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Research Portfolio

GRANT TITLE:

NETWORKS – Neuroscience-based Epilepsy Treatment With Optimised Retrospective Knowledge and Subcortical disconnection

GRANT TYPE:

EMERGING LEADER FELLOWSHIP AWARD

grant amount:

£249,694.18

lead investigator:

Davide Giampiccolo

Co-Investigators:

-Professor John Duncan

institution:

University College London

Background

30% of people with epilepsy live with seizures that are not controlled by medication, which is known as drug-resistant epilepsy. Surgery to remove a small part of the brain where seizures occur is an option for people with drug-resistant epilepsy, but unfortunately seizures can start again in up to 50-80% of people who have this surgery.

"A third of individuals with epilepsy are resistant to medication, for whom surgery is the only possible cure. However only half of patients become seizure free using current surgical techniques. There is increasing evidence that the brain’s pathways are as involved in seizures as its surface, the cortex, so disconnecting these may support seizure freedom. With this project, we aim to evaluate which connections are the most important targets for surgery to enable seizure freedom, to help those patients for which there is no other cure.

The Study

Emerging evidence indicates that epilepsy occurs through a network involving many parts of the brain. In this project, the team will investigate if disconnecting this network can improve the chances of people becoming seizure-free after surgery.

The first stage of this project will look at state-of-the-art brain images and clinical data collected over the last 15 years from over 1000 people who have already had surgery for epilepsy. The team will use this information to identify which brain pathways are important for stopping seizures. They will then use machine learning to analyse the connections that should be targeted to be seizure-free after surgery.

The second stage of this project will build on this to offer participants this disconnection surgery, as an alternative to traditional epilepsy surgery, to see if they have a greater chance of long-term freedom from seizures.

Significance

This research will shed light on how epilepsy works, and which connections in the brain are involved, opening up new surgical possibilities in the future. This work may also pave the way for new techniques in the future such as targeted disconnection laser surgery.