Emerging technologies help advance the understanding, detection and control of epilepsy

December 06, 2015

PHILADELPHIA, December 6, 2015 - A smartphone-induced EEG waveform and an intelligent algorithm for seizure detection are among the emerging technologies to be unveiled at the American Epilepsy Society's (AES) 69th Annual Meeting. Four innovative studies presented at the meeting promise to reshape current paradigms for seizure detection and epilepsy management.

In the first study, (abstract 3.277) researchers from Brighton and Sussex Medical School demonstrate that electrodermal (EDA) biofeedback - a technique that uses electrodes to detect changes in the skin's electrical activity - is an effective method for reducing seizure frequency in patients with drug-resistant epilepsy.

The authors' prior work showed that increased skin conductance in patients with epilepsy can calm over excitability in the motor cortex, and that skin conductance is associated with regional changes in brain activity.

In the current study, the authors explored whether EDA biofeedback restores normalcy to the complex networks of neural tasks that often run amuck in patients with epilepsy. They examined clinical trial data from eight patients with temporal lobe epilepsy who received EDA biofeedback training three times a week for four weeks and fMRI scans at the first and last sessions.

One month of biofeedback training reduced seizure frequency by an average of 40 percent in all patients, the authors report. Increased network connectivity was noted in regions of the brain responsible for emotional arousal and control of the motor cortex.

"Our findings suggest that EDA biofeedback is an accessible, non-pharmacological, and side effect-free treatment for patients with drug-resistant epilepsy," says Yoko Nagai, Ph.D., a Wellcome Trust Research Fellow at the Brighton and Sussex Medical School.

A second study (abstract 3.114) uncovers a previously unknown waveform associated with smartphone use. Researchers from the Mayo Clinic in conjunction with colleagues at Rush University Medical Center have identified the waveform during video EEG monitoring of 129 patients evaluated for epilepsy at institutions in Florida and Illinois.

Dubbed the 'texting rhythm,' the waveform is induced by active text messaging and produces a reproducible, stimulus-evoked, generalized frontocentral monomorphic burst of 5-6 Hz theta. The waveform was not observed during voice calls or during non-texting activities involving cognition, speech/language or movement in one arm of the study. According to the authors, the waveform may reflect the neural coding observed during non-auditory communication, and its significance should be assessed in further studies.

"These findings provide objective evidence that the use of smartphones is capable of altering neurophysiologic function. This feature of the EEG could represent a unique brain-technology interface that could further our understanding of the way in which some people communicate without verbal expression or visual cues. From a practical standpoint it provides an objective measure in the brain that could potentially interfere with tasks that require full attention, such as driving," says William Tatum, D.O., a neurologist at the Mayo Clinic in Florida.

In a third study, (abstract 3.092) researchers from Johns Hopkins University use data acquired in real time to train a machine learning algorithm for seizure detection. Few technologies can reliably warn patients of an impending seizure due to wide variations in seizure onset patterns and the locations where seizures originate and spread in the brain. Modern seizure detection technologies rely on machine learning algorithms to sort EEG features into seizure or non-seizure events, but the clinical data needed to build reliable, patient-specific algorithms can be hard to come by.

The researchers circumvent this challenge by constantly retraining the machine learning algorithm with the patient's own brain patterns. Using intracranial recordings from patients with focal epilepsy who were undergoing presurgical evaluation, they describe an algorithm capable of detecting previously unnoticed seizures between 0 to 4 seconds after onset, even when those seizures had novel ictal signatures. The ability of the algorithm to adapt to changing brain activity often allows for the detection of seizure onset before clinical symptoms appear.

"The use of a dynamically adaptive algorithm is a promising strategy for detecting seizures with characteristics that are unknown at the time of the patient's admission," says Daniel Ehrens, a Ph.D. candidate and Howard Hughes Medical Institute Gilliam Fellow in the laboratory of Christophe Jouny, M.S.,Ph.D., at the Johns Hopkins Hospital.

A fourth study (abstract 2.084) describes a carbon nanotube-based strategy for enhancing the power of the Responsive Neurostimulation System (RNS), the only FDA-approved intracerebral neuromodulation therapy to date for patients with drug-resistant focal epilepsy. The electrodes used in the RNS act locally, activating neurons within 4 mm of the electrode's surface. Carbon nanotubes could potentially expand this area of influence by enhancing the conductivity of the brain near the electrode.

The authors performed cytotoxicity testing on human brain cells to confirm the safety of functionalized carbon nanotubes. Computational and experimental modeling experiments demonstrated that the nanotubes indeed expand the area of activation.

"Functionalized metallic-type carbon nanotubes are biocompatible within the brain and could enhance the volume of activation by an electrode via direct neurostimulation. This could allow the electrode to interface with and activate a greater extent of the epileptogenic circuit," says Marvin Rossi, M.D., Ph.D., an associate professor of neurology at Rush University Medical Center.
About the American Epilepsy Society:

The American Epilepsy Society is a medical and scientific society whose members are engaged in research and clinical care for people with epilepsy. For more than 75 years, AES has provided a dynamic global forum where professionals from academia, private practice, not-for-profit, government and industry can learn, share and grow. Find out more at aesnet.org.

Information Contacts:

Natalie Judd, Big Voice Communication, 203-389-5223, natalie@bigvoicecomm.com

Tess Aaronson, Big Voice Communication, 203-389-5223, tess@bigvoicecomm.com

American Epilepsy Society

Related Epilepsy Articles from Brightsurf:

Focal epilepsy often overlooked
Having subtler symptoms, a form of epilepsy that affects only one part of the brain often goes undiagnosed long enough to cause unexpected seizures that contribute to car crashes, a new study finds.

Antibodies in the brain trigger epilepsy
Certain forms of epilepsy are accompanied by inflammation of important brain regions.

Breaching the brain's defense causes epilepsy
Epileptic seizures can happen to anyone. But how do they occur and what initiates such a rapid response?

Using connectomics to understand epilepsy
Abnormalities in structural brain networks and how brain regions communicate may underlie a variety of disorders, including epilepsy, which is one focus of a two-part Special Issue on the Brain Connectome in Brain Connectivity, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

Epilepsy: Triangular relationship in the brain
When an epileptic seizure occurs in the brain, the nerve cells lose their usual pattern and fire in a very fast rhythm.

How concussions may lead to epilepsy
Researchers have identified a cellular response to repeated concussions that may contribute to seizures in mice like those observed following traumatic brain injury in humans.

Understanding epilepsy in pediatric tumors
A KAIST research team led by Professor Jeong Ho Lee of the Graduate School of Medical Science and Engineering has recently identified a neuronal BRAF somatic mutation that causes intrinsic epileptogenicity in pediatric brain tumors.

Can medical marijuana help treat intractable epilepsy?
A new British Journal of Clinical Pharmacology review examines the potential of medicinal cannabis -- or medical marijuana -- for helping patients with intractable epilepsy, in which seizures fail to come under control with standard anticonvulsant treatment.

Fertility rates no different for women with epilepsy
'Myth-busting' study among women with no history of infertility finds that those with epilepsy are just as likely to become pregnant as those without.

Do women with epilepsy have similar likelihood of pregnancy?
Women with epilepsy without a history of infertility or related disorders who wanted to become pregnant were about as likely as their peers without epilepsy to become pregnant.

Read More: Epilepsy News and Epilepsy Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.