Grant: Project Grant

The insula, the fifth lobe of the brain, is a complex structure hidden by the frontal, temporal and parietal brain lobes. Despite important advances in the comprehension of frontal, temporal and parietal epilepsies, insular epilepsy remains to date a relatively neglected disease. Our group is among the few in the world to have expertise in the diagnosis and treatment of insular epilepsy. By systematically recording insular activity directly during epilepsy investigations, our group showed that a significant portion of patients suspected with other forms of epilepsy actually suffer from insular seizures. In addition, we showed that failure to recognize insular seizures can lead to wrong selection of surgical targets and dramatic epilepsy surgery failures. The main issue faced by clinicians is that they don't recognize or poorly understand insular epilepsy, thus they cannot diagnose it efficiently. In this proposal, we tackle this important challenge by addressing the following questions: 1) What are the clinical symptoms or combinations of symptoms the are highly suggestive of insular epilepsy? 2) What is the value of modern brain imaging techniques for detecting insular epilepsy, 3) How does the insula interact with other regions of the brain to generate seizures? 4) Do neural interactions between the insula and other brain regions bear predictive factors regarding the chances of success of epilepsy surgeries? Ultimately, we expect the knowledge gathered during the proposed research to bring the clinical management of insular epilepsy patients to the level reached for other forms of epilepsy. By providing clinicians with efficient tools for understanding and diagnosing insular epilepsy, in addition to uncovering new factors for insular epilepsy surgery success, better surgical outcomes will be achieved.