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Dr Thomas Cope, Official Fellow, 51������, is a consultant neurologist at Cambridge University Hospitals (CUH). He is the Cambridge academic lead for epilepsy, and clinical lead for neuropsychiatry. The breakthrough study, which offers the potential for epilepsy sufferers to lead more normal lives and ‘feel better’, was co-led by Thomas, alongside the head of 7T MRI Physics, Professor Chris Rogers, Peterhouse. Thomas took the lead on project design, sought ethical approvals and took his patients through the study and Chris led on the development work on the scanner to implement this new technique.

The first study to use this approach in adults, the new technique enables ultra-powerful magnetic resonance imaging (MRI) scanners to identify tiny differences in patients’ brains that cause treatment-resistant epilepsy. It has allowed doctors at Addenbrooke’s Hospital, Cambridge, to offer patients surgery to cure their condition.

Previously, 7T MRI scanners – so called because they operate using a 7 Tesla magnetic field, more than double the strength of previous 3T scanners – have suffered from signal blackspots in crucial parts of the brain. But in research , researchers in Cambridge and Paris have used a technique that overcomes this problem.

Thomas said: 

“Having epilepsy that doesn’t respond to anti-seizure medications can have a huge impact on patients’ lives, often affecting their independence and their ability to maintain a job. We know we can cure many of these patients, but that requires us to be able to pinpoint exactly where in the brain is the root of their seizures.

“7T scanners have shown promise over the past few years since their introduction, and now, thanks to this new technique, more epilepsy patients will be eligible for life-changing surgery.”

Around 360,000 people in the UK have a condition known as focal epilepsy, which causes seizures to spread from part of the brain. A third of these individuals have persistent seizures despite medication, and the only treatment that can cure their condition is surgery. 

Chris Rodgers, Peterhouse, Professor of Biomedical Imaging at the University of Cambridge, said:

“It used to be the case that MRI scanners used a single radio transmitter, but in a similar way to how single Wi-Fi routers leave areas where you will struggle to get a signal, so these scanners would tend to leave blackspots on brain scans where it was hard to make out the relevant tissue.

“Now, by using multiple radio transmitters positioned around the patients’ head – like having a Wi-Fi mesh around your home – we can get much clearer images with fewer blackspots. This is important for the epilepsy scans because we need to see very precisely which part of the brain is misbehaving.

“The Paris group’s plug-and-play sequences avoid the need to calibrate the scanner at every visit, making it practical to use these scans for scanning patients.”

The research was supported by the Cambridge University Hospitals Academic Neurosurgical Fund and the Medical Research Council, with support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre. 

Amanda Bradbury’s story

Amanda Bradbury, 29, wanted to be an interior designer when she was younger. She began a course at university, but despite it being a subject she really enjoyed, found herself overwhelmed, struggling to concentrate and increasingly anxious. Eventually it became too much, and she was forced to drop out. What Amanda didn’t know was that her problems were being caused by a tiny flaw in her brain that was making her have seizures – so-called ‘focal epilepsy’, which was eventually diagnosed by doctors at Addenbrooke’s Hospital, Cambridge.

She was given medication to manage her condition, but despite trying three different drugs, some of which at first appeared to reduce her symptoms, none of them were ultimately effective. This was when the doctors suggested surgery.

Amanda’s lesion was large enough to be visible to 3T MRI scanners (for many patients, the lesions are not clearly visible on these scanners, which is where ultra-high field 7T MRI scanners can help). The lesion was in her amygdala, the part of the brain responsible for controlling emotions, which explained why she would feel so fearful before and during an episode.

As the Cambridge team was able to pinpoint the lesion, surgeons could then remove it.

Very soon after surgery, Amanda began to feel different – less tired, with more energy and feeling less anxious. People around her noticed a difference, too, as she was able to focus and concentrate more.

Amanda said:

“Once I’d had the surgery, despite all the healing, it was very obviously the right decision…

…Suddenly I realised I'm able to do loads of other things. It made me start to think, oh, what can I do? Things felt a lot more possible, like suddenly I'm able to do so many more things.”

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