Improving the presurgical evaluation of patients with refractory focal epilepsy using advanced neuroimaging techniques
Lead Research Organisation:
University College London
Department Name: Institute of Neurology
Abstract
Epilepsy is a common neurological condition affecting around 1% of the population (600,000 people in the UK). Frequent seizures carry risk of injury and death and significant psychosocial consequences, affecting relationships, employment and the ability to drive. There are over 20 medications to treat epilepsy, but a third of people with epilepsy continue to have seizures despite medication.
Surgical treatment of epilepsy in which the abnormal part of the brain is removed is an effective technique to cure or improve seizures suitable for some people with epilepsy. The National Hospital for Neurology and Neurosurgery, with the Epilepsy Society and UCL Institute of Neurology, is the largest centre in the UK undertaking epilepsy surgery (100 operations a year) and has an internationally known research programme to improve the identification of patients for surgery and understand and improve the outcomes.
In order for a person to be suitable for surgery, it is necessary to confirm that seizures are arising from one part of the brain and that it is safe to remove this part. This requires many tests including MRI brain scans. Despite advances in technology, around 30% of people with seizures arising from one part of the brain have completely normal MRI scans. Further investigation with other types of scan is expensive, may involve radiation exposure and is not available in most places, unlike MRI. If imaging cannot identify the source of seizures, recording wires may be placed directly onto the brain surface. This is available in only a few places, is invasive, very expensive and carries some risk.
In my previous research, presented and published internationally, I developed MRI techniques to improve the safety of surgery and understand its effects on the brain. I showed preliminary results in which new MRI techniques could identify the source of seizures in patients with normal MRI scans.
In the first part of this project, I will assess several new MRI techniques to determine which are helpful in identifying the source of seizures in people with severe epilepsy and normal standard scans. I will use new ways of acquiring MRI scans and will work with colleagues in the UCL Centre for Medical Image Computing, with whom I have worked for the last 5 years, and the Montreal Neurological Institute to develop new ways to analyze the scans by computer to detect subtle abnormalities not seen by the human eye.
These developments will enable a larger proportion of people with epilepsy to undergo surgery and be cured or significantly improved from epilepsy. MRI may replace some more expensive and less readily available scans. This will simplify and shorten the investigation pathway so surgery can take place more quickly. Since MRI is widely available at all epilepsy surgery centres, the new techniques can be introduced elsewhere to improve assessment and treatment for people with epilepsy. Understanding of these techniques can also be applied to other conditions such as dementia and stroke.
In the second part, I will build on my prior work using MRI to make surgery safer. I used a special type of MRI scan to identify connections in the brain important for vision and displayed these connections to the surgeon when they were operating so they could treat epilepsy without damaging vision and thus allow people to return to driving. At present, there are many limitations with this and analysis takes a long time. I will improve the technique to give more detailed and accurate images of the brain more quickly. The results and software will be made freely available to allow other centres to adopt the technique.
Overall more people will be identified as suitable for surgical treatment, more quickly and at lower cost using techniques that are applicable to all epilepsy surgery centres rather than just at highly specialised units. A greater understanding of these new MRI techniques will allow them to be used in many other conditions.
Surgical treatment of epilepsy in which the abnormal part of the brain is removed is an effective technique to cure or improve seizures suitable for some people with epilepsy. The National Hospital for Neurology and Neurosurgery, with the Epilepsy Society and UCL Institute of Neurology, is the largest centre in the UK undertaking epilepsy surgery (100 operations a year) and has an internationally known research programme to improve the identification of patients for surgery and understand and improve the outcomes.
In order for a person to be suitable for surgery, it is necessary to confirm that seizures are arising from one part of the brain and that it is safe to remove this part. This requires many tests including MRI brain scans. Despite advances in technology, around 30% of people with seizures arising from one part of the brain have completely normal MRI scans. Further investigation with other types of scan is expensive, may involve radiation exposure and is not available in most places, unlike MRI. If imaging cannot identify the source of seizures, recording wires may be placed directly onto the brain surface. This is available in only a few places, is invasive, very expensive and carries some risk.
