New tool to assess epilepsy cases that need surgery

  • The Cognition and Brain Plasticity group at IDIBELL, the Bellvitge University Hospital and the University of Barcelona have found an indicator that could help predict the evolution of patients with drug-resistant epilepsy who need surgery.
  • It seems that a greater number of neuronal connections in a certain region of the brain is an indicator of a better prognosis and of being less likely to continue suffering epileptic fits after surgery.
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The best known symptom of epilepsy are seizures, more or less recurrent, which may or may not be accompanied by convulsions. In the case of temporal lobe epilepsy, these episodes are caused by an excessive increase in nerve discharges in a certain area of ​​the temporal lobe of the brain. The main form of treatment for epilepsy is medication, which normally makes it possible to control the seizures and to continue a normal life, but sometimes this measure is not effective and it is necessary to resort to neurosurgery, which resects or disconnects the problem area of the rest of the brain. This makes it possible to cure epilepsy or at least reduce the frequency of seizures, but about half of patients continue to experience seizures in the long term.

In general, it is very difficult to predict the outcome and the evolution of the patient after surgery, since epilepsy is a highly variable disease. Therefore, before proceeding with this intervention, a relatively complex personalized evaluation must be carried out. With this objective, neuroimaging tools have been discovered that can help to carry out this evaluation, including functional magnetic resonance imaging at rest, which measures neuronal activity.

The Brain Cognition and Plasticity group at IDIBELL, the Bellvitge University Hospital and the University of Barcelona, ​​in a study led by Dr. Estela Cámara and Dr. Jacint Sala, has used this functional magnetic resonance imaging tool to identify which patients they could benefit more from neurosurgery and provide a more reliable prognosis before the intervention. The results have been published in the journal BMC Neurology and show that patients with greater neuronal connectivity in the most affected area of ​​the brain have a better prognosis after resection. The study participants have been in follow-up for more than 6 years after the intervention, which has made it possible to confirm which ones have really stopped having epileptic seizures and, therefore, have been cured.

These results are a great contribution to personalized medicine in terms of the pre-surgical evaluation of people with epilepsy,” says Dr. Càmara, “but despite being quite promising, they still need to be expanded to larger samples to include them in practice. clinic safely ”.

 

 

The Bellvitge Biomedical Research Institute (IDIBELL) is a biomedical research center created in 2004. It is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona and the City Council of L’Hospitalet de Llobregat.

IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).

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