Grant round winners 2011

Epileptic disorders can be divided into two groups; those that are focal and those that are generalised. In the past it was thought that generalised epilepsy resulted from an abnormality affecting the whole brain, whilst focal epilepsy involved a defect in just a small area of the brain. However recent evidence suggests that there are, in fact, localised and widespread networks of brain abnormality in both types of epilepsy.

Scientists now believe that epilepsy arises in networks of interconnected brain regions, and that the pattern of epilepsy depends upon a) the networks that are affected, b) the areas of the brain involved and c) how the networks interact with each other. However, knowledge about how brain networks function in epilepsy is still very limited.

Professor Mark Richardson and colleagues, at King’s College London, have been awarded £80,658, over 18 months, to carry out a project entitled Dissecting abnormal cortico-subcortical brain networks in mesial temporal lobe epilepsy using neuroimaging, in which they will try and understand the network mechanisms underlying temporal lobe epilepsy (TLE). The team will use novel imaging techniques to explore brain abnormalities in people with TLE, and they will then try to find out how the abnormal regions interact with deeper brain structures such as the thalamus and striatum (which are known to be very important in controlling brain networks), to produce the clinical picture of TLE.

Vagus Nerve Stimulation and Deep Brain Stimulation (DBS) are two treatments that may be prescribed in addition to anti-epileptic drugs (AEDs) when AEDs alone fail, and both work by modifying abnormal brain networks. They are far from perfect as therapies, however, probably due to the lack of knowledge about how they work, and there is a lot of interest in developing better treatments that act in this manner.

Professor Richardson is hopeful that the understanding gained from this project will lead to rapid improvements in DBS treatment for TLE, and to new network-modifying therapies in the future.