In my previous research, presented and published internationally, I developed MRI techniques to improve the safety of surgery and understand its effects on the brain. I showed preliminary results in which new MRI techniques could identify the source of seizures in patients with normal MRI scans.
In the first part of this project, I will assess several new MRI techniques to determine which are helpful in identifying the source of seizures in people with severe epilepsy and normal standard scans. I will use new ways of acquiring MRI scans and will work with colleagues in the UCL Centre for Medical Image Computing, with whom I have worked for the last 5 years, and the Montreal Neurological Institute to develop new ways to analyze the scans by computer to detect subtle abnormalities not seen by the human eye.
These developments will enable a larger proportion of people with epilepsy to undergo surgery and be cured or significantly improved from epilepsy. MRI may replace some more expensive and less readily available scans. This will simplify and shorten the investigation pathway so surgery can take place more quickly. Since MRI is widely available at all epilepsy surgery centres, the new techniques can be introduced elsewhere to improve assessment and treatment for people with epilepsy. Understanding of these techniques can also be applied to other conditions such as dementia and stroke.
In the second part, I will build on my prior work using MRI to make surgery safer. I used a special type of MRI scan to identify connections in the brain important for vision and displayed these connections to the surgeon when they were operating so they could treat epilepsy without damaging vision and thus allow people to return to driving. At present, there are many limitations with this and analysis takes a long time. I will improve the technique to give more detailed and accurate images of the brain more quickly. The results and software will be made freely available to allow other centres to adopt the technique.
Overall more people will be identified as suitable for surgical treatment, more quickly and at lower cost using techniques that are applicable to all epilepsy surgery centres rather than just at highly specialised units. A greater understanding of these new MRI techniques will allow them to be used in many other conditions.
Technical Summary
Research questions:
1. Can arterial spin labelling (ASL) reliably identify interictal hypoperfusion and determine the laterality and broad localisation of epilepsy in comparison to FDG-PET?
2. Can neurite orientation density and dispersion imaging (NODDI) identify subtle structural abnormalities, particularly malformations of cortical development?
3. Are developmental MRI techniques such as sodium MRI and glucose chemical exchange saturation transfer (GlucoCEST) of benefit?
4. Can voxel-based and more advanced analyses of multimodal MRI data, including both conventional structural scans and these new data detect subtle abnormalities?
5. Is higher resolution diffusion tensor imaging (ZOOM-DTI) beneficial for optic radiation tractography?
6. Can automated seed placement and real time probabilistic tractography improve tractography processing?
Patients with refractory focal epilepsy undergoing presurgical assessment and conventional MRI will be invited to have additional research scans and healthy age/sex-matched controls will undergo the same scans. Standard postsurgical follow up includes clinical assessment and repeat scans at 4 and 12 months.
ASL and NODDI will be processed as in previous literature and software will be developed to perform voxel-based analysis and improve the detection of subtle abnormalities. This will improve the understanding of data from these scans in epilepsy and other conditions and allow a greater proportion of patients to undergo surgery with a cheaper and more streamlined assessment process.
Patients with temporal lobe epilepsy will undergo ZOOM-DTI and tractography data will be used to guide surgery with postoperative assessment of visual outcomes. Atlas-based techniques for automated seed point placement will be further developed for the optic radiation and corticospinal tract. Tractography processing will be implemented on a graphical processing unit (GPU) to enable more accurate results to be available more quickly.
1. Can arterial spin labelling (ASL) reliably identify interictal hypoperfusion and determine the laterality and broad localisation of epilepsy in comparison to FDG-PET?
2. Can neurite orientation density and dispersion imaging (NODDI) identify subtle structural abnormalities, particularly malformations of cortical development?
3. Are developmental MRI techniques such as sodium MRI and glucose chemical exchange saturation transfer (GlucoCEST) of benefit?
