Approximately 30% of patients with temporal lobe epilepsy (TLE) do not respond to medication and may turn to surgical removal of the seizure-onset zone. However, 30-40% of patients who undergo surgery still may not achieve seizure freedom, in part due to imprecise localization of the seizure onset zone (SOZ).

Andy Revell, an M.D., Ph.D. candidate in the Davis Lab, aims to develop techniques which more accurately predict the SOZ through his work on graph theory, which he presented this week at the 2019 ICTALS meeting.

By using high resolution imaging of fiber networks in epilepsy patients, Revell developed neural network models that predict how a seizure may spread throughout the brain. He plans to further develop these models with the goal of accurately predicting SOZ and surgical outcomes in individual patients, as developing a greater understanding of epileptic networks and how the spread of seizures relates to the SOZ may provide critical information to clinicians during the surgical planning process.

For patients whose epilepsy is not controlled by medication, surgical intervention may offer the possibility of achieving seizure freedom— but after epileptic tissue is removed, how does the brain respond?

This is the question Ph.D. student Campbell Arnold has been researching at the CNT. At the ICTALS 2019 meeting, he presented his work on developing methods for assessing cortical thickness in patients after epilepsy surgery.

Cortical thickness is a known biomarker for epilepsy progression and is related to connectivity between brain regions. Arnold’s study found that the invasiveness of a patient’s surgical procedure was related to the scope of postoperative cortical thinning.

As new surgical techniques, such as laser ablation, offer minimally invasive surgical options to patients, Campbell plans to further develop and test his methods of assessing the brain’s postoperative development.

Brittany Scheid, a Ph.D. student at the CNT, presented her work this week on controllability dynamics in the context of responsive neurostimulation (RNS) in epilepsy patients. Average controllability, she explained, is a measure of specific brain regions’ ability to affect their surrounding networks.

By applying clinical electrode recordings to models of epileptic network connectivity, Scheid demonstrated that the average controllability of underlying networks is constantly changing.

Additionally, Scheid’s analysis of clinical data revealed that RNS electrode implants were most effective when placed peripheral to the actual seizure onset zone.

These findings may contribute to our understanding of not only how seizures spread in epileptic networks, but also how they might be stopped even before they begin.

Andy Revell, an M.D., Ph.D. student mentored by Dr. Davis at the Center for Neuroengineering and Therapeutics, successfully defended his thesis proposal before a faculty panel Tuesday. Revell’s project focuses on applying graph theory to the modeling of neural networks in the context of epilepsy. Approximately 30% of patients with temporal lobe epilepsy (TLE) do not respond to medication and may turn to surgical removal of the seizure-onset zone. By modeling epileptic networks in individual TLE patients, Revell hopes to better predict surgical outcomes and even localize seizure onset in otherwise ambiguous cases.

Preya Shah, M.D., Ph.D., a former student in the Center for Neuroengineering and Therapeutics, published a paper on Friday in Brain highlighting the contributions of neural structure to functional networks in epilepsy.

The article, titled “Characterizing the role of the structural connectome in seizure dynamics”, reveals the presence of patient-specific spatiotemporal patterns, indicating that seizure dynamics are tightly controlled by the underlying structure of the brain. Understanding these highly stereotyped patterns may pave the way for new therapies and individualized intervention strategies in epilepsy.

Click HERE to read the full article.

The Epilepsy Foundation of Eastern PA has a new monthly podcast called “Epilepsy&.” This new series aims to intertwine inspiring stories of epilepsy patients with discussions of novel medical advancements.

In this episode, Dr. Davis talks about what research and funding can do for the lives of those with epilepsy and how her own research is paving the way for new diagnostic techniques and treatments. She also talks about her journey to becoming an epileptologist and how physicians can encourage bright minds to pursue a career in epileptology so that we can continue to expand the bounds of what we know about the disease. One of Dr. Davis’ former patients joins her in this conversation.

Listen to Episode 2: Epilepsy & Research (Part 2) HERE.

The Epilepsy Foundation of Eastern PA has a new monthly podcast called “Epilepsy&.” This new series aims to intertwine inspiring stories of epilepsy patients with discussions of novel medical advancements. In their first episode, “Epilepsy & Research,” Dr. Davis joins one of her patients in discussion of his journey with epilepsy as a father and lawyer. Dr. Davis also touches upon her clinical approaches to diagnosis and treatment and how her research aims to improve these methods. Listen to the episode HERE.

Listen to other episodes of “Epilepsy&” HERE.

Dr. Preya Shah, PhD, an former MD/PhD student in the Center for Neuroengineering and Therapeutics, published a paper on Monday in Human Brain Mapper with research completed as part of her doctoral thesis. This article, entitled “Structural and functional asymmetry of medial temporal subregions in unilateral temporal lobe epilepsy: a 7T MRI study,” provides insights on how 7T MRI can be used in localizing brain network disruptions in mesial temporal lobe epilepsy (TLE) patients and consequently in distinguishing between TLE subtypes.

Click HERE to read the full article.