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Neuroimaging Research Areas and Projects

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Neuroimaging Research Areas and Projects

Read about current research areas and projects running under our world leading neuroimaging programme.

Optimizing epilepsy surgery (Wellcome Trust, Epilepsy Research UK)

Removal of the temporal part of the piriform cortex greatly increases the chances of seizure freedom after temporal lobe resection for temporal lobe epilepsy.

The part to be removed is shown in green in the orthogonal 2D  and 3D images. The part indicated in purple is in the frontal lobe and needs to be left intact.  These data are uploaded to the neurosurgical navigation system to guide the surgery (Fig 1). 
The part to be removed is shown in green in the orthogonal 2D  and 3D images. The part indicated in purple is in the frontal lobe and needs to be left intact.  These data are uploaded to the neurosurgical navigation system to guide the surgery (Fig 1). 

 

EpiNav is a 3D multimodal interactive software platform that enables image-guided solutions for the entire epilepsy surgery pathway. 

The green area is to be resected and the pale blue, that is needed for motor control, is to be spared (Fig 3).
The Planning module provides computer assistance planning of multiple SEEG trajectories, including target selection and avoidance of blood vessels for quick and efficient planning (Fig 2). 

Identification of the site of epilepsy onset in the brain may require the placement of many electrodes in the brain, and this then leads to planning a resection, that does not damage crucial parts of the brain. 

The green area is to be resected and the pale blue, that is needed for motor control, is to be spared (Fig 3).
The green area is to be resected and the pale blue, that is needed for motor control, is to be spared (Fig 3).

 

 

Tractography to show critical nerve pathways

We need to precisely visualize the parts of the brain needed for vision, so that they are not damaged in epilepsy surgery, we have developed refined methods to do this (Fig 4).
We need to precisely visualize the parts of the brain needed for vision, so that they are not damaged in epilepsy surgery, we have developed refined methods to do this (Fig 4).

 

Analysis of brain structure (MRC, Epilepsy Society (Sobell Trust), NIHR)

Machine learning detection of covert abnormalities

Identifying focal abnormalities that underlie refractory epilepsy is crucial in the consideration of epilepsy surgery. We have created a multivariable AI based program to identify covert abnormalities in individuals who are considering surgery and validating this with the sites of seizure onset in individuals having intracranial EEG at NHNN. 

Automated detection of hippocampal sclerosis using contemporary machine learning approaches (Fig 5).
Automated detection of hippocampal sclerosis using contemporary machine learning approaches (Fig 5).
In the case shown, we identified abnormalities in the right temporal and frontal lobes. A right frontal lobe resection was carried out after stereo EEG, and seizure-freedom post-surgery was achieved (Fig 6).
In the case shown, we identified abnormalities in the right temporal and frontal lobes. A right frontal lobe resection was carried out after stereo EEG, and seizure-freedom post-surgery was achieved (Fig 6).
We have used serial MRI to demonstrate the accelerated loss of the gray matter of the brain over years in individuals with  epilepsy, indicating the progressive effects of epilepsy on the brain (Fig 7). This will be invaluable in trials of therapies to prevent this damage. 
We have used serial MRI to demonstrate the accelerated loss of the gray matter of the brain over years in individuals with  epilepsy, indicating the progressive effects of epilepsy on the brain (Fig 7). This will be invaluable in trials of therapies to prevent this damage. 

 

 

Functional MRI (fMRI)

In the last 20 years we have been using functional MRI (fMRI) at Epilepsy Society's Chalfont Centre to map where different functions such as language and vision occur in the brain. For example our research has enabled us to see exactly which part of the brain we use if we want to think of words, name objects or describe a picture. 

Language, memory and brain function (UCLH Biomedical Research Centre, UCLH-BRC)

Difficulties with language and memory are a significant issue in people with epilepsy. Epilepsy surgery may be a suitable treatment option in some people however in some there is worsening of language and memory functions that can significantly impact of quality of life.

fMRI can show where in the brain language and memory is carried out. This enables us to predict the risks of surgery and lateralise language functions pre-surgically (Fig 10), our next step is to use this information to design surgery that does not affect language.
fMRI can show where in the brain language and memory is carried out. This enables us to predict the risks of surgery and lateralise language functions pre-surgically (Fig 10), our next step is to use this information to design surgery that does not affect language.
We have created memory fMRI tests to localise memory functions in people with epilepsy and to predict memory effects of epilepsy surgery, and how epilepsy affects memory (Fig 11).
We have created memory fMRI tests to localise memory functions in people with epilepsy and to predict memory effects of epilepsy surgery, and how epilepsy affects memory (Fig 11).

 

Pharmaco-fMRI (Newton Foundation)

Adverse effects of epilepsy medication  has a very negative effect on quality of life. Functional MRI (fMRI) can show the brain activation that underpin language and memory and thought. 

We are using this to determine the effects of epilepsy medication on thinking processes (Fig 9) and shows how some medication, especially in combination, may have a profound effect on brain function. 
We are using this to determine the effects of epilepsy medication on thinking processes (Fig 9) and shows how some medication, especially in combination, may have a profound effect on brain function. 

 

Post-mortem MRI (Epilepsy Society, grant applications in progress)

Sudden unexpected death in epilepsy (SUDEP) is one of the top ten causes of premature death in the UK and sudden death is 24 times more likely to occur in people with epilepsy than the general population.  We aim to offer post-mortem MRI scans in patients who potentially died from SUDEP, as well as provide a service for people who prefer not to have scalpel post-mortems for their loved ones, 

Inflammation and blood brain imaging (MRC)

Depression, is common in epilepsy.

Brain inflammation occurs in epilepsy and depression. We will use novel MRI to demonstrate  this brain inflammation that may give rise to seizures and depression (Fig 8) so that we may identify effective therapies.
Brain inflammation occurs in epilepsy and depression. We will use novel MRI to demonstrate  this brain inflammation that may give rise to seizures and depression (Fig 8) so that we may identify effective therapies.

 

Functional MRI

In the last 20 years we have been using functional MRI (fMRI) at Epilepsy Society's Chalfont Centre to map where different functions such as language and vision occur in the brain.

Epilepsy Navigator

Epilepsy Navigator is an interactive 3D-neuronavigation system that enables the best operative approach for inserting electrodes into the brain in order to pinpoint the areas where seizures arise from. These plans are now being used to direct a robotic system for placing the electrodes through the skull and into the brain.