Ph.D., 1986, Yale University, Epidemiology
B.A., 1979, Cornell University, Psycology
Fields
of Interest:
Seizure disorders and epilepsy, research methodology, epidemiology
Contact: atberg@niu.edu
(815) 753-1644
Office: MO 429A; Lab: 429
Dept. of Biological Sciences
Northern Illinois University
DeKalb, IL 60115
Chair – Commission on Classification and Terminology of the International League Against Epilepsy
NIH Epilepsy Benchmark Steward
Jacob K. Javits Neuroscience Investigator Award, June 2007
American Epilepsy Society Clinical Research Investigator Award, 2008
Berg AT, Langfitt J, Shinnar S, Vickrey BG, Sperling MR, Walczak T, Bazil C, Pacia SV, Spencer SS. How long does it take for partial epilepsy to become intractable? Neurology 2003; 60:186-190.
Hirtz D (chair), Berg AT, Bettis D, Camfield C, Camfield P, Crumrine P , Gaillard WD, Schneider S, Shinnar S. Practice Parameter: Treatment of the child with a first unprovoked seizure. Neurology 2003; 60: 166-175.
Berg AT, Blackstone NW. Of cabbages and kings: perspectives on classification from the field of systematics. Epilepsia 2003 44:8-12.
Berg AT, Vickrey BG, Langfitt J, Sperling MR, Walczak T, Shinnar S, Bazil C, Pacia SV, Spencer SS. The Multicenter Epilepsy Surgery Study: recruitment and selection for surgery. Epilepsia 2003;44:1425-1433.
Spencer SS, Berg AT, Vickrey BG, Sperling MR, Bazil CW, Shinnar S, Langfitt JT, Walczak TS Pacia S, Ebrahimi N, Frobish D. Initial Outcomes in the Multicenter Study of Epilepsy Surgery. Neurology 2003; 61:1680-1685.
Berg AT. La classification des épilepsies : actuelle et future. Encyclopédie Médicale et Chirurgicale, Neurologie 2003 1-044-C-60.
Berg AT, Lin J, Ebrahimi N,Testa FM, Levy SR, Shinnar S. Modeling remission and relapse in pediatric epilepsy: application of a Markov process. Epilepsy Research 2004; 60: 31-40.
Berg AT, Smith, SN, Frobish D, Beckerman B, Levy SR, Testa FM, Shinnar S.
Longitudinal assessment of adaptive behavior in infants and young children with newly diagnosed epilepsy: influences of etiology, syndrome, and seizure control. Pediatrics 2004;114:645-650.
Berg AT, Shinnar, Testa FM. Levy SR, Frobish D, Susan S, Beckerman B. Status Epilepticus after the initial diagnosis of epilepsy in children. Neurology 2004:63;1027-1034.
Berg AT, Shinnar S, Testa FM, Levy SR, Smith SN, Beckerman B. Mortality in Childhood Onset Epilepsy. Arch Pediatr Adolesc Med 2004:158;1147-1152.
Berg AT. Stopping anti-epileptic drugs after successful surgery: What do we know and what do we still need to learn? Epilepsy 2004; 45:1-2.
Berg AT. Understanding the delay before epilepsy surgery: Who develops intractable focal epilepsy and when? CNS Spectrums 2004;9:136-144.
Sirven JI, Berg AT. Marijuana as a treatment for epilepsy and multiple sclerosis? A “grass roots” movement. Neurology 2004; 62:1924.
Berg AT. Postsurgical treatment of epilepsy. Epilepsy Currents 2004; 4:127-130.
Zerr DM, Blume HK, Berg AT, Del Beccaro MA, Gospe SM, Allpress AL, Christakis DA. Nonfebrile Illness Seizures: A Unique Seizure Category? Epilepsia 2005; 46:952-955
Berg AT, Smith SN, Frobish D, Levy SR, Testa FM, Beckerman B, Shinnar S. Special education needs in children with newly diagnosed epilepsy. Dev Med Child Neurol. 2005; 47:749-753.
Devinsky O, Barr WB, Vickrey BG, Berg AT, Bazil CW, Pacia SV, Langfitt JT, Walczak TS, Sperling MR, Shinnar S, Spencer SS. Changes in depression and anxiety after resective surgery for epilepsy. Neurology 2005; 65: 1744-1749.
