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Recently approved stimulation system to detect and interrupt incipient epileptic seizures using artificial intelligence / New option for drug resistance / Study at the Medical Center - University of Freiburg aims to personalize treatment significantly

For around 250,000 * epilepsy patients in Germany, medication does not help or does not help enough. At the end of September, the world's first minimally invasive brain pacemaker for epilepsy patients was approved, which can significantly reduce the frequency and severity of seizures. The European approval studies were conducted at the Epilepsy Center - University of Freiburg Medical Center. In a follow-up study as part of the Brain-MEP project, the research team led by Prof. Dr. Andreas Schulze-Bonhage, Head of the Epilepsy Center at the Department of Neurosurgery at the Medical Center - University of Freiburg, is now investigating how artificial intelligence can be used to detect the first seizure signals and interrupt them with targeted stimulation so that a seizure does not occur in the first place. The scientists and physicians also want to find out which patients will particularly benefit from the treatment so that they can offer it in a targeted manner. The study is expected to run until spring 2024.

"The brain pacemaker can fundamentally change the lives of many epilepsy patients. We can use it to very successfully treat people who have suffered from non-treatable epilepsy, sometimes for decades," says study leader Schulze-Bonhage. The thin membrane of the stimulator is placed under the scalp and reduces seizures by means of light electrical impulses that the pacemaker transmits to the brain.

Further personalizing effective therapy

"We have already been able to show that the brain pacemaker is very effective when a defined area of the brain receives light electrical stimulation for 30 minutes a day. With the new study, we want to go one step further. The stimulation should then take place very quickly when a seizure begins," says Schulze-Bonhage. A so-called closed-loop system will be used to permanently measure brain activity using a built-in electroencephalogram (EEG). Artificial intelligence will then be used to identify typical signals at the start of a seizure and trigger suitable stimulation. "We also want to understand even more precisely for whom the treatment is particularly promising. This would allow us to offer stimulation specifically to these epilepsy patients," explains Schulze-Bonhage. The study is being carried out using existing patient data and new data obtained in the study.

Small intervention, big effect

In previous studies, the brain pacemaker was used in people for whom years of drug therapy attempts did not work sufficiently and for whom epilepsy surgery on the brain was not an option. The system is placed under the scalp. It is not necessary to open the skull bone, which further reduces the risk of such an intervention compared to open brain surgery. The approval data showed a clear advantage for many of the patients treated in terms of the frequency and severity of seizures. One patient was even able to use the system to acutely terminate seizures and thus reduce motor seizures by around 75 percent.

What is initially being developed for epilepsy patients could also be used in the future for other neurological diseases for which there are currently only inadequate treatments, such as for rehabilitation support after a stroke, the treatment of severe depression or for chronic pain.

The overall BRAIN-MEP project is being led by the medical technology company Precisis GmbH, and the Faculty of Engineering at the University of Freiburg is also involved in projects to further develop the brain pacemaker.

Contact:
Prof. Dr. Andreas Schulze-Bonhage
Head of
Pre-surgical epilepsy diagnostics - Epilepsy Center
Department of Neurosurgery
Medical Center - University of Freiburg
Phone: 0761 270-54250
andreas.schulze-bonhage@uniklinik-freiburg.de

* An earlier version of the press release incorrectly referred to one million people affected.