4. Can voxel-based and more advanced analyses of multimodal MRI data, including both conventional structural scans and these new data detect subtle abnormalities?
5. Is higher resolution diffusion tensor imaging (ZOOM-DTI) beneficial for optic radiation tractography?
6. Can automated seed placement and real time probabilistic tractography improve tractography processing?
Patients with refractory focal epilepsy undergoing presurgical assessment and conventional MRI will be invited to have additional research scans and healthy age/sex-matched controls will undergo the same scans. Standard postsurgical follow up includes clinical assessment and repeat scans at 4 and 12 months.
ASL and NODDI will be processed as in previous literature and software will be developed to perform voxel-based analysis and improve the detection of subtle abnormalities. This will improve the understanding of data from these scans in epilepsy and other conditions and allow a greater proportion of patients to undergo surgery with a cheaper and more streamlined assessment process.
Patients with temporal lobe epilepsy will undergo ZOOM-DTI and tractography data will be used to guide surgery with postoperative assessment of visual outcomes. Atlas-based techniques for automated seed point placement will be further developed for the optic radiation and corticospinal tract. Tractography processing will be implemented on a graphical processing unit (GPU) to enable more accurate results to be available more quickly.
Planned Impact
Improved health and well-being of people with epilepsy
Epilepsy is a major global problem and delays for surgical treatment through failing to consider patients for surgery and to subsequently identify appropriate patients. Improved imaging techniques will enable a greater proportion of patients to be deemed suitable for surgery with consequent improved quality of life. Assessment will occur more quickly, be more convenient with fewer hospital visits and involve less exposure to radiation and risk.
Beneficial economic effects for society
People with severe epilepsy are frequently unable to work, consume significant healthcare resources and many survive on social security benefits. By facilitating a greater number of patients to undergo surgery leading to seizure freedom or marked improvement enables a return to the workforce and increased economic output. It benefits psychosocial factors such as relationships and holding a driving licence.
Improved economy and organisation of healthcare delivery
At present the evaluation pathway for epilepsy surgery can be lengthy and involves nuclear medicine techniques that have limited availability (PET is not available at all centres; SPECT may require patients to go abroad). If these techniques can be avoided in some patients, this has beneficial cost and resources implications for the NHS and increases patient throughput. Utilising MRI techniques that can be implemented on clinical scanners would enable a greater number of centres to perform presurgical assessment.
Such benefits may extend to the treatment of patients with other conditions requiring similar investigation including cerebrovascular disease and dementia/neurodegenerative disorders which are very common important healthcare problems.
Implications for healthcare policymakers and changed practices
Although consideration for epilepsy surgery is enshrined in current NICE guidelines for the treatment of epilepsy, such referral typically occurs late in the disease. By increasing the utility of epilepsy surgery, this can inform guidelines and service provision with the aim to change practice in the UK (and abroad) by considering surgery and the potential benefits at a much earlier stage.
Close working with a charity, the Epilepsy Society
The Epilepsy Society is a charity that is the UK's leading provider of epilepsy services working for the benefit of all people affected by epilepsy. They create a powerful voice for people with epilepsy and actively campaign for their rights and influence policy on healthcare, social reform and welfare. By continuing to work closely with them, the third sector will be aware of research advances to inform the public and policy.
Commercialisation and exploitation
Scanner manufacturers include sequences for diffusion imaging, and more recently arterial spin labelling (ASL), as standard in scanner console software. Tractography processing modules may be available on the scanner or in separate commercial packages. If the novel techniques are beneficial, scanner manufacturers may wish to include optimal sequences for ASL and diffusion acquisitions suitable for NODDI as standard. Processing modules for these techniques and the improved tractography algorithms developed could be included in commercial packages.
