The Brno Centre for Epilepsy is using experimental artificial intelligence for the diagnosis and treatment of epilepsy. Photo credit: MUNI.
Brno, Feb 10 (BD) – Epilepsy is estimated to affect from 0.5-1% of the population, up to 50 million people worldwide. However, in a considerable number of patients, the symptoms of the disease are not reduced by medication. In such cases, the solution is usually surgery, or therapy in the form of stimulation. At the Brno Centre for Epilepsy, specialists are researching how to use artificial intelligence to make the localization of the epileptic focus more effective.
“Unfortunately, in about a third of patients, even if they comply with all regimen regulations and take their medication correctly, we will never manage to eliminate their seizures completely,” said Professor Milan Brázdil, head of the 1st neurological clinic at St. Anne’s University Hospital (FNUSA) and the Masaryk University Faculty of Medicine. “In such patients, it is then possible to locate the place in the brain where seizures occur and, if possible, remove it.”
However, this is not always possible. At that point, doctors then use the so-called neurostimulation method of treatment, by stimulating the vagus nerve or deep brain stimulation of the anterior thalamic nuclei. During the surgical procedure, doctors insert special electrodes deep into the patient’s brain and lead a wire under the skin to a stimulator sewn into a subcutaneous pocket in the subclavian region near the heart.
“Newer stimulators can register the activity of the heart, and since we know that a significant proportion of patients experience an increase in heart rate at the beginning of an epileptic attack, the stimulator can sophisticatedly evaluate any change in heart rate and start extra stimulation, outside of the set mode,” said Brázdil, who started using this method to treat the first patients in Brno 10 years ago.
Today, a team of neurologists from Brno is already one step further in researching the treatment of a disease that afflicts 70,000-100,000 people in the Czech Republic. Using artificial intelligence, whose potential has been developing rapidly in recent years across all medical fields, especially in diagnostics, they focus directly on electrical signals in the brain.
“We are dealing with how artificial intelligence can help in pre-operative diagnosis, when it is necessary to calculate in which part of the brain the epileptic focus is located,” said Petr Nejedlý, a PhD student of Professor Brázdil at the Faculty of Medicine. “For this purpose, we use neural networks that go through EEG recordings and look for patterns corresponding to epileptic activity. The main goal is to develop a method that can analyse long-term EEG recordings and numerically quantify which parts of the brain are behaving abnormally.”
The exceptional potential of the project is reflected by the fact that Nejedlý recently received the Brno Ph.D. Talent grant, which is awarded to support the most talented doctoral students.
Brázdil emphasises the importance of the exact localization of the epileptic focus: “The site of the seizure must be precisely defined as part of the surgical treatment, so that we can, if necessary, safely and successfully remove it. It tends to be problematic if patients have more such deposits, or if they are located in places important for speech or movement, for example.”
In addition to the exact location of the seizure, epileptologists have also been focusing on its early detection. If an impending attack is detected in advance, the patient has enough time to take medication and moderate its force. Professor Brázdil gave some predictions to the direction epilepsy therapy may take in the not-so-distant future: “There are already efforts to continuously measure the brain’s electrical activity with electrodes that are placed under the scalp and connected to smart watches. In time, a smart watch could therefore signal an impending attack.”
