripples co-occurring with spikes (ripples-on-spike) and independent from spikes (ripples-alone), and evaluate their localizing value as biomarkers of epileptogenicity in children with...
Article
Full-text available
Objective To localize the seizure onset zone (SOZ) and irritative zone (IZ) using electric source imaging (ESI) on intracranial EEG (iEEG) and assess their clinical value in predicting epilepsy surgery outcome in children with focal cortical dysplasia (FCD). Methods We analyzed iEEG data from 25 children with FCD-associated medically refractory ep...
Conference Paper
Full-text available
Rationale High frequency oscillations (HFOs) are emerging biomarkers of epileptogenicity that are typically investigated with intracranial EEG (iEEG). A major limitation of iEEG, linked to its invasiveness, is that it can only sample a portion of the entire cerebral cortex. Full-head non-invasive tests are often necessary to optimize iEEG placement...
Article
Full-text available
Objective: To determine the relationship between nutritive sucking and microstructural integrity of sensorimotor tracts in newborns with brain injury. Study design: Diffusion imaging was performed in ten newborns with brain injury. Nutritive sucking was assessed using Nfant®. The motor, sensory, and corpus callosum tracts were reconstructed via...
Conference Paper
Full-text available
Introduction: Patients with medically refractory epilepsy (MRE) need surgical resection of the epileptogenic zone (EZ) to gain seizure-freedom. High-frequency oscillations (HFOs, > 80 Hz) are promising biomarkers of the EZ that are typically localized using intracranial electroencephalography (icEEG). The goal of this study was to localize the cor...
Article
Full-text available
Despite extensive literature showing damages in the sensorimotor projection fibers of children with hemiplegic cerebral palsy (HCP), little is known about how these damages affect the global brain network. In this study, we assess the relationship between the structural integrity of sensorimotor projection fibers and the integrity of intergyral ass...
Conference Paper
Full-text available
Rationale For patients with medically refractory epilepsy (MRE), the success of epilepsy surgery depends on the availability of a precise biomarker of epileptogenicity. High-frequency oscillations (HFOs) have emerged as reliable epilepsy biomarkers. Ripple HFOs (>80 Hz) can be seen using magnetoencephalography (MEG) or scalp electroencephalography...
Article
Full-text available
Introduction Epilepsy surgery is a potentially curative treatment for medically refractory epilepsy (MRE). The goal of epilepsy surgery is the resection of the epileptogenic zone. Before surgery, MEG and scalp EEG are used to estimate the epileptogenic zone noninvasively by localizing the irritative zone (IZ), which is the area where interictal epi...
Article
Full-text available
Introduction Approximately 20–30% of children with epilepsy develop medically refractory epilepsy (MRE), and require surgical resection of the epileptogenic zone for seizure-freedom. High-frequency oscillations (HFOs), recorded with intracranial electroencephalography (iEEG) and separated into ripples (>80 Hz) and fast-ripples (>250 Hz) are new pro...
Article
Full-text available
Introduction: This study evaluates magnetoencephalographic (MEG) spike population as compared with intracranial electroencephalographic (IEEG) spikes using a quantitative method based on distributed source analysis. Methods: We retrospectively studied eight patients with medically intractable epilepsy who had an MEG and subsequent IEEG monitorin...
Article
Neonatal feeding has been traditionally understudied so guidelines and evidence-based support for common feeding practices are limited. A major contributing factor to the paucity of evidence-based practice in this area has been the lack of simple-to-use, low-cost tools for monitoring sucking performance. We describe new methods for quantifying neon...
Article
Full-text available
Problem: Current methods of identifying infants with Neonatal Brain Injury (NBI) may not be sensitive enough to detect in the neonatal period and others are too costly to be used routinely. Study Design: Longitudinal cohort. Expected Outcomes: Demonstrate clear evidence of the association between early abnormalities in feeding performance and und...
Article
Full-text available
Up to a third of patients with epilepsy are medically intractable and need resective surgery. To be successful, epilepsy surgery requires a comprehensive preoperative evaluation to define the epileptogenic zone (EZ), the brain area that should be resected to achieve seizure-freedom. Due to lack of tools and methods that measure the EZ directly, thi...
Article
Full-text available
Neonatal feeding has been traditionally understudied so guidelines and evidence-based support for common feeding practices are limited. A major contributing factor to the paucity of evidence-based practice in this area has been the lack of simple-to-use, low-cost tools for monitoring sucking performance. We describe new methods for quantifying neon...
Article
Full-text available
Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promisin...