Spencer SS, Berg AT, Vickrey BG, Sperling MR, Bazil CW, Shinnar S, Langfitt JT, Walczak TS, Pacia SV. Predicting long-term seizure outcome after resective epilepsy surgery. The Multicenter study. Neurology 2005;65:912-918.
Berg AT. Pierre Loiseau et l’épilepsie sous l’angle de la forme et du fond. Epilepsies 2005 ;17 : 22-24.
Berg, AT, Vickrey, BG, Langfitt, JT, Sperling, MR, Shinnar, S, Bazil, C Walczak, T, Spencer, SS Reduction of AEDs in postsurgical patients who attain remisson. Epilepsia 2006; 47:64-71.
Berg AT, Kelly M. Defining intractability: Comparisons among published definitions Epilepsia 2006;47:431-436.
Berg AT, Vickrey BG, Testa FM, Levy SR, Shinnar S, DiMario F, Smith S. How long does it take epilepsy to become intractable: a prospective study. Ann Neurol 2006:60:73-79.
Chin PS, Berg AT, Spencer SS, Lee ML, Shinnar S, Sperling MR, Langfitt JT, Walczak TS,
Pacia SV, Bazil CW, Vassar S, Vickrey BG. Patient-perceived impact of resective epilepsy surgery. Neurology 2006; 66: 1882-1887
Langfitt JT, Vickrey BG, McDermott MP, Messing S, Berg AT, Spencer SS, Sperling MR, Bazil CW, Shinnar S. Validity and responsiveness of generic preference-based HRQOL instruments in chronic epilepsy. Quality of Life Research 2006;15:899-914.
Engel J (chair), Andermann F, Avanzini G, Berg A, Berkovic S, Blume W, Dulac O, Fejerman N, Lüders H, Seino M, Williamson P, Wolf P (participants). Report of the ILAE classification core group. Epilepsia; 2006; 47:1558-1568.
Theodore W, Spencer SS, Wiebe S, Langfitt JT, Ali A, O’Shafer P, Berg AT, Vickrey BG. Epilepsy in North America. Epilepsia; 2006; 47: 17001722.
Berg AT. Defining intractable epilepsy. in Blume WT, Carlen PL, Starrveld E, Wiebe S, Young GB. Intractable Epilepsies. Advances in Neurology, Vol 97. Lippincott Williams&Wilkins 2006, Phildelphia, pp:5-10.
Berg AT. Epidemiological aspects of epilepsy. in Wyllie E, The treatment of epilepsy: principles and practice, 4th edition. 2006 Lippincott Williams and Wilkins, Baltimore 109-116.
Berg AT, Spencer SS. What is the best way to measure outcome? In Miller JW and Silberg DL (eds). Epilepsy surgery: principles and controversies. 2006 Taylor&Francis, New York 633-638.
Berg AT, Engel J. Hippcampal atrophy and the prognosis of epilepsy – some answers, more questions. Neurology 2006;67:12-13.
Berg AT, Langfitt JT, Spencer SS, Vickrey BG. Stopping drugs after epilepsy surgery: a survey of US epilepsy center neurologists. Epilepsy and Behavior 2007;10:219-222.
Spencer SS, Berg AT, Vickrey BG, Sperling MR, Bazil CW, Haut S, Langfitt JT, Walczak TS, Devinsky O. Health-Related Quality of Life Over Time Since Resective Epilepsy Surgery. Ann Neurol 2007;62:327-334.
Berg AT, Vickrey BG, Testa FM, Levy SR, Shinnar S, DiMario F. Behavior and social competency in children with idiopathic and cryptogenic epilepsy. Dev Med Child Neurol 2007; 49:487-492.
Berg AT. Hypotheses, tests, methods, and innovation: the balancing act in research. Epilepsia 2007;48:2204-2216.
Shorvon SD, Berg AT. Pertussis vaccination and epilepsy – An erratic history with a new twist in the tale. Epilepsia 2008;49:219-225.
Berg AT, Langfitt JT, Testa FM, Levy SR, DiMario F, Westerveld M, Kulas J. Global Cognitive Function in Children with Epilepsy: A community-based study. Epilepsia 2008;49:608-614.
