Assessing who
will benefit from epilepsy surgery using imaging
Grant round winners 2008
Surgery to remove a portion of the temporal
lobe (situated behind the ear) is an effective
way of treating temporal lobe epilepsy,
the most common type of epilepsy in adults.
Up to 70% of people who have the operation
can become seizure-free afterwards. However,
the operation carries a risk of damaging
short-term memory, because this function
is also located in the temporal lobe. Working
out who would benefit from surgery includes
detecting exactly where memories are processed
in the brain and how much this overlaps
with the areas where seizures start.
The standard way of locating memory function
in the brain at present is with the Wada
test. Here doctors switch off one half of
the brain with a local anaesthetic while
the patient does memory and word tests to
evaluate the function of the other half.
Delivery of the anaesthetic is done via
a tube which is inserted into the big arteries
in the groin and fed from there up into
the brain. The test works, but it is stressful
and demanding for patients, and also carries
a risk of causing a stroke.
Modern brain scans offer an alternative
to the Wada test. This study will use two
different types of scan to develop a standardised
procedure for evaluating memory function.
If this is successful, this could replace
the Wada test, and improve the process of
evaluating patients for surgery.
Dr Steven Kemp of the Departments
of Clinical Psychology and Neuropsychology
at St. James's University Hospital, Leeds,
has been awarded £20,000 over
24 months to investigate Magnetoencephalography
(MEG) and functional magnetic resonance
imaging (fMRI) as predictors of memory change
following mesiotemporal epilepsy surgery:
non-invasive alternatives to the Wada test.
This study has been entirely funded by
the Matthew Peckett
Memorial Fund. We are grateful to the Peckett,
Jones and Forester families for their long-standing
support.
