Seizure Prevention via Control of Neuronal Activity

Lead Research Organisation: University of Bristol
Department Name: Engineering Mathematics

Abstract

Epilepsy is a very common and serious disease. At the moment, about one third of people with epilepsy continue to have seizures despite taking the best tablet treatment available. A few can be treated successfully by removing part of the brain where seizures start, but for most people with epilepsy this is not an option. This means that we urgently need completely new treatments for epilepsy.

Other kinds of brain disease (such as Parkinson s disease) can be very successfully treated using electrical stimulation of the brain. This involves inserting tiny wires into critical parts of the brain that go wrong in Parkinson s disease. Electrical current is then used to change the way these parts of the brain work, which has proved a highly successful treatment.

In the brains of people with epilepsy, seizures arise only some of the time, and the rest of the time the brain is behaving normally. This means that we need to find a treatment approach that can keep the brain in the normal state and steer it back towards the normal state if it begins to drift towards a seizure. In this proposal, we aim to develop a technique to constantly measure whether the brain is in a stable normal state or is dirfting towards a seizure, and to deliver electrical stimulation to critical parts of the brain to keep things stable and stop seizures from arising. The electrical stimulation will change all the time depending on what the simultaneous measurement is telling us.

We will develop this system using three parallel approaches. First of all, we will use computer predictions to work out likely ways this approach might work. We will then try out these methods in an expreimntal system. Alongside this, we will collect information from some of our patients to see if our ideas are likely to work in people with epilepsy.

Technical Summary

Epilepsy is the commonest serious primary brain disease affecting 380,000 people in the UK, with 30,000 new cases per year. A third of people with epilepsy have a poor response to most antiepileptic drugs (AEDs); these people account for the majority of costs (#1.93billion per annum) and mortality (~2000 deaths per annum) of epilepsy. In such cases, resective surgery can be highly successful as an epilepsy treatment. However, surgery is only suitable for a minority (probably less than 5%) of these patients, mainly due to an inability to identify the epileptogenic zone or the epileptogenic zone is close to an area of eloquent cortex (e.g. motor strip, Brocas area).

Consequently, other radically different, new approaches are urgently required and recently, motivated by its success in alleviating symptoms in Parkinson?s disease, brain stimulation has emerged as a possible treatment option. Such a treatment strategy for epilepsy is presently in an embryonic state and the proposed project is designed to place it on a solid theoretical and clinical foundation, using a truly multidisciplinary approach combining internationally leading expertise in theoretical, experimental and clinical epilepsy research.
 
Description Epilepsy - Watershed 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Primary Audience Public/other audiences
Results and Impact 3 experts, including myself, were involved in a Q&A session with 75 members of the public on novel uses of mathematics in epilepsy research and described potential new treatments.

None to date.
Year(s) Of Engagement Activity 2009
 
Description Sheffield Neuroscience 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Primary Audience Public/other audiences
Results and Impact As part of an overview of translational neuroscience, aspects of this work were discussed with interested members of the public and patients

A number of follow-up emails from patients requesting further information
Year(s) Of Engagement Activity 2010