Epilepsy affects its victims in many ways. Sometimes it manifests itself as a sudden change in behavior, such as uncontrolled, repeated movements of limbs. Other times, seizures cause loss of motor ability or unconsciousness. The World Health Organization estimates more than 50 million people worldwide have the condition, making it one of the most common neurological disorders.
Despite this, pharmacological treatments are often ineffective.
“Approximately 30% of epilepsy patients are resistant to available medicines,” said Fabrice Bartolomei, professor in Neurology at the Timone Hospital in Marseille and leader of EPINOV*, a collaborative project aimed at improving epilepsy surgery management and prognosis by modeling each patient’s brain in virtual 3D.
Current treatment for drug-resistant epilepsy requires surgeons to remove the epileptogenic zone of a patient’s brain—the sections that cause the electrical bursts of activity known as seizures. However, they can be extremely difficult to locate.
“Clinicians currently use a combination of non- invasive MRI, non-invasive scalp recordings of electrical brain activity, questionnaires, and invasive intracranial recordings to identify which part of the brain should be resected,” Bartolomei said. “However, interpreting the electrical recording results is not easy.”
To help surgeons identify where to operate, a team of researchers, clinicians and developers in 2018 created EPINOV. The computer models display the physiology of each patient’s brain, together with its dynamic, electrical behavior, which could not be done before. [Dassault Systèmes, which makes software used to imagine sustainable innovations, is an industrial partner member of EPINOV. Dassault Systèmes created the created the Living Heart model being tested by the US FDA for use in clinical trials, and is developing a new virtual brain model.]
Clinical trials of the process began in June 2019 with approximately a dozen patients in France. It will take no more than 2 months to create a virtual model of each patient’s brain. Data from the clinical trial will validate the added value of the virtual brain technology to surgical decisions or point toward improvements.
“The goal of the project is to give clinicians a tool that shows a 3D version of the patient’s brain with the epileptogenic zone superimposed on top,” Bartolomei said. “This will simplify the process of identifying the faulty brain zone, ensure that the operation will free the patient from seizures, cause little to no impact on the patient’s quality of life, and improve the delivery of effective personalized treatments.”
* This work is supported by a public grant overseen by the French National Research Agency (ANR) as part of the second “Investissements d’Avenir” program (reference: ANR-17-RHUS-0004).
