Grant: Operating Grant

Epilepsy is one of the most common and serious neurological conditions, affecting up to 300,000 Canadians. About 30% of these patients have seizures that cannot be controlled by any available therapy. One devastating aspect of seizures is their seemingly unpredictable nature, which precludes driving and many types of employment. If it was possible to predict seizures before they occur, then preventative action could be taken to avoid them, thereby opening new treatment options. For example, patients could have implantable devices (e.g., deep brain stimulators or drug delivery devices) that would be activated during the transitional period leading into seizures, known as the pre-ictal period. In this proposal, we plan to identify and characterize markers of the pre-ictal period in persons with epilepsy. Increasing evidence suggests that seizures are preceded by changes in overall brain activity, increased blood flow, and changes in the activity rate of cells in different brain regions. We hypothesize that these changes are reliable predictive markers for seizure onset. We will test this hypothesis by identifying pre-ictal changes in i) brain activity levels using functional magnetic resonance imaging, ii) synchronization of brain activity, and iii) brain blood flow. Overall, the proposed research will lead to a better understanding of how seizures begin and how to predict them. It is important to note that the technology is currently available to monitor some of these markers in freely moving patients who have measuring devices of these markers surgically implanted. Because our centre uses this technology, we will be uniquely positioned to begin clinical trials using these markers to predict seizures and deliver therapies to prevent the onset of seizures.