New York, NY [November 2, 2026] — Researchers at the Icahn School of Medicine at Mount Sinai have received more than $3 million from the National Institutes of Health (NIH) for a five-year study of advanced magnetic resonance imaging (MRI) methods that may help locate seizure-causing brain regions in people with drug-resistant epilepsy. The researchers aim to determine whether these methods could improve diagnosis and inform treatment planning.
The team will test whether MRI measurements of brain tissue stiffness and blood flow can help identify where seizures begin, particularly when standard MRI scans show no clear abnormality. More precise localization could help clinicians assess whether surgery is an option and plan care for people whose seizures continue despite medication.
“Accurately identifying the brain region responsible for seizures is essential when considering surgery, but standard MRI scans do not always reveal where seizures originate,” says Priti Balchandani, PhD, Mount Sinai Professor in Engineering Medicine at the Icahn School of Medicine at Mount Sinai and the study’s Principal Investigator. “We hope to determine whether information about brain stiffness and blood flow can provide clinicians with additional clues to help pinpoint these regions and guide treatment decisions.”
Epilepsy is a neurological disorder marked by recurrent seizures. Medication controls seizures for many people, but some continue to have seizures despite treatment. For eligible people with drug-resistant epilepsy, surgery may improve seizure control or stop seizures. Surgical planning depends partly on identifying the brain tissue where seizures begin—a challenge when standard imaging shows no clear target.
“Improving the lives of people with epilepsy is at the heart of everything we do,” says Lara Marcuse, MD , Co-Director of the Mount Sinai Epilepsy Program. “For patients whose seizures do not respond to medication, precise identification of where seizures begin is critical to guiding treatment decisions and determining whether and what particular method of surgery may be an option.”
The Mount Sinai team will study two complementary MRI approaches. Magnetic resonance elastography (MRE) measures tissue properties, including stiffness. Advanced MRI methods also measure blood flow in the brain. Together, these measurements may reveal differences between seizure-causing regions and nearby tissue that routine scans do not show.
The research draws on the team's earlier use of MRE to study brain tissue changes associated with early Alzheimer's disease and its work with ultra-high-field MRI for epilepsy imaging. In discussions with neurosurgeons, researchers learned that surgeons sometimes notice differences in tissue stiffness during epilepsy operations. Surgeons may consider these observations alongside other clinical findings when deciding which tissue to remove.
“This study builds on an important surgical observation: The brain tissue where seizures begin can feel firmer than the surrounding tissue,” says Madeline Fields, MD , Co-Director of the Mount Sinai Epilepsy Program. “Measuring these differences noninvasively could help us locate seizure onset more precisely and guide more patients toward effective treatment.”
“This observation raised an important question: How could we measure some of these tissue properties before surgery, without an invasive procedure, and use that information to help identify the seizure focus?” says Oleksandr Khegai, PhD, a senior scientist and developer of advanced MRI methods in Dr. Balchandani's lab. “This study will allow us to investigate that possibility systematically.”
The study will enroll 100 people with drug-resistant epilepsy: 50 whose MRI scans show visible brain lesions and 50 whose scans do not. It will also enroll 50 healthy volunteers. Participants will undergo advanced MRI examinations using 7-tesla (7T) and/or 3-tesla (3T) scanners. Researchers will analyze blood samples for markers associated with gliosis, a tissue response involving changes in glial cells that can occur after brain injury or disease.
Where available, researchers will compare imaging results with electroencephalography (EEG), a test that measures electrical activity in the brain; tissue removed during surgery; and clinical outcomes after treatment. These comparisons will assess how reliably the MRI measurements identify seizure-causing regions and whether they could inform clinical decisions.
Mount Sinai's recently installed, Food and Drug Administration-cleared 7T clinical MRI scanner will allow researchers to study brain structure and tissue properties at very high resolution. The team will develop and evaluate imaging methods on this system and investigate whether they can be adapted for 3T MRI scanners, which are more widely available in clinical care.
The project brings together Mount Sinai specialists in epilepsy, neurosurgery, neuroradiology, MRI technology, and biomarker analysis, along with collaborators at the University of Washington who contribute expertise in MRE biomechanical analysis.
After the grant period, the team hopes to conduct a larger clinical trial to test whether adding these measurements to patient care improves treatment decisions and outcomes. The researchers also hope to explore their use in children with drug-resistant epilepsy.
“Better treatment starts with better diagnosis,” says Dr. Balchandani. “Our long-term goal is to develop imaging approaches that give clinicians a clearer picture of where seizures originate and, ultimately, help more patients find effective treatment.”
The team includes Dr. Balchandani and collaborators Lara Marcuse, MD; Madeline Fields, MD; Fedor Panov, MD; Bradley Delman, MD; Claudia Kirsch, MD; Fanny Elahi, MD, PhD; Oleksandr Khegai, PhD; Akbar Alipour, PhD; and Mehmet Kurt, PhD, of the University of Washington.
Their collaboration builds on previous research supported by the NIH, the National Science Foundation, and the American Epilepsy Society. The project is supported by NIH grant 1R01NS150462, funded by the National Institute of Neurological Disorders and Stroke.
-####-
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the seven member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to New York City’s large and diverse patient population.
The Icahn School of Medicine at Mount Sinai offers highly competitive MD, PhD, MD-PhD, and master’s degree programs, with enrollment of more than 1,200 students. It has the largest graduate medical education program in the country, with more than 2,700 clinical residents and fellows training throughout the Health System. The Graduate School of Biomedical Sciences offers 12 degree-granting programs, conducts innovative basic and translational research, and trains more than 470 postdoctoral research fellows.
Ranked No. 9 nationwide in National Institutes of Health (NIH) grant funding, the Icahn School of Medicine at Mount Sinai is among the 90th percentile of U.S. private medical schools in Sponsored Programs Direct Expenditures per Principal Investigator, according to the Association of American Medical Colleges. More than 6,900 scientists, educators, and clinicians work within and across dozens of academic departments and multidisciplinary institutes with an emphasis on translational research and therapeutics. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai.
-------------------------------------------------------
* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.