Vibrations in the heart of epilepsy: innovative guided epilepsy surgery based on electrical high frequency oscillations

Epilepsy is one of the most common brain disorders, affecting many individuals, with about 30% not responding adequately to medication. Focal epilepsy, which originates from a specific source in the brain, can potentially be cured through surgical removal of that source. During surgeries, electrical signals can be directly measured from the cerebral cortex, and high-frequency oscillations (HFOs) in EEG signals assist in pinpointing the source of the epilepsy.

To measure and interpret these signals, we focused on characteristics typical of epileptic seizures and HFOs,   including phase-amplitude coupling at low frequencies, abrupt changes, and functional connectivity. We utilized artificial intelligence to distinguish between healthy and diseased tissue based on spectral signal characteristics. While AI effectively recognized healthy tissue and indirectly identified diseased areas, human observation typically relies on detecting visible anomalies.

We recorded EEG directly from the cerebral cortex using high-density electrode grids in patients with epilepsy and during brain tumor surgeries. This approach proved beneficial in better identifying both the epilepsy and the tumor. Our team has developed a medical product designed to guide neurosurgeons directly to the epileptic source. This initiative emerged from collaboration between UMC Utrecht and two companies: one specializing in medical product design and the other in neurosurgical monitoring.

The project has resulted in a new partnership focused on creating flexible electrode grids, developing a graphical user interface, exploring market opportunities for our findings, and enabling direct measurement and transfer of signals.

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