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Engineering a better treatment for epilepsy

Watch a video about Sridevi Sarma's work to improve treatment of epilepsy patients »

Watching her aunt battle Parkinson's disease was an emotionally draining experience for Sridevi Sarma. But it also sparked in Sarma — then a doctoral student studying electrical engineering — a curiosity about the human brain, one of the world's most complex electrical networks.

Sarma, an assistant professor in the Department of Biomedical Engineering, has focused her research on improving treatment for people with brain ailments, including epilepsy. The neurological illness affects 50 million people worldwide, and in a third of these cases, medication cannot prevent seizures. In such cases, the only treatment options are surgery or an implant that shoots a short pulse of electricity into the brain when a seizure is detected.

The implant, though, triggers false alarms, often sending electrical pulses through the brain when unnecessary. Sarma and her team in the Institute for Computational Medicine are working to develop new software that they hope will address this issue and improve anti-seizure technology.

"These devices are very good at detecting when a seizure is about to happen, but they also produce lots of false positives, sometimes hundreds in one day," Sarma says. "If you introduce electric current to the brain too often, we don't know what the health impacts might be."

Sarma's software was tested on real-time brain activity recordings collected from four drug-resistant epilepsy patients. In a study recently published in the journal Epilepsy & Behavior, Sarma's team reported that its system yielded superior results, including flawless detection of actual seizures and up to 80 percent fewer false alarms. Although the testing was not conducted on patients in a clinical setting, the results were promising.

"We're making great progress in developing software that is sensitive enough to detect imminent seizures without setting off a large number of false alarms," Sarma says.

Further fine-tuning is under way, using brain recordings from more than 100 epilepsy patients at The Johns Hopkins Hospital, where several epilepsy physicians have joined in the research. Sarma hopes that, within a few years, her system will be incorporated into a brain implant that can be tested on people with drug-resistant epilepsy.

"There is growing interest in applying responsive, or closed-loop, therapy for the treatment of epileptic seizures," says Gregory K. Bergey, professor of neurology and director of the Johns Hopkins Epilepsy Center. "Developing detection methods that can both provide this early detection and yet not be triggered by brain activity that will not become a clinical seizure has been a real challenge. Dr. Sarma's group appreciates how important this is."

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