Neurotechnology Edges to the Forefront of Epilepsy Treatment

This flexible electronic device can stick to the wet surfaces of living, moving tissues such as the heart, and sense and control the electrical activity of these tissues. Scientists are now investigating whether a similar electrode array could suppress seizure activity by interrupting electrical circuits in the brain. | AAAS/Science

It may be possible one day to control epileptic seizures with light, or with a device similar to a pacemaker, according to epilepsy researcher and medical entrepreneur Brian Litt.

Litt, a professor of neurotechnology and bioengineering at the University of Pennsylvania, recently gave a crash course in the latest neurotechnologies at the forefront of treating epilepsy at a briefing in Washington, D.C., at the Rayburn House Office Building.

AAAS and its journal Science Translational Medicine co-hosted the briefing with sponsorship from the Dana Foundation.

The goal shared by Litt and others is to improve treatment options for the millions of people suffering from reoccurring seizures. Right now the only treatments available are antiepileptic drugs, or surgery to remove the chunks of brain tissue that contain the faulty neurons that cause seizures. There is no cure.

Litt and colleagues are currently developing a device that detects the electrical wave fronts generated by the rapid-firing neurons involved in epilepsy. Made up of flexible electrodes that stick to brain tissue, the technology works much like therapies currently used to treat abnormal heart rhythms. In these procedures, electrodes help detect abnormal electrical circuits in heart muscle, which are then interrupted by making tiny lesions in the muscle. A stimulating electrode array could potentially suppress seizure activity by interrupting electrical circuits in the brain.

Litt and colleagues described the device in a 2010 Science Translational Medicine paper, showing the technology's capacity to map electrical pulses and stimulate heart tissue in pigs.

Litt also talked about a telemetry unit, a device implanted in the brain that records and analyzes Electroencephalography (EEG) signals to predict seizures. The device receives data from implanted electrodes, predicts seizure activity using an algorithm, and subsequently pings an alert to a cell phone or pager. The implantable telemetry unit could help patients keep track of when seizures are brewing, and is currently being tested in dogs (who have epilepsy at about the same frequency as humans).

Litt, a professor of neurotechnology and bioengineering at the University of Pennsylvania, recently gave a crash course in the latest neurotechnologies at the forefront of treating epilepsy at a briefing in Washington, D.C., at the Rayburn House Office Building.

The latest experimental approaches to treat epilepsy involve light. They are based on an approach called optogenetics, which involves genetically altering neurons in the brain to make them responsive to light. By shining a light onto brain tissue, researchers can then manipulate specific populations of neurons responsible for seizure activity.

Scientists are using optogenetics to turn brain circuits on and off, in the hopes of figuring out the specific roles these circuits play in epilepsy. "We're approaching early pilot trials of these types of technologies, Litt said.

Erin Heath (left, Associate Director, AAAS Office of Government Relations), Brian Litt and Megan Frisk (Associate Editor at Science Translational Medicine) | AAAS/Nadia Ramlagan

The work Litt and his colleagues in other labs have been doing is paying off. Last month the FDA approved an implantable device called the RNS system for use in people with epilepsy.

"We have evidence from the RNS system that seizures can be stopped sometimes," Litt said.

All of these technologies encompass the larger, unfolding story of how better tools to map the brain are helping researchers devise new ways to treat disease and improve patients' quality of life.

"The Congressional briefing was an excellent way to invite a leader in the field, Dr. Brian Litt, to discuss how neural technologies of today and of the future can be used to understand and treat human disease, and why policymakers and the public should be interested in advances in this research area," said Megan Frisk, Associate Editor at Science Translational Medicine and co-organizer of the briefing.