Neuromodulation of Epileptogenicity by Autonomic Training

Epilepsy affects an estimated 70 million people around the world and is one of the most common neurological disorders in children as well as adults (Ngugi et al. 2010). In as many as 1/3 of patients, seizures are poorly controlled with medication. Recent drug development has provided potential solutions, however, rates of drug-resistant focal epilepsy remain relatively unchanged in the last 30 years (Brodie 2017). Even for individuals in whom drugs have efficacy, up to 17% experience limiting side-effects (Chen et al. 2017). Epilepsy surgery may be an option for a selected number, but even 30-40% of those do not become seizure-free (Baud et al. 2018). So there remains a significant portion of patients for whom surgery is either not an option or who did not become seizure-free after surgery. New treatment options are therefore urgently needed.

Galvanic Skin Response (GSR) modulation is one potential alternative treatment that has been shown to reduce seizure rate (Yoko Nagai et al. 2018), though the acute mechanistic effect of GSR is yet to be elucidated. Further establishing the feasibility of GSR modulation as a tool to combat epilepsy is of great importance and is the focus of the NEAT project. We hypothesise that modulation of GSR has acute effects on brain dynamics and reduces how epileptic a brain is.

Trial objectives and purpose
This research is a student project that forms part of a PhD. This research has primary and secondary objectives.
Primary Objectives
- Investigate if intentionally increasing and decreasing arousal, measured with GSR, will cause changes to global and laminar brain dynamics that act to reduce how epileptic a brain is.
- Investigate if intentionally increasing and decreasing arousal, measured with GSR, will cause a reduction in abnormal epileptic brain patterns observed in EEG
Secondary Objectives
- Investigate if the extent to which people increase or decrease their level of arousal affects the extent to which their brain connectivit