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Dr Ronit Pressler

Dr Ronit Pressler

Clinical Principal Research Associate

Developmental Neurosciences Dept

UCL GOS Institute of Child Health

Joined UCL
15th Oct 2008

Research summary

The development and assessment of novel therapies for the treatment of neonatal seizures.

Co-ordinating and leading a consortium of 14 European Research Teams with over 50 basic scientists and clinicians (including neonatologists, neurophysiologists, paediatric neurologists, pharmacologists and statisticians) and successfully completing the project and clinical trial of "Treatment of Neonatal Seizures with medication off-patent" (NEMO) funded by the EU-FP7 framework.  NEMO has been Europe's first multicentred, controlled trial of antiepileptic drugs for newborn babies (http://nemo-europe.com/).  Unlike in adults, no new antiepileptic drugs have been developed for newborn babies, mainly because of ethical and logistical challenges, including the need for continuous electro-encephalography (EEG) monitoring for drug development.  We assessed whether bumetanide would be an effective novel antieptic drug.  However due to an increased occurrence of hearing loss the trial had to be stopped early.  The results of this study were published and highlighted in Lancet Neurology (Pressler et al, Lancet Neurology 2015), which reflects that NEMO has taken a "major step towards improving the treatment of seizures in neonates" (Glass H, Lancet Neurology 2015).

Epileptiform discharges and cognitive function in children with epilepsy:

Epileptiform EEG discharges are common in children with epilepsy.  However they are not confined to people with epilepsy and the frequency of such discharges is only weakly associated with indices of severity.  Indeed their clinical relevance in highly controversial and a principle of treatment is to avoid over-interpretation of epileptiform activity.  Experimental data shows that interictal spikes and ictal discharges are generated by different populations of neuron through different cellular and network mechanisms and may represent a condition that delays or prevents seizure onset.  Cognitive testing during EEG monitoring has shown disturbances of cognitive function during subclinical discharges.  The latter phenomenon of Transistory Cognitive Impairment (TCI) has been confirmed in some 50 studies, but the impact on daily life is still unclear.  My PhD aimed to study the effect of epileptiform discharges on psychosocial functioning in children with epilepsy.  I performed a randomised controlled clinical trial treating subclinical discharges in children with epilepsy and was able to show for the first time that suppression of discharges was associated with an improvement of behaviour (Pressler et al 2005.  I continued this work with EEG-correlated fMRI (Centeno et al, under peer-review, Choudhary et al HBM 2013) and PET (McGinnity et al 2015) studies, and in our current study on the effect of epileptiform discharges in sleep on memory consolidation in children with focal epilepsy.

Teaching summary

Dr Ronit Pressler teaches regularly at National and International MSc and postgraduate courses.  She also teaches externally at King's, MSc in epilepsy and on behalf of the BPNA at their short courses on epilepsy.  She has been on faculty and organising committees of several internationally run courses, including Helsinki, Berlin, London, and Istanbul.

Biography

Dr Ronit Pressler is a Consultant in Clinical Neurophysiology and Clinical Lead of the Telemetry Unit at Great Ormond Street Hospital, London.  She has research interests in: The development and assessment of novel therapies for the treatment of Neonatal seizures & Epileptiform discharges and cognitive function in children with epilepsy, publishing more than 25 peer reviewed papers and 10 book chapters.  She is Chair of the ILAE's Neonatal Task Force. She has won awards and honours including MD summa cum laude (with highest honours) by The University of Berlin, Merryl Dow Award, best poster award from the German branch of the ILAE, Cologne. 

Publications