Epilepsy Research Group

Since 2006 there have been a number of new developments and expansion in the Epilepsy Research Group with more than £1 million of active research grants and five new full-time research staff and PhD students. The major areas of research activity continue to be in imaging, electrophysiology, genetics and new treatments in epilepsy.

Dr Mark Richardson has just commenced a £470,000 three-year project (in collaboration with Dr Matthias Koepp at UCL) to study the functional integrity of the frontal lobes of patients with frontal lobe epilepsy and juvenile myoclonic epilepsy using a combination of fMRI and MR tractography. In addition, a PhD studentship is funding a study of thalmic nuclei in focal epilepsies, using very high-resolution T1 and T2 signal mapping of the thalamus, combined with probablistic tractography and fMRI. We are also investigating the reproducibility and predictive value of fMRI of memory in the presurgical evaluation of patients with temporal lobe epilepsy. These projects involve close collaboration with the Centre for Neuroimaging Sciences (Prof Steve Williams and Professor Gareth Barker) as well as the KCH department of Neuroradiology (Dr Jo Jarosz).

Current projects in electrophysiology build strongly on the recent development of Single Pulse Electrical Stimulation (SPES) through the work of Dr Gonzalo Alarcon and Dr Antonio Valentin. In collaboration with Dr Richardson and Professor Kerry Mills this work is being extended to examine if cortical excitability in the seizure focus changes prior to seizures and to determine whether non-invasive transcranial magnetic brain stimulation (TMS) could subsitiute for the highly invasive SPES. Dr Alarcon and Dr Richardson are also developing methods to study the activity of individual human neurons during cognitive tasks, making use of opportunities presented by intracranial studies in presurgical patients. We are also examining whether electrophysiological signals can be used to predict seizure onset. Much of the work in electrophysiology is supported by members of the Theoretical Neurosciences Network (of which we are also a member centre), especially Dr John Terry (University of Bristol) and Dr Rodrigo Quian Quiroga (University of Leicester and CalTech). Dr Shane Delamont is continuing investigation of brainstem physiology in relation to epilepsy. This has included studies of cardiac, respiratory and movement parameters in wakefulness and sleep, especially in relation to seizure onset and to compare epilepsy with non-epileptic attack disorder (in collaboration with Dr Mellers and Dr Goldstein, IoP). Dr Michael Koutroumanidis continues work on the detailed characterisation EEG phenomena, especially in IGE syndromes.

A thriving programme in epilepsy genetics is led by Dr Lina Nashef in collaboration with Doctors Makoff, Asherson and Emslie at the IoP. A range of approaches include the analysis of large IGE kindreds and association studies in IGE using pooled DNA (in collaboration with Dr Nick Moran). In addition, studies to examine the role in epilepsy (and sudden death in epilepsy) of genes known to have roles in cardiac disease are underway. Dr Robert Elwes is leading the collection of a cohort of patients with epilepsy and mesial temporal sclerosis for genetic association studies, in collaboration with Drs Nashef, Jarosz and Makoff.

New techniques in epilepsy surgery are the subject of a number of projects, including a study of thalamic stimulation for epilepsy (Mr Richard Selway), studies of vagus nerve stimulation and a study of gamma-kife treatment for temporal lobe epilepsy (Mr Selway and Dr Franz Brunnhuber, in collaboration with Mr Lindquist, Cromwell Hospital). Dr Elwes is conducting monotherapy studies with new drugs in chronic epilepsy.