A breakthrough in brain imaging is offering renewed hope to thousands of people in the UK living with drug-resistant epilepsy. Researchers at Addenbrooke’s Hospital in Cambridge have successfully employed an ultra-powerful 7 Tesla (7T) MRI scanner, coupled with a new technique called ‘parallel transmit’, to identify subtle brain abnormalities that were previously undetectable. This advancement is significantly increasing the number of patients eligible for curative surgery.
Approximately 360,000 people in the UK live with focal epilepsy, a condition where seizures originate in a specific area of the brain. Around a third of these patients find their seizures persist despite medication, leaving surgery as their only viable path to a cure. Identifying the precise source of the seizures is crucial for surgical planning, and until now, conventional MRI scans have often fallen short.
The new technique addresses a common limitation of 7T scanners – ‘signal dropouts’ which create dark patches on the scans, particularly in the temporal lobes, a common area for epilepsy-causing lesions. By utilising eight radio transmitters around the patient’s head instead of the traditional single transmitter, the researchers have created a ‘mesh’ of signals, eliminating these blackspots and providing a clearer, more detailed view of the brain.
The research, published in Epilepsia, involved 31 patients with drug-resistant epilepsy recruited at Addenbrooke’s. The parallel transmit 7T scanner revealed previously unseen structural lesions in nine patients, confirmed suspected lesions in four, and allowed doctors to rule out lesions in another four. In a remarkable 58% of cases, the scans led to a change in the patient’s management plan, with nine offered surgery and one offered laser therapy.
“Having epilepsy that doesn’t respond to anti-seizure medications can have a huge impact on patients’ lives,” explains Dr Thomas Cope, a consultant neurologist at Cambridge University Hospitals. “We know we can cure many of these patients, but that requires us to be able to pinpoint exactly where in the brain is the root of their seizures.”
The advanced scanning technique is proving to be both effective and practical, with patients reporting minimal side effects, such as occasional dizziness. The “plug-and-play” sequences developed by the team in Paris, mean the scanner doesn’t require recalibration for each patient, making it easily implementable in a clinical setting. This promises to bring life-changing surgery within reach for even more epilepsy sufferers.
