Grant: Project Grant

There are more than 50 million people worldwide who have epilepsy and there are an estimated 5 million new cases diagnosed annually. Unfortunately, patients with this disorder can have tens to hundreds of seizures per day, and poor response to medication can make seizure-control extremely difficult. Focal Cortical Dysplasia (FCD) is the most common cause of focal epilepsy in children and continues into adulthood. Epilepsy surgery is the first-line of treatment for FCD, which consists of removing parts of the brain responsible for the seizures. Success of surgery depends on the ability to find and remove all abnormal tissue, while preserving the brain. Patients for whom the borders of the lesion are not well-defined often fail surgery and continue to have seizures. This can lead to neurodevelopmental delays, poor social skills, low self-esteem, repetitive bodily injuries, and even death. Despite advances in neuroimaging and electrophysiology methods, detecting FCD brain lesions remains very challenging. Indeed, many areas of FCD are not visible on Magnetic Resonance Imaging (MRI) and even though the lesion is seen the borders are undetectable. Surgery for such poorly-defined cases is significantly less successful (50% post-surgical seizure-freedom) when compared to cases of radiologically well-defined lesions, such as, brain tumors. Thus, novel methods for delineating FCD borders are urgently needed to improve the outcome of epilepsy surgery. By using the biochemical information from a laser-based near-infrared technique called Raman spectroscopy (RS), we will study the biomolecular underpinnings of FCD and use this information to develop intraoperative guidance systems allowing surgeons to distinguish between normal brain and dysplastic tissue. This offers the potential to improve neurosurgical precision, accuracy, safety and completeness of resections.