Research staff skills
Researchers at the EPSRC Doctoral Training Programme at the Centre for Medical Image Computing will benefit from a link to an active clinical service where advances can rapidly be translated into clinical use and improve the strong link between basic research and clinical application. This will enable research students to recognise the importance and role of clinical translation and how these can be introduced in practice and would form an important part of the training which can be subsequently applied elsewhere as researchers frequently work in the commercial sector following their doctoral degree.
Epilepsy is a major global problem and delays for surgical treatment through failing to consider patients for surgery and to subsequently identify appropriate patients. Improved imaging techniques will enable a greater proportion of patients to be deemed suitable for surgery with consequent improved quality of life. Assessment will occur more quickly, be more convenient with fewer hospital visits and involve less exposure to radiation and risk.
Beneficial economic effects for society
People with severe epilepsy are frequently unable to work, consume significant healthcare resources and many survive on social security benefits. By facilitating a greater number of patients to undergo surgery leading to seizure freedom or marked improvement enables a return to the workforce and increased economic output. It benefits psychosocial factors such as relationships and holding a driving licence.
Improved economy and organisation of healthcare delivery
At present the evaluation pathway for epilepsy surgery can be lengthy and involves nuclear medicine techniques that have limited availability (PET is not available at all centres; SPECT may require patients to go abroad). If these techniques can be avoided in some patients, this has beneficial cost and resources implications for the NHS and increases patient throughput. Utilising MRI techniques that can be implemented on clinical scanners would enable a greater number of centres to perform presurgical assessment.
Such benefits may extend to the treatment of patients with other conditions requiring similar investigation including cerebrovascular disease and dementia/neurodegenerative disorders which are very common important healthcare problems.
Implications for healthcare policymakers and changed practices
Although consideration for epilepsy surgery is enshrined in current NICE guidelines for the treatment of epilepsy, such referral typically occurs late in the disease. By increasing the utility of epilepsy surgery, this can inform guidelines and service provision with the aim to change practice in the UK (and abroad) by considering surgery and the potential benefits at a much earlier stage.
Close working with a charity, the Epilepsy Society
The Epilepsy Society is a charity that is the UK's leading provider of epilepsy services working for the benefit of all people affected by epilepsy. They create a powerful voice for people with epilepsy and actively campaign for their rights and influence policy on healthcare, social reform and welfare. By continuing to work closely with them, the third sector will be aware of research advances to inform the public and policy.
Commercialisation and exploitation
Scanner manufacturers include sequences for diffusion imaging, and more recently arterial spin labelling (ASL), as standard in scanner console software. Tractography processing modules may be available on the scanner or in separate commercial packages. If the novel techniques are beneficial, scanner manufacturers may wish to include optimal sequences for ASL and diffusion acquisitions suitable for NODDI as standard. Processing modules for these techniques and the improved tractography algorithms developed could be included in commercial packages.
Research staff skills
Researchers at the EPSRC Doctoral Training Programme at the Centre for Medical Image Computing will benefit from a link to an active clinical service where advances can rapidly be translated into clinical use and improve the strong link between basic research and clinical application. This will enable research students to recognise the importance and role of clinical translation and how these can be introduced in practice and would form an important part of the training which can be subsequently applied elsewhere as researchers frequently work in the commercial sector following their doctoral degree.
People |
ORCID iD |
Gavin Winston (Principal Investigator / Fellow) |
Publications
Winston GP
(2015)
The role of magnetic resonance imaging techniques in the diagnosis, surgical treatment and biological understanding of epilepsy.
in Quantitative imaging in medicine and surgery
Caciagli L
(2020)
Thalamus and focal to bilateral seizures: A multiscale cognitive imaging study.
in Neurology
Sinha N
(2023)
Intracranial EEG Structure-Function Coupling and Seizure Outcomes After Epilepsy Surgery.
in Neurology
Sinha N
(2021)
Structural Brain Network Abnormalities and the Probability of Seizure Recurrence After Epilepsy Surgery.
