Can we predict a person’s response to antiepileptic drug treatment?

Posted Jul 28 2017 in News from Epilepsy Research UK

The ability to predict who will respond to antiepileptic drug (AED) treatment is something that epilepsy researchers are striving for. Not only would it reduce long, unfruitful trials of AEDs, it would generally make epilepsy care much more efficient.

Professor Mark Richardson and colleagues, at King’s College London, have used a novel combination of functional MRI (fMRI) and EEG to try and find out whether differences in brain shape and behaviour of neuronal networks can distinguish people who will and won’t respond.

This ERUK-supported grant was a pilot study (of £ 29,172*), meaning that it was very new and early research. We fund a pilot grant stream to help scientists with brand new theories gain preliminary data for potential further funding. There is, of course, a risk that an idea will come to nothing, but there is also a chance that it will be ground-breaking!

The team did encounter a significant set-back during the study, but the results they gained definitely warrant further research. Let’s see what Professor Richardson said:

We looked for subtle features of brain scans and EEGs that can predict whether a person recently diagnosed with epilepsy will respond to their prescribed drug treatment. At the moment, we cannot predict who will respond and who will not.

“In this study, we collected MRI brain scans and EEGs simultaneously in a group of people with recently-diagnosed epilepsy. We studied them again six months after they started treatment. We used novel methods to analyse the scans and EEGs.

“This is a pilot study, which means that we are exploring this method in a small group, to see if it holds enough promise to explore in a much larger group.

“We found that features of brain shape differed between patients and healthy controls, and were slightly different between responders and non-responders. We found that the brains (neuronal networks) of patients were abnormally tightly connected (“synchronised”) but this did not differ between responders and non-responders.

“We encountered an important setback, which is that a relatively large number of our subjects did not start any drug treatment. Also, among those that did, almost all responded. Therefore, we could not compare sufficient numbers of responders and non-responders to make confident statements about what we found.

“(Despite this) our findings of abnormality of brain structure and baseline, with a hint that this is worse in non-responders, is definitely suitable for a future definitive proposal. Our findings related to brain network synchronisation are also promising and worthy of further study.

“We expect the structural imaging findings and network synchronisation findings to motivate a component of a Medical Research Council programme, which we will apply for in 2018.”

ERUK wishes the team all the best in securing further funding for this line of research, and looks forward to hearing about its progress.

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* The funding for this pilot study supported the costs of scanning only. King’s College London covered the costs and other resources for data analysis amongst its group of collaborators.

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