About

Kathryn Adamiak Davis, M.D., M.S.T.R., is an Associate Professor of Neurology at the Hospital of the University of Pennsylvania and serves as the Associate Director of the Center for Neuroengineering and Therapeutics at the University of Pennsylvania. She is also the Division Chief of Epilepsy within the Department of Neurology. Her training in clinical epilepsy and biomedical research spans over two decades, with a focus on utilizing invasive neurophysiology and neuroimaging techniques to better localize epileptic networks in patients with medication-refractory epilepsy. Her goal is to improve localization methods to enable epileptologists to assign patients to the most effective therapies, such as seizure control devices, resective surgery, or continued medical management. Dr. Davis has expertise in epilepsy, presurgical evaluation of epilepsy patients, electroencephalography (EEG), and epilepsy neuroimaging.

Research topics

• Medicine
• Sociology
• Psychology
• Medical education
• Nursing
• Medical emergency
• Internal medicine
• Neuroscience
• Family medicine

Selected publications

• Penn 3T-7T Paired Epilepsy Imaging

  Pennsieve Discover · 2026-01-01

  datasetOpen access

  This dataset comprises multimodal paired 3T and 7T MRI scans collected from 30 patients with drug-resistant focal epilepsy along with intracranial EEG data.

  PublisherDOI

• Improving Standardization and Access to Care via Seizure Pathways in the Emergency Department

  Western Journal of Emergency Medicine · 2026-01-04

  articleOpen access

  INTRODUCTION: Seizures are one of the most common neurological presentations to an emergency department (ED), often as a first seizure of life or a breakthrough seizure. There is practice variation regarding the diagnostic workup and management for these patient populations. A standardized pathway for emergent evaluation of first seizure of life or breakthrough seizure currently does not exist, resulting in variability in evaluation and timing of outpatient care. METHODS: We created standardized pathways for evaluation and management of patients presenting to the ED with a first seizure of life or breakthrough seizure. These pathways, implemented at a large, quaternary-care hospital system, were utilized on 130 patients presenting with a seizure and compared with all patients with seizure on whom the pathway was not used, between May 2022-October 2023. Outcomes of interest included ED length of stay (LOS), proportion of patients admitted, time to outpatient follow-up, and difference in resource utilization. We compared categorical variables using chi-square test and continuous variables using the Wilcoxon rank-sum test. Equality of variance between the two cohorts was tested using the Levene test. RESULTS: There was no statistically significant difference between the percentage of male and female patients evaluated via standard-of-care model (45.6% and 49.5%) and those on the pathway (56.9% and 43.1%). The average age of patients was similar between standard-of-care and pathway groups (41 and 39 years, respectively). Median ED LOS was 5.0 (Interquartile range [IQR] 2.9-9.4) hours for standard of care and 4.8 (IQR 3.1-7.0) hours for pathway (P = .34), with a significant difference in variability in time for pathway group (P < .001). Fewer patients were admitted or observed with pathway use (P < .02). Median time to outpatient follow-up was 41.0 days (IQR 17.0-93.0) with standard of care and 23.5 days (IQR 8.0-57.0) with pathway use (P < .001). More urinalyses (P < .001), drug screens (P < .001), alcohol levels (P < .001) and computed tomography for first seizures (P < .001) were ordered for the pathway group. Fewer magnetic resonance imaging studies were ordered for patients in the breakthrough seizures group using the pathway (P < .001). CONCLUSION: Standardized pathways to approach seizure presentation in the ED can reduce variability in care, improve time to outpatient neurologic care, and standardize seizure-safety counseling.

