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Mechanisms and Prognostic Value of Ictal Onset Patterns for Epilepsy Neurostimulation

Award Number: K23NS146693
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 03/01/2026
PERIOD OF PERFORMANCE END DATE: 04/30/2031

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Mechanisms and Prognostic Value of Ictal Onset Patterns for Epilepsy Neurostimulation - PROJECT SUMMARY/ABSTRACT Dr. Andrew Michalak is an Assistant Professor of Neurology at New York University Grossman School of Medicine (NYUGSoM) with clinical expertise in epilepsy. His long-term goal is to be a physician scientist using multiscale electrophysiology to bridge the gap between the basic mechanisms of epilepsy and therapeutic options for patients. Outcomes after responsive neurostimulation (RNS) implantation for drug-resistant epilepsy vary widely, and there are currently no known biomarkers to guide lead placement or patient selection. Ictal onset patterns (IOPs) are used widely for predicting response to surgical resection, but we do not know if they are effective for guiding RNS placement. Furthermore, classifying IOPs is subjective and time-consuming. This proposal explores the basic mechanisms that give rise to ictal onset patterns using hybrid micro-/macroelectrode recordings, determines their use in predicting RNS outcomes, and uses machine learning to classify ictal patterns rapidly across the full ictal period. The specific aims are (1) identify interictal neural mechanisms that generate IOPs via multiscale recordings, (2) quantify the predictive value of IOPs for seizure reduction after RNS, and (3) determine the accuracy of neural networks to classify the full ictal period. This proposal builds on Dr. Michalak’s prior research on epilepsy surgery outcomes and microscale electrophysiology. With a mentor team of experts in the field from NYUGSoM, Dr. Michalak will gain expertise in multiscale electrophysiology methods and analysis, signal processing, and machine learning. Dr. Michalak’s mentors (Drs. Friedman, Flinker, Liu, and Devinsky) have strong track records of mentorship and will provide specific expertise in these areas. He will take advantage of the high volume of surgical epilepsy at NYUGSoM and a large retrospective dataset, as well as an existing multicenter collaboration with University of Pennsylvania and University of California – San Francisco. The data and training derived from this career development award and his strong mentorship will position Dr. Michalak as an independent clinician scientist and leader in the field of epilepsy biomarker research and therapeutic strategies.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $247,994 )
2026	2026	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	2/20/2026	NEW	$247,994
														Subtotal = $247,994

Grand Total All Awards = $247,994

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Mechanisms and Prognostic Value of Ictal Onset Patterns for Epilepsy Neurostimulation

Award Number: K23NS146693

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 03/01/2026

PERIOD OF PERFORMANCE END DATE: 04/30/2031

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