Innovative EpLink Research Funded through 2018

A recent funding announcement from the Ontario Government has assured that EpLink - the Epilepsy Research Program co-directed by Epilepsy Canada President Dr. Mac Burnham - will maintain its funding through 2018. EpLink is a major initiative of the Ontario Brain Institute, which received the news of its extended funding in March of this year.

The EpLink Epilepsy Program is unique in Canada, linking more than twenty-five researchers (working at nine different university and hospital sites across Ontario), five industry partners, five non-profit advocacy groups and a national NFP organization dedicated to epilepsy research.The EpLink Program will bring these workers more the $2 million per year in research support. Dr. Burnham shares responsibility for direction of the program with Dr. Jorge Burneo of London, Ontario.  It’s his hope that EpLink’s influence will spread far beyond the province’s borders and will form a template that can be adopted by provincial governments all across Canada.

Dr. Burnham notes that the goals of the EpLink Program are translational in nature. Though its studies involve cutting edge science, its major focus is to improve clinical care for epilepsy in the very near future. To accomplish this goal, EpLink is partnering with industry, since its support is necessary to bring new discoveries from bench to bedside. EpLink is also partnering with non-profit regional and provincial epilepsy associations in Ontario.

The research projects supported by the EpLink Program involve almost every area of epilepsy care. They are divided into six different themes: 1) Epidemiology and Diagnosis, 2) Medical Control of Seizures – Pharmacological, 3) Medical Control of Seizures – Non-Pharmacological, 4) Imaging for Surgery, 5) Surgery and Stimulation and 6) Genetics and Epigenetics. While there is not space to describe all of the projects, reviewing a few of them may give some sense of the depth and breadth of the EpLink Program.

In Epidemiology and Diagnosis, for instance, Dr. Michele Shapiro in Hamilton is testing whether longer initial EEGs will more accurately diagnose epilepsy after the first seizure, whereas Dr. Jorge Burneo in London is trying to assess the number of patients who develop epilepsy after traumatic brain injury and Dr. Elizabeth Donner in Toronto is studying the occurrence of SUDEP and the risk factors associated with it.

The Medical Control of Seizures – Pharmacological relates to drug development and delivery. Dr. McIntyre Burnham in Toronto, for instance, is involved in the pre-clinical testing drugs related to the ketogenic diet, while Dr. Peter Carlen is working on the transmucosal delivery of benzodiazepines to treat cluster seizures.

The theme of Medical Control of Seizures – Non-Pharmacological involves quite a variety of interesting projects. In Hamilton, Dr. Gabriel Ronen is testing whether physical exercise can improve seizure control, while in Ottawa; Dr. Sharon Whiting is investigating the cost-effectiveness of diet therapy – a treatment that should be more widely used. Dr. Elizabeth Kerr in Toronto is testing whether a computer-based training program can improve working memory in children with epilepsy – a study which maybe the first of a number of projects targeting the co-morbidities of epilepsy.

Surgery is the only real cure for epilepsy, and the increasing success of surgery has been largely based on improvements in non-invasive imaging. Imaging for Surgery is one of our most technically advanced themes, with a number of studies focused on MRI and MEG. Dr. Rob Bartha in London, for instance is using 7T MRI to re-screen patients previously screened with 3T MRI. The hope is that the more powerful technique will identify structural abnormalities missed in the earlier screening. Drs. Peters and Khan, also in London, are trying to fuse multi-spectral imaging techniques to create an atlas of epileptogenic brain tissue to assist surgery. Drs. Cheyne and Otsubo in Toronto are working to combine MEG and MRI for more accurate localization of interictal spikes, while Drs. Doesburg and Snead, also at the Hospital for Sick Children, are mapping network connectivity to improve the localization of epileptogenic foci.

The largest project in our Surgery and Stimulation theme relates to the development of computerized systems to detect seizure onset and to suppress seizures with brain stimulation. This effort is being led by Drs. Carlen, Bardakjian and Valiante at the Toronto Western Hospital, with related studies at the Hospital for Sick Children being conducted by Drs. Perez-Velazquez and Otsubo. Additional projects relate to monitoring the effects of surgery on quality of life (Dr. Mary Lou Smith) and predicting the memory deficits that may be caused by seizure surgery (Dr. Mary Pat McAndrews).

Our most "basic science" theme is Genetics and Epigenetics. The payoff from these studies may be some years away, but the impact will be very great. Dr. Danielle Andrade in Toronto, for instance, is studying the genetics of inherited temporal lobe, whereas Dr. Michael Poulter in London is studying methylation patterns in excised epileptic foci. Drs. Cortez and Snead are investigating the exciting possibility that early environment may prevent development of the phenotype in an animal model of West's syndrome.

Readers interested in more information can email Dr. Kathryn Hum, the EpLink Project Manager at eplink.obi@gmail.com or access the EpLink website at www.eplink.ca.