Powerful MRI Scans Aid Epilepsy Surgery

Key TakeawaysA new MRI technique can help find hard-to-detect brain lesions that are causing epileptic seizuresThe technique rings the brain with multiple powerful transmitters, to enhance the image and reduce blackspots on the scanA small-scale trial showed that the technique can find lesions in parts of the brain normally difficult to observe.WEDNESDAY, March 26, 2025 (HealthDay News) -- The first sign of seizures for Amanda Bradbury were auras in her vision that cropped up around age 19.Then came frequent bouts of anxiety, struggling to maintain focus and follow conversations, forgetting things, and having difficulty speaking or even swallowing.“One of the things that would happen before a seizure is I'd get an intense feeling of fear, which I now realize was seizure-related,” Bradbury, now 29, recalled in a news release.“I started leaving the house a lot less because of nerves, because it can affect your memory when you have a seizure” Bradbury continued. “I'd be too nervous to talk, because I would get confused. I just got more and more unsure about what was going on.”Bradbury was suffering from focal epilepsy, a type in which seizures spread from a misfiring region within the brain. In her case, the errant set of neurons -- called a lesion -- was in her amygdala, the part of the brain that controls emotions, which explains why she felt fearful prior to and during a seizure.Doctors cured her epilepsy with surgery that removed her lesion. They took this step after three different drugs failed to stop her seizures.Now, a new breakthrough could mean that even more patients with drug-resistant epilepsy will have that same option available to them.The lesion in Bradbury’s brain was big enough that it showed up on standard MRI scanners, but many people have seizure-causing lesions that are too small to show up on those scans.But researchers have found a way to use 7 Tesla MRI scanners -- which generate a magnetic field more than twice the strength of standard scanners -- to find epilepsy-causing lesions in the darkest recesses of the brain.Previously, 7T MRI scanners have suffered from signal blackspots in crucial parts of the brain, most commonly in the temporal lobes, where most cases of epilepsy arise.To overcome these blackspots, researchers implemented an MRI technique called “parallel transmit,” which uses eight transmitters around the brain rather than one.“It used to be the case that MRI scanners used a single radio transmitter, but in a similar way to how single wifi routers leave areas where you will struggle to get a signal, so these scanners would tend to leave blackspots on brain scans where it was hard to make out the relevant tissue,” researcher Chris Rodgers, a professor of biomedical imaging at the University of Cambridge, said in a news release.“Now, by using multiple radio transmitters positioned around the patients’ head -- like having a wifi mesh around your home -- we can get much clearer images with fewer blackspots,” he said. “This is important for the epilepsy scans because we need to see very precisely which part of the brain is misbehaving.”Researchers tested this approach with 31 epilepsy patients whose seizures were not responding to medication.The parallel transmit 7T scanner identified previously unseen lesions in nine of the patients, and in four others confirmed suspected lesions, results show. In an additional four patients, the scan showed that suspected lesions were, in fact, not the cause of their seizures.The images from the boosted 7T scanner were clearer than conventional 7T MRI images in more than half the cases, and in the remaining cases the images were equally clear.As a result of these findings, 18 of the 31 patients had changes in their epilepsy management:Nine patients were offered surgery to remove their lesions, and another had laser surgery.Three patients had lesions too complex for surgery to be an option.Five patients were offered an alternative technique that uses electrodes to pinpoint lesions and manage seizures.“Having epilepsy that doesn’t respond to anti-seizure medications can have a huge impact on patients’ lives, often affecting their independence and their ability to maintain a job,” senior researcher Dr. Thomas Cope, a clinical lecturer in neurology at the University of Cambridge, said in a news release.“We know we can cure many of these patients, but that requires us to be able to pinpoint exactly where in the brain is the root of their seizures,” Cope said. “7T scanners have shown promise over the past few years since their introduction, and now, thanks to this new technique, more epilepsy patients will be eligible for life-changing surgery.”Prior to her surgery, brainwave recordings revealed that Bradbury had been suffering seizures multiple times a day. She had thought they were happening perhaps a couple times a week.Soon after Bradbury underwent her surgery, she began to feel better – less tired and anxious, more energetic, more able to focus and concentrate.“Once I’d had the surgery, despite all the healing, it was very obviously the right decision,” Bradbury said. “Suddenly I realized I'm able to do loads of other things. It made me start to think, oh, what can I do? Things felt a lot more possible, like suddenly I'm able to do so many more things.”These include the most mundane tasks. “One thing I can do a lot easier now is clean the kitchen,” Bradbury said. “I can stand up, focus on what I'm doing and be chatting while I'm doing it.”The possibilities extend to greater ambitions. Bradbury wanted to be an interior designer and even attended a course at college, but her epilepsy caused her to drop out.She now works in office administration, but plans to get back into interior design as a hobby.“I want to try and do things that I enjoy, like interior design and things that are arty,” Bradbury said. “I want to experience these things more.”The new study appears in the journal Epilepsia.More informationThe Epilepsy Foundation has more on epilepsy surgery.SOURCE: University of Cambridge, news release, March 20, 2025 .What This Means For YouPeople with drug-resistant epilepsy should talk to their doctor about surgery as a possible treatment for their condition..Sign up for our weekly HealthDay newsletter

Powerful MRI Scans Aid Epilepsy Surgery

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