in Neurology
Binding LP
(2023)
Contribution of White Matter Fiber Bundle Damage to Language Change After Surgery for Temporal Lobe Epilepsy.
in Neurology
Peter Binding L
(2023)
The impact of temporal lobe epilepsy surgery on picture naming and its relationship to network metric change.
in NeuroImage. Clinical
Isen J
(2021)
Non-parametric combination of multimodal MRI for lesion detection in focal epilepsy.
in NeuroImage. Clinical
Horsley JJ
(2022)
Volumetric and structural connectivity abnormalities co-localise in TLE.
in NeuroImage. Clinical
Taylor PN
(2018)
The impact of epilepsy surgery on the structural connectome and its relation to outcome.
in NeuroImage. Clinical
Mancini M
(2019)
Automated fiber tract reconstruction for surgery planning: Extensive validation in language-related white matter tracts.
in NeuroImage. Clinical
Description | Charitable Grant |
Amount | £60,000 (GBP) |
Organisation | Toyota Foundation |
Sector | Private |
Country | Japan |
Start | 12/2017 |
End | 12/2018 |
Description | Multimodal prediction of seizure recurrence after unprovoked first seizure to guide clinical decision-making: A multi-centre study of cognition, mood and brain connectivity as predictors |
Amount | $1,139,850 (CAD) |
Funding ID | PJT-183906 |
Organisation | Canadian Institutes of Health Research |
Sector | Public |
Country | Canada |
Start | 09/2022 |
End | 09/2027 |
Description | NIHR North Thames CRN |
Amount | £100,000 (GBP) |
Organisation | National Institute for Health Research |
Department | NIHR Biomedical Research Centre |
Sector | Public |
Country | United Kingdom |
Start | 07/2016 |
End | 02/2019 |
Description | Neuroimaging biomarkers of cognitive dysfunction in people with epilepsy |
Amount | $249,500 (CAD) |
Funding ID | 21-31 |
Organisation | PSI Foundation |
Sector | Academic/University |
Country | Canada |
Start | 04/2021 |
End | 04/2024 |
Description | Research Grant |
Amount | £113,333 (GBP) |
Organisation | Fight for Sight |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 09/2015 |
End | 09/2017 |
Title | Hippocampal T2 profiling |
Description | Publicly available software scripts to automated determine T2 profiles with the human hippocampus from MRI imaging |
Type Of Material | Improvements to research infrastructure |
Year Produced | 2017 |
Provided To Others? | Yes |
Impact | In our centre, this has been introduced into routine clinical practice for the evauation of patients for epilepsy surgery in the National Hospital for Neurology & Neurosurgery. It has been made freely available so other centres can implement the same. |
URL | https://github.com/sjoerdvos/hippocampal_T2 |
Title | Data from: Thalamus and focal to bilateral seizures: a multi-scale cognitive imaging study |
Description | Objective To investigate the functional correlates of recurrent secondarily generalized seizures in temporal lobe epilepsy (TLE), using task-based fMRI as a framework to test for epilepsy-specific network rearrangements. As the thalamus modulates propagation of temporal-lobe onset seizures and promotes cortical synchronization during cognition, we hypothesized that occurrence of secondarily generalized, i.e. focal to bilateral tonic-clonic seizures (FBTCS), would relate to thalamic dysfunction, altered connectivity and whole-brain network centrality. Methods FBTCS occur in a third of patients with TLE and are a major determinant of disease severity. In this cross-sectional study, we analyzed 113 patients with drug-resistant TLE (55 left/58 right), who performed a verbal fluency fMRI task that elicited robust thalamic activation. Thirty-three patients (29%) had experienced at least one FBTCS in the year preceding the investigation. We compared patients with TLE-FBTCS to those without FBTCS via a multi-scale approach, entailing analysis of SPM12-derived measures of activation, task-modulated thalamic functional connectivity (psychophysiological interaction), and graph-theoretical metrics of centrality. Results Individuals with TLE-FBTCS had less task-related activation of bilateral thalamus, with left-sided emphasis, and left hippocampus than those without FBTCS. In TLE-FBTCS, we also found greater task-related thalamotemporal and thalamo-motor connectivity, and higher thalamic degree and betweenness centrality. Receiver operating characteristic curves, based on a combined thalamic functional marker, accurately discriminated individuals with and without FBTCS. Conclusions In TLE-FBTCS, impaired task-related thalamic recruitment coexists with enhanced thalamotemporal connectivity and whole-brain thalamic network embedding. Altered thalamic functional profiles are proposed as imaging biomarkers of active secondary generalization. |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | Yes |
