Grant: Project Grant

Epilepsy is a common neurological disorder in Canada, affecting up to 1% of the population. Although epilepsy can occur in all age groups, children are especially affected. While anti-seizure medication can effectively control epilepsy in many patients, ~30% of patients have pharmacy-resistant seizures. In children, uncontrolled epilepsy may result in significant difficulties in learning and cognitive functioning, and an elevated risk of injury and brain damage. In these patients, brain surgery to remove the seizure-causing area is the best option, with early interventions showing promise for better outcomes due to children's brain plasticity. This grant aims to address pressing challenges in managing pharmaco-resistant childhood epilepsy. Firstly, identifying the surgical target can be difficult, and Magnetic Resonance Imaging (MRI) fails to reveal the target in many patients, leading to invasive and costly investigations. Secondly, even carefully selected candidates may experience seizure recurrence and cognitive side effects after surgery. Effective predictors for individual outcomes are lacking, especially in children. To improve surgical decision-making for children with pharmaco-resistant seizures, we propose three objectives. Objective 1 focuses on developing patient-specific MRI markers for the seizure-generating region, while Objective 2 will develop a novel approach to simulate the impact of surgery on brain structure and functionally-relevant networks. Objective 3 will integrate preoperative MRI biomarkers and surgical simulations to better predict seizure and cognitive outcomes in individual children. By enhancing our ability to non-invasively identify the surgical target and to predict surgical outcomes, our project promises to improve the clinical decision-making for thousands of children suffering from pharmaco-resistant seizures in Canada.