  PublisherOA PDFDOI

• Cardioneuroablation for Ictal Asystole

  JACC. Clinical electrophysiology · 2026-04-01

  articleOpen access

  BACKGROUND: Cardioneuroablation (CNA) is an emerging therapy for vagally mediated bradyarrhythmias. Its role in ictal asystole, a rare but severe manifestation of epilepsy, remains poorly defined. OBJECTIVES: This study sought to summarize procedural characteristics and clinical outcomes of CNA performed for ictal asystole. METHODS: We conducted a retrospective multicenter study across 6 international centers, identifying adult patients who underwent CNA for ictal asystole (≥4 s) from 2017 to 2025. RESULTS: A total of 12 patients (aged 39 ± 9 years, 50% female) were included; 9/12 had focal impaired-awareness seizures. All patients exhibited sinus arrest during the events, with a mean asystole of 16 ± 8 s, and a median number of 7 syncopal events. Biatrial CNA (75% under conscious sedation) was facilitated by 3-dimensional electroanatomic mapping. Ganglionated plexi (GPs) were identified using anatomical landmarks and fractionated electrograms. Right superior (12 of 12), right inferior (10 of 12), and left inferior (9 of 12) GPs were most frequently ablated. After CNA, the sinus rate increased by ≥25% in 10 of 12 patients, and 9 of 12 demonstrated a blunted atropine response. No procedural complications occurred. Over a median follow-up of 20.5 months, 8 of 12 patients remained free from ictal asystole. Four patients experienced recurrent syncope at 2 to 15 months and underwent repeated CNA, with one of them achieving durable freedom from syncope. Two patients ultimately required a pacemaker implant. CONCLUSIONS: In patients with ictal asystole, biatrial CNA appears to be safe and may substantially reduce syncope burden, although repeated ablation or permanent pacing may be required. Prospective studies are needed to better define efficacy and long-term outcomes.

  PublisherDOI

• Status Epilepticus Protocol Variation Across Accredited National Association of Epilepsy Centers Members

  Neurology · 2025-05-16 · 3 citations

  articleOpen access

  OBJECTIVES: Status epilepticus (SE) is a neurologic emergency that requires urgent recognition and medical management. SE management remains heterogeneous across centers. METHODS: We analyzed SE treatment protocols from level 3 and level 4 epilepsy centers. Discrete data including stabilization measures, timing of treatment phases, medications, doses, and routes of administration were collected from each protocol and described using frequency for categorical variables and median for continuous variables. The distribution of treatment times and dosing were compared with the AES guideline. RESULTS: A total of 256 SE treatment protocols were included. Only 66% of SE protocols detailed treatment times. Doses below recommendations occurred in 4% of protocols for initial benzodiazepine (BZD) and 14% for first non-BZD medications. Infusion therapy was outlined in 61% of protocols. DISCUSSION: Despite the importance of timeliness in SE management, one third of institutional protocols did not specify treatment times. This analysis of US hospital inpatient SE protocols provides expert opinion regarding infusion therapy management and highlights gaps and targets for improvement in SE treatment.

  PublisherDOI

• Mesial‐to‐lateral gradients of epileptiform activity to localize mesial temporal lobe epilepsy

  Epilepsia · 2025-05-19 · 3 citations

  articleOpen access

  OBJECTIVE: Mesial temporal lobe epilepsy is a common localization of drug-resistant epilepsy in adults. Patients often undergo intracranial electroencephalographic monitoring to confirm localization and determine candidacy for focal ablation or resection. Clinicians primarily base surgical decision-making on seizure onset patterns, with imaging abnormalities and information from interictal epileptiform discharge (spikes) used as ancillary data. How the morphology and timing of spikes within multielectrode sequences may inform surgical planning is unknown, in part due to the lack of measurement methods for large datasets. We hypothesized that patients with mesial temporal lobe epilepsy have a distinct mesial-to-lateral spike gradient that differentiates them from other epilepsy localizations. METHODS: In a multicenter study at the University of Pennsylvania and the Medical University of South Carolina, we analyzed the timing and morphology of spikes and seizure high-frequency energy ratio in 75 patients with drug-resistant epilepsy. We compared these features across patients with mesial temporal lobe epilepsy, temporal neocortical epilepsy, and other localizations. RESULTS: A logistic regression model combining all features predicted a clinical localization of mesial temporal lobe epilepsy in unseen patients with an area under the receiver operating characteristic curve of .82 (compared to an area under the receiver operating characteristic curve of .70 for seizure-only features, DeLong test p = .08) and an average precision of .84. Spike rate was the most important feature in the combined model. SIGNIFICANCE: These findings advance surgical planning by demonstrating that quantitative spike analysis can effectively supplement seizure data in localizing mesial temporal lobe epilepsy. This approach could reduce reliance on prolonged seizure monitoring, potentially decreasing patient risk and hospitalization costs while improving surgical targeting. Our results support incorporating automated spike analysis into standard clinical workflows for epilepsy surgery evaluation.