URL | http://datadryad.org/stash/dataset/doi:10.5061/dryad.2bvq83bm8 |
Title | Structural brain network abnormalities and the probability of seizure recurrence after epilepsy surgery: supplementary material |
Description | Objective: We assessed pre-operative structural brain networks and clinical characteristics of patients with drug resistant temporal lobe epilepsy (TLE) to identify correlates of post-surgical seizure recurrences. Methods: We examined data from 51 TLE patients who underwent anterior temporal lobe resection (ATLR) and 29 healthy controls. For each patient, using the preoperative structural, diffusion, and post-operative structural MRI, we generated two networks: 'pre-surgery' network and 'surgically-spared' network. Standardising these networks with respect to controls, we determined the number of abnormal nodes before surgery and expected to be spared by surgery. We incorporated these 2 abnormality measures and 13 commonly acquired clinical data from each patient in a robust machine learning framework to estimate patient-specific chances of seizures persisting after surgery. Results: Patients with more abnormal nodes had lower chance of seizure freedom at 1 year and even if seizure-free at 1 year, were more likely to relapse within five years. In the surgically-spared networks of poor outcome patients, the number of abnormal nodes was greater and their locations more widespread than in good outcome patients. We achieved 0.84±0.06 AUC and 0.89±0.09 specificity in predicting unsuccessful seizure outcomes as opposed to complete seizure freedom at 1-year. Moreover, the model-predicted likelihood of seizure relapse was significantly correlated with the grade of surgical outcome at year-one and associated with relapses up-to five years post-surgery. Conclusion: Node abnormality offers a personalised non-invasive marker, that can be combined with clinical data, to better estimate the chances of seizure freedom at 1 year, and subsequent relapse up to 5 years after ATLR. |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | Yes |
URL | http://datadryad.org/stash/dataset/doi:10.5061/dryad.vx0k6djnv |
Description | ENIGMA Epilepsy |
Organisation | University of Southern California |
Department | Enigma Center |
Country | United States |
Sector | Academic/University |
PI Contribution | Data sharing and contribution to manuscripts of an international multicentre neuroimaging study on epilepsy |
Collaborator Contribution | Data sharing and contribution to manuscripts of an international multicentre neuroimaging study on epilepsy |
Impact | Several papers |
Start Year | 2018 |
Description | GOSH (Fight for Sight/MELD) |
Organisation | Great Ormond Street Hospital (GOSH) |
Department | NIHR Great Ormond Street Biomedical Research Centre |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | 1. Collaborative grant awarded from Fight for Sight for assessment of optic radiation tractography for epilepsy surgery guidance in children, this builds on my work in adults with my MRC Clinical Research Training Fellowship 2. Partner in a multi-centre collaborative study on automated detection of FCD in which I am supervising a student. |
Collaborator Contribution | 1. Funding application, supply ot staff (neurosurgery, ophthalmology, neurophysiology), appointment of post-doc research assistant. 2. Development of original scripts to perform machine learning on imaging data. |
Impact | PMID 32322185 |
Start Year | 2016 |
Description | MNI |
Organisation | McGill University |
Department | Montreal Neurological Institute and Hospital |
Country | Canada |
Sector | Hospitals |
PI Contribution | Acquisition and supply of imaging data and analysis of data |
Collaborator Contribution | Development of software algorithms to analysis imaging data. |
