Innovating epilepsy care: Exploring advanced brain imaging for drug-resistant epilepsy

A Simon Fraser University-led clinical research study is evaluating how advanced brain imaging could improve epilepsy surgery in British Columbia.

Epilepsy affects more than 50,000 people in B.C., according to the BC Epilepsy Society. The first line of epilepsy treatment is anti-seizure medication, but it can be ineffective. In these cases, brain surgery may be the only viable treatment—but determining whether surgery is possible requires highly precise brain mapping.

A powerful brain imaging technology called magnetoencephalography (MEG) offers new hope to children and adults living with drug-resistant epilepsy.

"MEG can help map where the seizures are originating in the brain. It's completely noninvasive and doesn't require the patient to actually have a seizure during the test," says Maggie Clarke, neuroscientist and director of the MEG program at the SFU ImageTech Lab.

There are only about 200 MEG machines worldwide. The only one in Western Canada is located at SFU's medical imaging facility in Surrey.

Clarke, lead researcher in the study, says MEG works alongside traditional tools like magnetic resonance imaging (MRI), electroencephalogram (EEG) and positron emission tomography (PET) and can also reveal information that these methods may miss.

Clarke is conducting the clinical research with collaborators from BC Children's Hospital, Fraser Health Authority, Vancouver General Hospital and the University of Alabama at Birmingham.

The noninvasive MEG could help identify more children and adults who would benefit from epilepsy surgery and may reduce the burden of epilepsy on patients and their families, as well as the health care system, says Mary Connolly, clinical professor of pediatrics and director of the Comprehensive Epilepsy Program at BC Children's Hospital.

"Current presurgical testing often requires patients to stay in the hospital for extended periods, where they undergo video-EEG monitoring in order to record their seizure," Connolly explains. "It is stressful, costly, and sometimes seizures don't occur in the hospital environment. MEG can localize seizure activity without needing an active seizure, making the process faster and more comfortable."

The MEG scan itself is quiet, short, and noninvasive. Patients sleep while lying in a comfortable bed with their heads placed inside the MEG helmet, making it suitable for everyone from infants to adults.

Early successful epilepsy surgery can stop or reduce epileptic seizures, which dramatically improves quality of life, reduces long-term health care costs, and decreases the risk of sudden unexpected death. Many people with uncontrolled epilepsy have learning challenges, ADHD, autism, intellectual disability and mood disorders, says Connolly.

"Some patients live with uncontrolled seizures for decades before surgery is performed," she says. "We are trying to change that by identifying people who will benefit from epilepsy surgery as early as possible."

Vancouver residents Brett and Jacci Sandler, whose family has been personally affected by epilepsy, helped secure funding from TD Bank Group to support the SFU-led study.

"As parents who've experienced the challenges of epilepsy firsthand, we know how critical early diagnosis and effective treatment can be," says Jacci Sandler. "Supporting this research is deeply personal for us. We believe MEG technology has the potential to change lives, and we're proud to help bring it closer to the families who need it most."

SFU and TD share a long-standing commitment to research projects supporting community and health care in B.C., says Kevin Hamaoka, senior vice president of commercial banking at TD.

"We're so proud to support SFU's vital work providing British Columbians with much-needed access to cutting-edge MEG technology," Hamaoka says. "At TD, we're continuing our investments in research, technology and innovative solutions focused on helping to make equitable health care accessible for all."

MEG is used for evaluation for epilepsy surgery in Europe, the U.S., and even Eastern Canada, but it's not currently available in clinical settings in B.C.

The research team hopes their findings will pave the way for MEG to become a standard part of epilepsy care, improving outcomes for patients and families across the province.

"Our study participants have been incredible. Children with epilepsy and their families face significant challenges, and it deeply affects every aspect of their lives," says Clarke. "We have this remarkable piece of equipment that can help change the lives of patients here in B.C. and potentially outside the province as well."

Ismail Mohamed, study collaborator and professor of pediatrics and neurology at the University of Alabama at Birmingham, agrees.

"I believe every patient being considered for epilepsy surgery should have access to a MEG scan. It can be the difference between a lifetime of seizures and a seizure-free life," says Mohamed.

"This work marks an important first step in exploring the clinical use of MEG in B.C.," adds Harinder Dhaliwal, study collaborator, neurologist and epileptologist.

"We believe we have the ability to improve the patient's quality of life with this first-of-its-kind technology on the West Coast."

Provided by Simon Fraser University