Tracking Epilepsy’s Impact in the Brain Could Allow for Earlier Treatment

Georgetown study explores whether cognitive deficits attributed to epilepsy can be detected in a child’s brain

WASHINGTON (September 23, 2015) — A very common form of epilepsy — called temporal lobe epilepsy — can cause memory and attention/concentration deficits, but how widespread is the impact on the brain and can it be tracked? These are the questions researchers at Georgetown University Medical Center are looking to answer. They say if extensive cognitive deficits can be identified in children, early aggressive treatment might be possible to halt cognitive decline.

The cognitive deficits children with temporal lobe epilepsy face often lead to learning challenges and subsequent academic underachievement.

“This form of epilepsy tends to become a chronic and poorly controlled disease continuing into adulthood,” says Temitayo O. Oyegbile, MD, PhD, assistant professor of medicine at Georgetown University Medical Center who treats patients at MedStar Georgetown University Hospital. “Unfortunately, the treatment options for this form of epilepsy are often limited to medications that don’t work in some children.”

Oyegbile says recent studies show that even though this epilepsy emanates from the temporal lobe, the cognitive deficits may extend to the whole brain. This suggests that the disorder may have a deleterious broad effect on the whole brain, potentially impacting multiple cerebral networks.

The study’s co-investigator, John VanMeter, PhD, director of the Center for Functional and Molecular Imaging, says functional MRI (fMRI) can be utilized to investigate the neural networks that are impacted in temporal lobe epilepsy. Specifically, functional connectivity and targeted fMRI tasks will provide information about the extent to which various networks are disrupted.

“The overall findings from this research will tell us if we’re able to identify deficits in functional connectivity and activation earlier than currently possible with neuropsychological assessments,” VanMeter says.

“If we can, prior research suggests that prompt, aggressive surgical intervention may be warranted to halt neurocognitive decline in these patients,” Oyegbile explains.

She and her team are recruiting children age 8 to 16 with temporal lobe epilepsy to participate in their study. Children without epilepsy are also needed to serve as controls, against which fMRI scans and other tests will be compared.

All study participants will undergo a comprehensive neuropsychological battery along with functional activation and connectivity testing in the fMRI scanner. There are no known harms from fMRI scanning. Study participants will be reimbursed $30 for taking part in the study ($15 for completing fMRI tasks and $15 for completing neuropsychological testing).

The study is sponsored by the Epilepsy Foundation. Oyegbile reports having no personal financial interests related to the study.

If you or someone you know is interested in participating in this study, please call Oyegbile at 202-243-3467 or email too3@georgetown.edu.

About Georgetown University Medical Center
Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis — or “care of the whole person.” The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health.

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