New technique could revolutionize surgical treatment of epilepsy

Generalized 3 Hz spike and wave discharges in a child with childhood absence epilepsy. Credit: Wikipedia.

Scientists at the University of Exeter have developed a pioneering new technique that could revolutionise the surgical treatment of epilepsy.

The team of scientists, led by Dr Marc Goodfellow and Professor John Terry, have developed the ground-breaking new method that can identify the specific regions of the brain that trigger seizures in people with epilepsy.

The new technique is designed to help surgeons and neurologists measure the relative contribution to the occurrence of seizures made by different , and so determine the brain regions to remove that will have most benefit to the individual.

The research is published in leading , Scientific Reports, on Thursday, July 7th 2016.

At present, people with epilepsy are treated initially through medication, which aims to dramatically reduce or remove the threat of seizures. However anti-epilepsy drugs prove ineffective in around one-third of people. In these cases, patients can elect to undergo surgery to remove small parts of the brain - which does not impact healthy brain function - but which can help reduce the chance of experiencing seizures.

Surgeons record electrical activity from the surface of the brain and study the electrical rhythms to attempt to identify the brain regions where seizures begin. However, current approaches are only partially effective with around 50% of people with epilepsy seeing significant long-term improvements following surgery.

The new method devised by the scientists, which used state-of-the-art mathematical modelling procedures, can more accurately distinguish the brain regions that are the source of seizure activity from those that become involved as a result of a seizure starting.

Professor Terry, Director of the EPSRC Centre for Predictive Modelling in Healthcare and an expert in Biological Modelling from Exeter's Mathematics department said: "This research has the potential to dramatically improve surgical success rates can be for those patients who need it, and so also dramatically improve their quality of life.

"The potential is truly outstanding. It gives surgeons valuable information on how different brain regions contribute to seizures, enabling them to predict the outcome of different surgical strategies and so better plan surgery.

"Imagine someone was in a theatre and sending text messages to random audience members, making their phones ring. Current techniques are in essence akin to removing those people who receive the messages - they are contributing to the disruption and so removing them could make a difference. But clearly it would be better to identify and remove the individual sending out the messages - the original source. That is what our methods achieve - identifying the original source."

The team honed their new methods through studying the electrical recordings from a series of 16 people with epilepsy. who have undergone surgery to treat seizures at a clinic in Switzerland.

They used the readings from before surgery to run their advanced model, and predict which areas would produce the most effective results. Crucially, they then compared their predictions to the actual outcomes achieved through surgery.

For people who responded well to surgery the brain regions removed by the surgeons were amongst those predicted by the model as leading to a good outcome. In contrast, for people who did not respond well to surgery the brain regions removed were not amongst those predicted by the model as leading to a good outcome.

Dr Goodfellow, a Mathematics lecturer at Exeter added: "We were able to compare, for the first time, predictions made by a computer model applied to pre-surgical brain recordings with the post-surgical outcomes from a group of people with epilepsy. We saw a very good agreement between the outcome predicted by our model with the actual outcome achieved through surgery.

"The potential for future treatment is clear - we are looking at a more accurate way of identifying exactly where to operate to give the best results for an individual, and so improve the lives of so many people who would otherwise have to live with the constant threat of seizures."

Estimation of brain network ictogenicity predicts outcome from epilepsy surgery, by Dr Marc Goodfellow, C Rummel, E Abela, M P Richardson, K Schindler and Prof John Terry is published online by Scientific Reports

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Computer model could hold key to personalized epilepsy treatment

Journal information: Scientific Reports

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Jul 07, 2016
Let's find better ways to deal with this matter than surgery.

Jul 07, 2016
Let's find better ways to deal with this matter than surgery.
I can understand your consternation at the prospect of an effective treatment for psychopathy that doesnt involve an icepick.

You know castration is sometimes offered as an alternative to incarceration for sex offenders yes? Perhaps they will soon have humane options for psychopaths.

A cure for your disease would be most humane for society as a whole.

"The high incidence of sociopathy in human society has a profound effect on the rest of us who must live on this planet, too, even those of us who have not been clinically traumatized. The individuals who constitute this 4 percent drain our relationships, our bank accounts, our accomplishments, our self-esteem, our very peace on earth.

"We are not commonly aware of, nor do we usually identify, the larger number of nonviolent sociopaths among us, people who often are not blatant lawbreakers, and against whom our formal legal system provides little defense."

Jul 07, 2016
otto, sit down and shut up. My daughter is an epilepsy patient and almost died from it.

I am in no mood to deal with your nasty and insensitive remarks.

My god, have you no decency at all?

Jul 07, 2016
I am in no mood to deal with your nasty and insensitive remarks.
This place gives you the bad mood everyday since you first come here. Don't say much for your mental healths.

Jul 07, 2016
otto, sit down and shut up. My daughter is an epilepsy patient and almost died from it
And because of your behavior here who knows if its true or not?

"Manipulation is the key to the psychopath's conquests. Initially, the psychopath will feign false emotions to create empathy, and many of them study the tricks that can be employed by the empathy technique. Psychopaths are often able to incite pity from people because they seem like "lost souls" as Guggenbuhl-Craig writes. So the pity factor is one reason why victims often fall for these "poor" people."
I am in no mood to deal with your nasty and insensitive remarks.

My god, have no no decency at all?
And I am never in a mood for dealing with selfish people who seek to gain sympathy from the suffering of others, either real or made up.

You get scummier every day george.

Jul 07, 2016
You are disgusting, and it is the reason you have to hide and cower behind a phony name.
You will regret your insensitivity and malicious nastiness.

Jul 07, 2016
Well, we have the evidence of the character of "Ira" and "otto", and "Stumpy", the three snipers who think they run this forum. Their personal attacks and their inherent disgusting lack of character are now evident.

They make fun of disabled veterans and anyone else who they feel cannot fight back. But I can, and will. That is why they are too SCARED to tell us who they really are. They are too SCARED to expose themselves to the consequences of their words.

Disgusting. We need a moderator, . . . and will get one.

Jul 07, 2016
Yeah we're scaredy cats.

"Most people are able to combine ideas that have consistent thought themes, but psychopaths have great difficulty doing this. Again, this suggests a genetic restriction to what we have called the Juvenile Dictionary. Not only are they using extremely restricted definitions, they cannot, by virtue of the way their brains work, do otherwise. Virtually all of the research on psychopaths reveals an inner world that is banal, sophomoric, and devoid of the color and detail that generally exists in the inner world of normal people. This goes a long way to explain the inconsistencies and contradictions in their speech."
Disgusting. We need a moderator, . . . and will get one
Mods are here. If you were a danger to the site or to participants you'd be gone.

Sometimes you just have to let the babies whine and cry themselves to sleep.

Poor widdle georgie. He gets no respect. Don't they know who he IS??

Jul 09, 2016
Sadly, this will only work when the relevant brain regions are relatively accessible.

IIRC, zapping deeper regions by eg stereotactic sub-chordate tractotomy has had cruelly mixed results...

( Hey, it's 'Brain Surgery' ! Few operations are 'minor' !! Worse, all carry the terrible risk that *any* intervention may create a new locus for epilepsy... )

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