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Epilepsy in Childhood – Making bedside brain imaging for children with epilepsy a reality

Dr Tim Tierney

Epilepsy Research UK & Young Epilepsy Fellow

- Wellcome Centre for Human Neuroimaging University College London

This year, Dr Tim Tierney was awarded the joint Epilepsy Research UK & Young Epilepsy Fellowship Award for his project aiming to make bedside brain imaging a reality. His research sets out to develop a precise and wearable brain scanner that can be worn in any hospital ward or residential setting. This scanner would eliminate the need for invasive assessments and ultimately provide enhanced surgical planning at a younger age for many more children. In this Research Blog, Dr Tierney discusses his career journey as a researcher so far, including the factors behind the development of this vital new fellowship project.

Securing a fellowship is an important step in any researcher’s career. A fellowship provides funding to pursue your own ideas and a platform to become an independent researcher. As a result, I feel very lucky to have been awarded this years’ Epilepsy Research UK & Young Epilepsy Fellowship. In this Research Blog, I will share exactly how fortunate I’ve been.

I completed my PhD at the UCL Institute of Child Health, where I studied brain imaging and its use for planning epilepsy surgery. I was lucky to have a great supervisor who involved me in lots of different projects where I was able to learn about a huge variety of brain imaging technologies. However, it was attending the epilepsy surgery meetings that drove home just how important good quality brain imaging could be. I was amazed to see how the clinicians integrated all the information from different tests and brain scans to help plan a child’s surgery. Observing this made me want to focus on how to optimise brain imaging to ensure the clinical team had the best possible data to work with.

The biggest challenge in acquiring good quality brain imaging data is making sure that a child stays as still as possible while having their brain scanned. If they move around during the scan, the quality of data is often negatively affected. This problem affects nearly all brain imaging techniques, but none more so than with young people. Having a technology that could still provide good quality data even while a child moves about would be transformative.

I was delighted when one of my PhD examiners offered me a job a few weeks after my exam to work on a new brain imaging device: The Optically Pumped Magnetometer (OPM). An OPM is a device that can identify where in the brain seizures are coming from, but its main advantage is that it can do so even while a child is moving about (ideal for planning brain surgery in children). Luck had struck again.

However, as amazing as this technology can be, it does have limitations. The main issue is that it requires a very expensive and specialised room called a magnetically shielded room, and not all hospitals have these. The device is also not as sensitive to the very fast brain activity that neurophysiologists are often interested in.

Then one day, during a spur of the moment conversation between an atomic physicist and neurophysiologist, the physicist mentioned that these weaknesses could be overcome by modifying our existing sensors. Eliminating these weaknesses would mean that not only would we have a system that could image brain activity while children moved about, but we could also do it very cheaply and with the sensitivity for all the types of brain activity neurophysiologists are interested in. This means we can take this technology from the laboratory straight to the patient’s bedside. Thus, my fellowship application ‘Bedside Brain Imaging’ was born.

I immediately began writing my fellowship application to convince Epilepsy Research UK and Young Epilepsy that this technology was worth investing in. After a lot of writing, support and encouragement from my colleagues, as well as many interviews, I got an amazing call from Epilepsy Research UK to tell me I had been successful in my application.

So, when I say I feel lucky to have this fellowship, I really mean it. Amazing supervision, chance encounters and impromptu conversations were the basis of what would eventually become this fellowship. It’s hard to thank everyone enough, but all I can say is that I really am truly grateful for everyone who was a part of this process. I’m particularly grateful to Epilepsy Research UK, Young Epilepsy and their supporters for believing in me and my research.

-Dr Tim Tierney

You can read more about Dr Tim Tierney’s research project on bedside brain imaging here