Berg AT. Vaccines, encephalopathies, and mutations. Epilepsy Currents 2007:7;40-42.
Berg AT. Introduction to the epilepsies. In Engel J, Pedley TA (ed). Epilepsy: A Comprehensive Text, 2nd edition. Lippincott-Raven Press. 2008, pp 761-766.
Berg AT, Langfitt JT Vickrey BG, Wiebe S. Outcome measures. In Engel J, Pedley TA (ed). Epilepsy: A Comprehensive Text, 2nd edition. Lippincott-Raven Press. 2008, pp 1929-1937.
Engel J, Fejerman N, Berg AT, Wolf P. Classification of the epilepsies. In Engel J, Pedley TA (ed). Epilepsy: A Comprehensive Text, 2nd edition. Lippincott-Raven Press. 2008, pp 767-772.
Engel J, Williamson P, Berg AT, Wolf P. Classification of epileptic seizures. In Engel J, Pedley TA (ed). Epilepsy: A Comprehensive Text, 2nd edition. Lippincott-Raven Press. 2008, pp 511-519.
Beghi E, Berg AT, Hauser WA. Special therapeutic considerations. In Engel J, Pedley TA (ed). Epilepsy: A Comprehensive Text, 2nd edition. Lippincott-Raven Press. 2008, pp 1327-1334.
Berg AT. Risk of recurrence after a first unprovoked seizure. Epilepsia. 2008: 49 (Suppl 1);13-18
Berg AT. The natural history of mesial temporal lobe epilepsy. Current Opin Neurol. 2008; 21:173-178.
Berg AT. Epidemiology of intractable generalized epilepsy. In Luders H, Najm I, &Bingaman W. Textbook of epilepsy surgery. Taylor&Francis, Abingdon UK 2008 pgs 207-214.
Pardoe, H Pell GS, Abbott DF, Berg AT, Jackson GD. Multisite voxel-based morphometry. Methods and a feasibility demonstration with childhood absence epilepsy. NeuroImage 2008 42:611-616.
Berg AT, Langfitt JT, Testa FM, Levy SR, DiMario F, Westerveld M, Kulas J. Residual Cognitive Effects of Uncomplicated Idiopathic and Cryptogenic Epilepsy. Epilepsy & Behavior 2008;13:614-619.
Berg AT. Our work is still cut out for us … Epileptic Disord 2008;10:68-69.
Berg AT. The risks, correlates, and temporal patterns of intractable epilepsy. In: Kahane P, Berg A, Loscher W, Nordli D, Perucca E, eds. Drug resistant epilepsies. Montrouge, France: John Libbey Eurotext, 2008:7-16
Scheffer IE, Berg AT. Classification and clinical features of absence epilepsies: how evidence leads to changing concepts. Epilepsia (in press).
Capovilla G, Berg AT, Cross JH, Moshe SL, Vigevano F, Wolf P, Avanzini G. Conceptual dichotomies in classifying epilepsies: partial versus generalized and idiopathic versus symptomatic (April 18-20th, 2008, Monreale, Italy) Epilepsia (in press).
Epidemiology, how it helps. Key Note address at the Epilepsy Society of Australia 19th annual meeting. 2004, Sydney, Australia.
Prognosis of childhood epilepsy. Presented as part of the Merril Putnam Symposium on the Prognosis of Epilepsy, Epilepsy Society of Australia 19th annual meeting. 2004, Sydney, Australia.
Concepts in Classification and their relevance to epilepsy. Berg AT, Blackstone NW. Presented at the International Symposium on Epileptic Syndromes in Infancy and Early Childhood. Tokyo, Japan, 2005.
The prognosis of childhood onset epilepsy. Presented at the International Symposium on Epileptic Syndromes in Infancy and Early Childhood. Tokyo, Japan, 2005.
Genetic Epidemiology: How and Why? Presented at the Parallel Session on Genetics, International Congress of Epilepsy. Paris France, 2005.
Mortality and life expectancy. Presented at the plenary session on mortality in epilepsy. American Epilepsy Society Meeting. 2006, San Diego, CA.
Cognitive and Psychological Issues in Epilepsy: the scope of the problem. NIH-NINDS Curing Epilepsy Conference. 2007, Bethesda, MD.
