- In a new study, scientists mapped lesions in the brain associated with epilepsy, identifying a brain circuit that can be targeted using brain stimulation.
- They said they hope their findings can help reduce the symptoms that accompany seizures.
- They added the brain mapping technique may also help predict whether people who have had a stroke might develop epilepsy.
It might be possible to use deep brain circuit stimulation to help control epilepsy and predict whether people who have had a stroke might develop the disease, according to a new study published in the journal JAMA Neurology.
In their research, Brigham and Women’s Hospital in Massachusetts scientists studied five datasets that included more than 1,500 people with brain lesions.
That allowed researchers to look for common network connections associated with epilepsy across different regions of the brain and different types of brain damage.
The researchers compared locations of brain damage in those with epilepsy to those without the disease.
The scientists reported that lesions associated with epilepsy were located throughout the brain. However, they shared a common network.
The scientists noted that disruption to the brain connections, not the location of the lesion, could be associated with epilepsy. The brain connections identified were in the basal ganglia and the cerebellum, structures found deep within the brain.
The researchers said mapping lesions in a brain network might help predict how likely someone is to develop epilepsy after a stroke.
They said common brain circuits could link different lesions, causing epilepsy.
The scientists analyzed 30 people with drug-resistant epilepsy who underwent deep brain stimulation.
They reported that there was more improvement if the stimulation was connected to the same brain network they identified when mapping brain lesions.
“In our study, we analyzed existing data from patients that received [deep brain stimulation] for drug-resistant focal epilepsy,” said Dr. Frederic Schaper, an assistant scientist at the Center for Brain Circuit Therapeutics at Brigham and Women’s Hospital and an instructor of neurology at Harvard Medical School in Massachusetts.
“All patients had [deep brain stimulation] electrodes implanted in the anterior thalamus, but the exact location of the [deep brain stimulation] electrode and stimulation sites differed slightly across patients,” Schaper told Medical News Today. “We found that patients with [deep brain stimulation] sites more connected to deep brain regions in the cerebellum and basal ganglia had better seizure control than patients that were less connected to these regions.”
“This finding suggests an important role for brain networks distant from the anterior thalamic [deep brain stimulation] site in the mechanism of action of [deep brain stimulation] for epilepsy and seizure control,” he added.
Deep brain stimulation is a surgical procedure where electrodes are implanted in specific areas of the brain, according to the American Association of Neurological Surgeons. These electrodes then send electrical impulses to help control abnormal brain activity.
A programmable device, similar to a pacemaker, is implanted in the chest and controls the amount of stimulation. A wire connects the device to the electrodes in the brain.
“It is not completely known how [deep brain stimulation] helps decrease seizures,” Schaper said. “Previous evidence from animal models and patients suggests [deep brain stimulation] disrupts brain networks involved in seizures. However, which brain networks are responsible for seizure control after [deep brain stimulation] are unknown.”
Schaper noted that deep brain stimulation has been approved by federal regulators and is considered a safe and effective therapy for drug-resistant focal epilepsy.
In this study, researchers looked for networks within the brain. They reported that if deep brain stimulation activates one node within the network, it can improve symptoms of epilepsy.
“This study is quite exciting,” said Dr Jean-Philippe Langevin, a neurosurgeon and director of Restorative Neurosurgery and Deep Brain Stimulation Program for Pacific Neuroscience Institute at Providence Saint John’s Health Center in California who was not involved in the study.
“The researchers found that the networks had more to do with epilepsy than brain lesions. If they could focus stimulation within the networks, they could affect epilepsy symptoms,” Langevin told Medical News Today.
Brain networks are the roads in the brain. Lesions are the stops on the road. The scientists found that when electrical currents were applied anywhere along the streets in a network, it affected the entire network.
“[Deep brain stimulation] works for other diseases,” Langevin told Medical News Today. These include Parkinson’s disease, dystonia, obsessive-compulsive disorder, and essential tremor. “Working within a single network would also hold true for these illnesses.”
“This is exciting because when patients come to us with seizures in the future, a scan can look at how the network is connected, making it easier to use [deep brain stimulation],” Langevin added. “We don’t typically use the scans in the study, but they do already exist.”
Warning signs before a seizure are different for different people.
However, there are some common signs:
- An impending feeling of doom
- A sound or tone – is the same for all seizures
- Trouble forming thoughts
- Difficulty coming up with words
- Hearing as if you were underwater
- Feeling of déjà vu or feeling that everything is unrecognizable
- Butterflies in the stomach
- Feeling like everything is distorted, such as everything is larger or smaller than it should be
If you are having a seizure, you are advised to lay on your side. If a person having a seizure can’t move, another person should roll them over.
A person having a seizure should also be moved to an area where they will not hurt themselves. For example, somewhere that is clear of furniture.
Make sure there is nothing tight around their neck such as a button shirt, necktie, or scarf. If so, you should loosen these items.
Don’t leave someone having a seizure. Sit with them until the seizure is over.