Epi-Cease : A Non-Invasive Closed-Loop Transcranial Direct Current Stimulation (tDCS)-based Device for Antiepileptic Drug Resistant Epilepsy
Creators: name: Adibi, Mohammad Amin
name: Poologaindran, Anujan
Publisher: name: The University of British Columbia
Year: 2017

description: Epilepsy is a chronic neurological disorder characterized by recurrent and unprovoked seizures due to abnormal electrical activity in the brain. Unfortunately, this disorder affects 50 million people worldwide and of all ages, making it the fourth most common neurological disorder. As a result, epilepsy reduces an individual’s quality of life and provides a challenge for family members and caregivers. Over the last few decades, many advances have been made in effectively treating and controlling epilepsy. Today, a focused history, physical examination, blood work, and video-EEG are all part of the standard protocol in the accurate and timely diagnosis of epilepsy. Once the epileptic etiology is identified, anti-epileptic drugs (AED) represent a first-line pharmacological treatment for these patients. Unfortunately, a portion of patients do not respond to multiple AEDs and may display dose-dependent side effects that warrant AED discontinuation. These patients are considered for neurosurgical intervention after case and extensive review. Many centres, including Vancouver General Hospital, employ temporal lobectomy for focal temporal lobe epilepsies. This procedure is quite effective for a small portion of patients but is highly invasive and can lead to complications in verbal memory in 0.4-4% of patients. More importantly, brain surgery is not for all patients and can only be applied to patients suffering from temporal lobe seizures. The goal of this proposal is to “non-invasively reduce the frequency, duration and/or severity of seizures in drug-resistant focal epilepsy patients”. Particularly, we set out to circumvent the highly invasive nature of brain surgery and its limited widespread use. Moreover, we wished to develop a technology that would non-invasively “abort” seizures in real-time. Our proposed solution, Epi-Cease, is a non-invasive closed-looped system that consists of a wearable head-strap tDCS (transcranial direct-current stimulation) that delivers non-invasive stimulation to abort a seizure. This device will communicate with an Apple Watch that will detect seizures based on motion sensing and physiological data. When detecting the onset of a seizure, the Apple Watch app will signal the tDCS module to deliver stimulation to the brain in real-time in order to suppress/abort seizure initiation.To assess the safety and efficacy of Epi-Cease, we will conduct a two-staged proof-of-concept study. First, we will validate the Apple Watch motion-sensing and physiological data app compared to traditional methods of epilepsy monitoring. Once validated, we will then recruit a small cohort (n=3) of low-risk epilepsy patients to test the technology before expansion. This technology would represent a quantum leap forward in the care of epilepsy patients as it would be the first, real-time non-invasive solution to abort seizures and effectively control focal epilepsies. Course name: Applied Pathophysiology