Impact | https://pubmed.ncbi.nlm.nih.gov/32814957/ https://pubmed.ncbi.nlm.nih.gov/32146320/ |
Start Year | 2017 |
Description | Newcastle Peter Taylor |
Organisation | Newcastle University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Acquisition and supply and imaging data and clinical data and input into analysis and interpretation of results. |
Collaborator Contribution | Analysis of data, and supervision of students in this area. |
Impact | https://pubmed.ncbi.nlm.nih.gov/29876245/ https://pubmed.ncbi.nlm.nih.gov/32623138/ https://pubmed.ncbi.nlm.nih.gov/32814957/ https://pubmed.ncbi.nlm.nih.gov/33186714/ https://pubmed.ncbi.nlm.nih.gov/33222308/ https://pubmed.ncbi.nlm.nih.gov/33361262/ https://pubmed.ncbi.nlm.nih.gov/33476430/ https://pubmed.ncbi.nlm.nih.gov/35656586/ https://pubmed.ncbi.nlm.nih.gov/35863179/ https://pubmed.ncbi.nlm.nih.gov/36750386/ All involve collaboration between neuroscience and computer science |
Start Year | 2016 |
Title | Automated hippocampal T2 profiling |
Description | Automated calculation of hippocampal T2 relaxometry values in an anterior-posterior gradient for detection of hippocampal sclerosis in patients with epilepsy. |
Type Of Technology | Software |
Year Produced | 2017 |
Open Source License? | Yes |
Impact | In our centre, this has been introduced into routine clinical practice for the evauation of patients for epilepsy surgery in the National Hospital for Neurology & Neurosurgery. It has been made freely available so other centres can implement the same |
URL | https://github.com/sjoerdvos/hippocampal_T2 |
Description | 2nd International Training Course on Neuroimaging of Epilepsy |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | Presentation multimodal imaging for surgical planning at an international workshop on epilepsy imaging, incorporating research advances |
Year(s) Of Engagement Activity | 2018 |
Description | Computer-aided interpretation of epilepsy imaging |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Talk at hospital neurology department informing about my research |
Year(s) Of Engagement Activity | 2017 |
Description | Epilepsy Neuroimaging Teaching Course, ILAE UK |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Neuroimaging training course for the International League Against Epilepsy (charity), attended by 30 participants from across the globe |
Year(s) Of Engagement Activity | 2017 |
Description | Epilepsy Society 21 years of MRI public video |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Participation in a video for emphasis the advances that have been in the 21 years of the MRI Unit, Epilepsy Society |
Year(s) Of Engagement Activity | 2016 |
URL | https://video.helloeko.com/AqNdpV?autoplay=true |
Description | Epilepsy Society Research Associate Members |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Supporters |
Results and Impact | Presentation of my current and planned research at the annual Epilepsy Society Research Associate Members meeting |
Year(s) Of Engagement Activity | 2016 |
Description | Image-guidance and computer-assisted imaging in epilepsy surgery |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Butler Epilepsy Lecture delivered at University of Alberta Hospital to a mixed audience |
Year(s) Of Engagement Activity | 2017 |
Description | Insight Investment Funding pitch |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Industry/Business |
Results and Impact | Presentation of current research programme as part of a pitch to be "Charity of the Year" for Insight Investments. This was to professional staff members and made available on the Intranet. |
Year(s) Of Engagement Activity | 2016 |
Description | Presentation and panel member at the Brain's Networks, Sahlgrenska Academy, Gothenburg |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Talk "What can clinical neurology learn from the brain's networks and vice versa" and panel member for debates between different disciplines looking at the Brain's Networks |
Year(s) Of Engagement Activity | 2015 |
Description | Talk at the Wessex Neurological Centre |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Talk "Neuroimaging for epilepsy" at the academic meeting of the Wessex Neurological Centre, University of Southampton |
Year(s) Of Engagement Activity | 2016 |