Grant: Project Grant

Around 65 million people worldwide have epilepsy, which is the tendency to recurrent unprovoked seizures. Everyone's lifetime risk is 1 in 26, which translates into over 1.4 million Canadians. While medications can often control seizures, just under half a million Canadians will still have unrelenting epilepsy with devastating everyday consequences on driving, working, quality of life, and even survival. Though medications can control seizures, they often come at the cost of debilitating side effects. In such cases, epilepsy neurosurgery is the preferred treatment; however, many individuals cannot qualify for surgery because the part of the brain giving rise to seizures - the "epileptogenic zone" (EZ) - cannot be identified, or cannot be narrowed down enough for surgery to be safe enough to avoid severe neurological deficits. To identify the EZ, brainwaves are recorded on a test known as the electroencephalogram (EEG) that records the electrical signature of epileptic activity. This signature varies widely depending on whether the patient is asleep or awake. In rapid eye movement (REM) sleep when most dreaming occurs, the EEG footprint of epileptic activity in the brain is thought to be smaller. Using actual EEG and magnetic resonance imaging data from patients with epilepsy, this project aims to rigorously quantify the size and location of epileptic activity to determine whether the EZ really is smaller in REM sleep. This project will also compare how much the EZ in REM sleep overlaps with the EZ recorded while awake or in other stages of sleep. These comparisons will determine whether REM sleep is the best state of consciousness to find the EZ. This project holds the promise of one day safely offering life-changing epilepsy neurosurgery to more patients than currently possible by using dreams to map out where seizures arise within the human brain.