Article
Full-text available
Objective: current clinical practice lacks of quantitative tools for the assessment of nutritive sucking and its coordination with breathing. This work aimed to fill this gap by integrating a module for neonatal breathing monitoring with a system for the measurement of sucking during bottle feeding. Methods: an in-house flow meter, based on two com...
Article
Full-text available
The quantitative monitoring of breathing, sucking, and swallowing is required to predict newborns’ neurodevelopmental outcomes. In particular, the coordination of breathing timing with respect to sucking cycle is crucial. In this work, we present the characterization of a low-cost flowmeter designed for noninvasive recording of breathing pattern du...
Article
Full-text available
The assessment of Oral-Motor Behavior (OMB) represents one the earliest noninvasive ways to evaluate the newborns' well-being and neuromotor behavior. This work aimed at developing a new low-cost, easy-to-use and noninvasive system for a technology-aided assessment of newborns' OMB during bottle feeding. A SUcking MOnitoring Device (SUMOD) was desi...
Data
Full-text available
Article
In this paper, we propose a novel, low cost flowmeter suitable for application in disposable breathing circuits. The sensor consists of two nominally identical transistors employed as hot sensing elements, placed into a pipe where the fluid flows. The working principle is based on the convective heat transfer between the transistors, heated by Joul...
Conference Paper
Full-text available
In newborns, a poor coordination between sucking, swallowing and breathing may undermine the effectiveness of oral feeding and signal immaturity of Central Nervous System. The aim of this work is to develop and validate a non-invasive device for recording respiratory events of newborns during bottle feeding. The proposed device working principle is...
Conference Paper
A bidirectional, low cost flowmeter for neonatal artificial ventilation, suitable for application in mono-patient breathing circuits, is described here. The sensing element consists of two nominally identical bipolar junction transistors employed as hot bodies. The sensor working principle is based on the convective heat transfer between the transi...
Conference Paper
Full-text available
In this work we propose a new method to study the development of motor planning abilities in children and, in particular, in children at high risk for ASD. Although several modified motor signs have been found in children with ASD, no specific markers enabling the early assessment of risk have been found yet. In this work, we discuss the problem po...
Conference Paper
Full-text available
Nutritive Sucking (NS) is a highly organized process that can reflect infants' maturation during the early post-natal period. The assessment of NS may provide a sensitive means of evaluating early motor skills and their development. Thus, a reliable tool for assessing sucking behavior may benefit diagnostics and treatment of newborns since the firs...
Article
Full-text available
Fiber Bragg Grating (FBG) technology is very attractive to develop sensors for the measurement of thermal and mechanical parameters in biological applications, particularly in presence of electromagnetic interferences. This work presents the design, working principle and experimental characterization of a force sensor based on two FBGs, with the fe...
Article
Action selection is extremely important, particularly when the accomplishment of competitive tasks may require access to limited motor resources. The spontaneous exploration of the world plays a fundamental role in the development of this capacity, providing subjects with an increasingly diverse set of opportunities to acquire, practice and refine...
Article
Full-text available
Recent advances in wearable sensor technologies for motion capture have produced devices, mainly based on magneto and inertial measurement units (M-IMU), that are now suitable for out-of-the-lab use with children. In fact, the reduced size, weight and the wireless connectivity meet the requirement of minimum obtrusivity and give scientists the poss...
Article
Full-text available
Nutritive Sucking (NS) is a highly organized process that is essential for infants' feeding during the first six months of their life. It requires the complex coordination of sucking, swallowing and breathing. The infant's inability to perform a safe and successful oral feeding can be an early detector of immaturity of the Central Nervous System (C...
Article
Full-text available
Motion capture based on magneto-inertial sensors is a technology enabling data collection in unstructured environments, allowing "out of the lab" motion analysis. This technology is a good candidate for motion analysis of children thanks to the reduced weight and size as well as the use of wireless communication that has improved its wearability an...
Article
Full-text available
The Sucking Efficiency (SEF) is one of the main parameters used to monitor and assess the sucking pattern development in infants. Since Nutritive Sucking (NS) is one of the earliest motor activity performed by infants, its objective monitoring may allow to assess neurological and motor development of newborns. This work proposes a new ecological an...
Cover Page
Full-text available
Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology Assessing the localization accuracy and clinical utility of electric and magnetic source imaging in children with epilepsy

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Projects (2)
Project
To lessen the negative impact of medically refractory epilepsy in children, a new pre-surgical biomarker that identifies reliably the area of the brain that generates the epileptic seizures is essential. Our research may lead to a significant improvement of the presurgical evaluation procedure and postsurgical outcome of pediatric patients with refractory epilepsy.