For decades, researchers have been looking for ways to predict a seizure. It is almost always an unexpected event, however, and the best tools we have (including artificial intelligence) come to predict an attack with few minutes in advance, one hour maximum.
Now, for the first time, research shows that brain activity could be used to predict the onset of epileptic seizures several days in advance.
A new hope
The University of California, San Francisco's Department of Neurology examined data from brain implants that are used to monitor and prevent seizures. Researchers have found patterns of brain activity that predict seizures. A day earlier, or even more, they can predict whether someone has seizures – this could be a great prospect for people with epilepsy.
“For 40 years, people have been trying to find ways to predict when someone is about to have a seizure. The best they can do now is to give the person a few minutes' notice." says Vikram Rao, co-author of the study published in The Lancet Neurology .
“This is the first time anyone has been able to predict an epileptic seizure long before it happens. It will allow people to plan their lives, to know when they are or are not most at risk."
Predicting a seizure: the data collected
The researchers used information obtained from NeuroPace, a responsive brain stimulation device. It was authorized for clinical use in 2013 to detect abnormal brain activity and deliver an electrical impulse to prevent seizures.
Epilepsy is a neurological disease characterized by recurrent seizures or periods of abnormal electrical activity in the brain. When a person has a seizure they may lose consciousness or have convulsions.
Seizure prediction would be an innovation capable of revolutionizing the lives of those with epilepsy. People should not worry about episodes while swimming, or cooking.
Listen to brain activity
Studying brain patterns in epileptic patients is difficult. Most of the data is collected in a hospital or research setting for short periods. But NeuroPace offers a new window into the patient's brain activity.
As a brain implant, it continuously listens to the brain's activity, and allows researchers to look at even years of continuous EEG data. I'm talking about data collected while people go about their daily lives, which is much more reliable. A type of collection that seemed impossible to do in this field.
The team looked at the data from 18 patients with a brain implant, patients followed for several years. This data allowed them to create an algorithm to predict an epileptic seizure. They then tested the algorithm on similar data collected in a 10-year clinical study that included 157 people.
The system really anticipates a seizure
Study results tell us that the timing of a seizure is not as arbitrary as it seems. The team found monthly brain cycles that indicated a higher risk of having a seizure, and they believe they could someday use this knowledge to help patients anticipate an episode, take medications, and plan their days.
“Our findings in this research make me optimistic that we may one day be able to tell a patient that based on their brain activity, they have a 90% chance of having a seizure the next day. And therefore should avoid triggers like alcohol and high-risk activities like driving,” Rao added.
The next step? A prospective study. NeuroPace was designed to detect and stop a seizure before it begins. Its application for long-term forecasting is still in the early stages, but after further study it can finally be used.
It will be a great day, that.