  PublisherDOI

• Pennsieve: A Collaborative Platform for Translational Neuroscience and Beyond

  Scientific Data · 2025-11-19 · 3 citations

  articleOpen access

  The exponential growth of neuroscientific data necessitates platforms for data management and multidisciplinary collaboration. In this paper, we introduce Pennsieve, an open-source, cloud-based scientific data management platform that supports findable, accessible, interoperable, and reusable (FAIR) data sharing. It has integrated tools for data visualization, processing, and peer-reviewed data publishing that promote collaborative research and high-quality datasets optimized for downstream analysis, both in the cloud and on-premises. Pennsieve welcomes data submissions from individual investigators and small labs through entire consortia. It already serves more than 80 research groups worldwide and forms the core for several large-scale, interinstitutional projects and major government neuroscience research programs. Pennsieve stores over 125 TB of scientific data, with 35 TB of data publicly available in more than 350 high-impact datasets. By facilitating scientific data management, discovery, and analysis, Pennsieve fosters a robust and collaborative research ecosystem for neuroscience and beyond.

  PublisherOA PDFDOI

• Epileptiform Activity and Seizure Risk Follow Long‐Term Non‐Linear Attractor Dynamics

  Advanced Science · 2025-04-07

  articleOpen access

  Many biological systems display circadian and slow multi-day rhythms, such as hormonal and cardiac cycles. In patients with epilepsy, these cycles also manifest as slow cyclical fluctuations in seizure propensity. However, such fluctuations in symptoms are consequences of the complex interactions between the underlying physiological, pathophysiological, and external causes. Therefore, identifying an accurate model of the underlying system that governs the multi-day rhythms allows for a more reliable seizure risk forecast and targeted interventions. The primary aim is to develop a personalized strategy for inferring long-term trajectories of epileptiform activity and, consequently, seizure risk for individual patients undergoing long-term ECoG sampling via implantable neurostimulation devices. To achieve this goal, the Hankel alternative view of Koopman (HAVOK) analysis is adopted to approximate a linear representation of nonlinear seizure propensity dynamics. The HAVOK framework leverages Koopman theory and delay-embedding to decompose chaotic dynamics into a linear system of leading delay-embedded coordinates driven by the low-energy coordinate (i.e., forcing). The findings reveal the topology of attractors underlying multi-day seizure cycles, showing that seizures tend to occur in regions of the manifold with strongly nonlinear dynamics. Moreover, it is demonstrated that the identified system driven by forcings with short periods up to a few days accurately predicts patients' slower multi-day rhythms, which improves seizure risk forecasting.

  PublisherOA PDFDOI

• Improving the Detection of Mild Cognitive Impairment with FlowGAN: a Framework for ASL to FDG-PET Image Synthesis

  medRxiv · 2025-07-10

  preprintOpen access

  Abstract Background and Significance 18 F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) is commonly used to measure regional metabolism for diagnosis and monitoring of Alzheimer’s Disease (AD). However, FDG-PET is expensive and not widely available. Regional cerebral blood flow (CBF) is coupled to regional glucose metabolism and can be imaged noninvasively using Arterial Spin Labeling (ASL) perfusion MRI. Previously, we developed FlowGAN to synthesize FDG-PET images from ASL CBF and T1w MRI for lateralization of temporal lobe epilepsy (TLE). This study aims to extend FlowGAN to AD by examining the diagnostic potential of FlowGAN PET in mild cognitive impairment (MCI). Methods We included 47 MCI and 31 cognitively unimpaired (CU) individuals. FlowGAN, a generative adversarial network (GAN) for translating T1w MRI and ASL CBF maps into FDG-PET-like images, was trained using a 12-fold cross-validation scheme. We then evaluated the synthetic PET volumes by comparing them to true PET images both in appearance and for their classification performance in distinguishing MCI from CU via a random forest (RF) model, within regions of interest (ROIs). Results Synthetic FlowGAN PET volumes showed significant structural similarity to true PET volumes (SSIM = 0.958). Moreover, the performance of the best RF models for classification of MCI versus CU were comparable between the original PET and FlowGAN PET, both when considering all ROIs (PET AUC = 0.87, 95% CI: [0.79, 0.95]; FlowGAN AUC = 0.86, 95% CI: [0.77, 0.94]) and only a subset (PET AUC = 0.84, 95% CI: [0.77, 0.94]; FlowGAN AUC = 0.83, 95% CI: [0.74, 0.92]). Conclusions FlowGAN PET performs comparably to true PET in both appearance and classification. Since ASL can be acquired as part of a routine multimodal MRI protocol that is typically performed in patients with cognitive complaints, these findings may lead to improved access to diagnosis and treatment for AD.

