An international team of researchers has developed a new approach to help identify which brain regions are most responsible for each epileptic patientâ€™s seizures, according to a new study published in the journal PLOS Computational Biology. The strategy could help reduce or stop seizures by allowing surgeons to target specific brain areas for treatment.
“What is truly exciting about our findings is the opportunity that such a method offers to identify the specific brain regions involved in the generation of seizures, which in turn can provide guidance on how to optimize surgical interventions to stop seizures,” said lead strategist Marinho Lopes of the University of Exeter in the United Kingdom.
Epilepsy is a neurological disorder that affects about one out of every 100 people around the world. Although medications can often successfully control the seizures that characterize the disease, about one third of patients do not respond to these drugs and require further treatment. Some patients receive surgery to remove brain regions that cause seizures, but only about half of these surgeries lead to long-term freedom from seizures.
To help determine which areas of the brain are contributing most to a particular patientâ€™s seizures, surgeons have typically examined electroencephalograms (EEGs), which reveal electrical activity in different regions of the brain. In the new study, a team of scientists and mathematicians, led by Professor John Terry of Biomedical Modelling at the University of Exeter, sought to improve on this method.
The researchers first evaluated a database of EEG recordings taken from 16 patients with epilepsy who had already undergone surgery for their seizures. The team discovered that certain brain regions showed greater connections between each other and within themselves than did other regions. This well-connected network is called a “rich club.”
Using a mathematical modeling approach, the research team then predicted that targeting rich clubs by removing the particularly well-connected nodes would be able to reduce the number of seizures experienced by a patient.
Real-world clinical data on these 16 patients confirmed this prediction: When surgery removed a greater proportion of the rich club, which is distinct in each patient, patients experienced fewer or no seizures in the long-term.
Next, the researchers plan to confirm these findings using data from more patients. They also want to investigate whether this approach can be improved by integrating information from additional brain imaging techniques.