What is intractability and are there predictors? Presented at the 27th International Epilepsy Congress. Singapore. 2007.
Use of Testable Hypotheses in Construction of Classification. 27th International Epilepsy Congress. Singapore, 2007.
Intractable epilepsy: Risks, Correlates, and Temporal Patterns. 4th Progress in Epileptic Disorders workshop: Drug Resistant Epilepsies. Sitges, Spain. April 4-5, 2008.
Update on the classification of the epilepsies: where are we now. Workshop on Conceptual dichotomies: idiopathic versus symptomatic and partial versus generalized. Monreale, Italy, April 18-20, 2008
NIH workshop on Sudden Unexplained Death in Epilepsy (SUDEP). November 12-14, 2008, Bethesda, MD.
Phenomenology and epidemiology of childhood absence epilepsy. CAE symposium. Annual meeting of the American Epilepsy Society, Seattle WA, December 5-9, 2008.
FDA Alert on AEDs and Suicidality: Methodolgical Considerations. With DC. Hesdorffer. Suicidality Forum Discussion. Annual meeting of the American Epilepsy Society, Seattle WA, December 5-9, 2008.
Current Grant Support
PI: NINDS 2R37-NS31146 "Long-term outcome of childhood onset epilepsy"
Epilepsy is a complex set of diverse neurological disorders characterized by recurrent unprovoked seizures. It affects 1-2% of the population. Approximately half of all new cases arise during infancy, childhood and early adolescence. Our understanding of the nature of epilepsy has evolved considerably over the years. The ancients believed epilepsy was due to supernatural forces. Contagion was a popular theory for a while as was criminal insanity. The first major “modern” neurological treatise on epilepsy was published in 1881 by Sir William Gowers. As it was based on the most severe cases institutionalized in specialized hospitals, the conclusions were that epilepsy was a relentlessly progressive and intractable disorder. It was not until the 1970s in the US that the first population-based epidemiological study forever changed our understanding of the disorder by showing that the majority of people with epilepsy enjoy prolonged periods during which they are seizure free.
Much has yet to be understood about the long-term nature of the epilepsies. The goals of the Connecticut Study of Epilepsy (CSE) have been to contribute to our understanding of this disorder. The CSE is an NIH-funded study begun in 1993. On a state-wide basis, 613 children with newly diagnosed epilepsy were recruited. Most of the original cohort is still actively being followed a median of 12 years later. As these young people enter adulthood, we are now focusing two specific areas:
Brain morphometry: About half of adults with intractable epilepsy who are treated surgically have epilepsy of childhood onset; yet, prospective studies find few children with surgically treatable intractable epilepsy. This phenomenon occurs most typically in a specific form of epilepsy known as mesial temporal lobe epilepsy or MTLE which involves limbic networks. It is associated with a hallmark MRI lesion of hippocampal atrophy and increased signal on T2 weighted images. Even though MTLE often starts in childhood, it is rarely detected in children. Using serial MRI imaging and in collaboration with colleagues from the Brain Research Institute in Melbourne Australia, we are looking at changes in hippocampal volumetry and quantitative asymmetries in hippocampal signal as subtle early markers of the more serious lesions visually apparent in adults with full-blown intractable MTLE.
In addition, the BRI collaboration is also using a new technique, voxel-based morphometry (VBM), to identify subtle anatomical variations associated with idiopathic (presumed genetic) forms of epilepsy in which brain appear anatomically normal.
Cognitive and behavioral co-morbidity: Epilepsy is disorder of the brain that involves more than just seizures. Anything that can alter brain function sufficiently to induce a seizure may alter other aspects of brain function as well. People with epilepsy, have higher rates of a variety of behavioral and cognitive difficulties which predate the onset of seizures and may linger even after the active phase of the disorder has passed. These appear to be independent of specific brain injuries, medication effects, and seizure activity. The cognitive and behavioral co-morbidities associated with epilepsy and their long-term consequences represent a major focus of the CSE as the study cohorts matures into adulthood and the majority become seizure-free and are able to discontinue medications. The cognitive and behavioral co-morbidities were also a major focus for the March 2007 Conference held at NIH, Curing Epilepsy: Translating Discoveries into Therapies
and have now become one of the new NIH-NINDS Benchmarks for epilepsy research.