A new technique which could revolutionise the treatment of epilepsy is to be tested thanks to a £10 million grant from the Wellcome Trust and the Engineering and Physical Sciences Research Council (EPSRC).
Led by Newcastle University, and including teams from Imperial College London and UCL, the CANDO project seeks to develop a brain implant that uses light waves to try to counteract the disrupted brain activity which causes epileptic seizures.
The project will last seven years and will involve designing a small device, about the size of a drawing pin, to be implanted into the patient’s brain. It will continually monitor and interact with brain activity to stabilise disrupted networks of neurons. The technique will also involve a form a gene therapy called optogenetics, which will be used to make the specific neurons that need to be targeted light-sensitive.
In the UK there are around 600,000 people who have the condition. The usual treatment is through drugs, but for about a third of patients they have limited impact.For these patients surgery can be an option. For that to be possible the area of the brain from where the seizures are originating needs to be found and removed. However, often a single area causing seizures cannot be found, or if ti can it may lie within a region of the brain that cannot be removed without causing unacceptable side-effects. And even in patients who are able to have surgery, the seizures can come back after a few years.
The only other possible treatment is the use of implants. Current implants work in such a way that means they only start to operate once a seizure has started, and it is often too late by then. However, the new device will monitor the brain’s neurons to try to act before a seizure starts, providing a more effective solution.
Dr Andrew Jackson, a Wellcome Trust Fellow in neuroscience, and Professor Anthony O’Neill, Siemens Professor of Microelectronics, will lead the research at Newcastle University. Dr Jackson said: “This is a new way of trying to prevent seizures before they happen. Currently implants only kick in once the seizure has started, which is often too late. If our technique works then it should be more effective and make a real difference to patients’ lives.”
The implant will be tested using human brain slices removed during surgery, computer modelling, and animal models.
Dr Roger Whittaker, Clinical Senior Lecturer and Honorary Consultant Clinical Neurophysiologist in the Newcastle upon Tyne NHS Hospitals Foundation Trust, who leads the clinical aspects of the project, said: “Patients who can’t rely on drugs to help them with their epilepsy can really suffer. This innovative approach could offer a better long-term solution for that group and really have a positive impact on their lives.”
Emma Dowling, 28, has lived with epilepsy since she was a girl. When she was diagnosed at eight years old she was put on drug treatment, and then later had surgery to remove part of her brain. Emma said: “I started hearing voices and would suddenly stop what I was doing when I was younger, which can be an early sign of epilepsy. The drugs I was put on have quite severe side-effects and were affecting my memory, which made it harder at school.
“They also became less effective as I got older and I started having seizures more frequently. Some would be ‘grand mal’ seizures where I’d shake on the floor but others would be lower-key ones where my brain just zoned out. I had a couple of those during job interviews. It really affects your confidence.
“Eventually I had surgery when I was 25 but I still have auras and take some drugs as well. I have been offered more surgery, but there are side-effects to that as well, and it just feels funny that they are removing parts of your brain.
“Something like this project, which could stop seizures before they happen and doesn’t involve removing brain cells, would be amazing for epilepsy sufferers like me. I have managed to get on with my life and I have a job now but it has been a lot harder for me because of my condition.”
Dr Ted Bianco, Director of Technology Transfer at the Wellcome Trust, said: “It was the express purpose of this funding competition to support the development of adventurous new technologies that push the boundaries of what will be possible in tomorrow’s medicine. Such an ambition is writ large in this project that brings together engineering, the basic neurosciences and clinical management to ameliorate the disabling effects of epilepsy.Should the research be successful, the underlying technology may open the way to advances in the treatment of other neurological disorders.”
The above story is based on materials provided by Wellcome Trust, Clare Ryan.