  PublisherOA PDFDOI

• Annotating neurophysiologic data at scale with optimized human input

  Journal of Neural Engineering · 2025-06-12 · 7 citations

  articleOpen accessCorresponding

  Abstract Objective. Neuroscience experiments and devices are generating unprecedented volumes of data, but analyzing and validating them presents practical challenges, particularly in annotation. While expert annotation remains the gold standard, it is time consuming to obtain and often poorly reproducible. Although automated annotation approaches exist, they rely on labeled data first to train machine learning algorithms, which limits their scalability. A semi-automated annotation approach that integrates human expertise while optimizing efficiency at scale is critically needed. To address this, we present Annotation Co-pilot, a human-in-the-loop solution that leverages deep active learning (AL) and self-supervised learning (SSL) to improve intracranial EEG (iEEG) annotation, significantly reducing the amount of human annotations. Approach. We automatically annotated iEEG recordings from 28 humans and 4 dogs with epilepsy implanted with two neurodevices that telemetered data to the cloud for analysis. We processed 1500 h of unlabeled iEEG recordings to train a deep neural network using a SSL method Swapping Assignments between View to generate robust, dataset-specific feature embeddings for the purpose of seizure detection. AL was used to select only the most informative data epochs for expert review. We benchmarked this strategy against standard methods. Main result. Over 80 000 iEEG clips, totaling 1176 h of recordings were analyzed. The algorithm matched the best published seizure detectors on two datasets (NeuroVista and NeuroPace responsive neurostimulation) but required, on average, only 1/6 of the human annotations to achieve similar accuracy (area under the ROC curve of 0.9628 ± 0.015) and demonstrated better consistency than human annotators (Cohen’s Kappa of 0.95 ± 0.04). Significance . ‘Annotation Co-pilot’ demonstrated expert-level performance, robustness, and generalizability across two disparate iEEG datasets while reducing annotation time by an average of 83%. This method holds great promise for accelerating basic and translational research in electrophysiology, and potentially accelerating the pathway to clinical translation for AI-based algorithms and devices.

  PublisherDOI

• Seizure characteristics and outcomes in patients with pleomorphic xanthoastrocytoma

  Neuro-Oncology Advances · 2025-01-01

  articleOpen access

  Abstract Background Pleomorphic xanthoastrocytomas (PXAs) are rare brain tumors that are often associated with seizures. There are limited data characterizing epilepsy phenotypes in relation to PXA tumor biology and survival outcomes. Methods This is a retrospective observational study of 35 patients with PXA who received treatment at the University of Pennsylvania or Dana-Farber Cancer Institute. Demographic and clinical features were assessed in PXA patients with or without seizures and with respect to seizure freedom following tumor resection. Results During their clinical course, 27 (77%) developed tumor-related epilepsy (TRE), with 25 (71%) initially presenting with a seizure. Compared to those without TRE, patients with TRE were more likely to have a BRAF-mutated PXA and less likely to have frontal lobe tumor localization. Patients with TRE who became seizure-free after the initial resection up to the time of progressive disease were found to have a lower age of seizure onset, smaller tumor diameter, and more likely to have BRAF-mutated tumors compared to those who were not seizure-free. However, following the last tumor resection and accounting for tumor recurrences, there were no significant differences in clinical features between those who were seizure-free and those who were not. Overall survival was 88% after 5 years and 59% after 10 years, with similar survival rates between patients with and without TRE. Conclusion These findings indicate that BRAF-mutated and BRAF-wildtype PXAs have distinct epilepsy phenotypes. Further investigation of the interplay between tumor biology and seizures may help guide counseling and targeted therapeutic strategies for PXA-related epilepsy.

  PublisherOA PDFDOI

Recent grants

• Localizing epileptic networks using novel 7T MRI glutamate imaging

  NIH · $980k · 2016–2021

• Biomarkers to Predict Outcome from Responsive Brain Stimulation for Epilepsy

  NIH · $3.6M · 2023–2026

• Optimized Intracranial EEG Targeting in Focal Epilepsy based upon Neuroimaging Connectomics

  NIH · $3.3M · 2021–2027

Frequent coauthors

• Brian Litt

  178 shared

• Ezequiel Gleichgerrcht

  Emory University

  115 shared

• Robert E. Gross

  Emory University

  106 shared

• Nishant Sinha

  University of Pennsylvania

  101 shared

• Ruben Kuzniecky

  100 shared

• Joel M. Stein

  University of Pennsylvania

  100 shared

• Danielle S. Bassett

  McGill University

  90 shared

• Timothy H. Lucas

  Neurotech (United States)

  89 shared