Research predicting epilepsy

“Epilepsy is one of the worst neurological conditions,” says Mark Cook who, as Chair of Medicine at the University of Melbourne and Director of Neurology at St Vincent’s Hospital, is uniquely positioned to make this observation.

The University of Melbourne graduate has dedicated his professional life to treating the condition, having witnessed his father suffering seizures and the inadequacy of available treatments.

For epilepsy sufferers, Professor Cook explains, typical activities such as driving, swimming, or even attending work are made extremely difficult due to the unpredictability of seizures.

“I guess that’s the part that affects me most,” he says. “We soak people in medications with significant side effects to prevent seizures that might only be occurring for a few minutes every year.”

The ability to predict seizures could dramatically improve sufferers’ lives – and Professor Cook’s early research revealed hints that it might be possible. That led him to the Department of Electrical and Electronic Engineering at the University of Melbourne, where he teamed up with Associate Professor David Grayden.

Their initial research was hindered by technical limitations in consistently recording electrical activity in the brain, key to predicting the onset of seizures. That changed when they discovered Seattle-based company NeuroVista.

“NeuroVista developed a device which was implanted into the head to record exactly what we needed – long-term electrical signals,” Professor Cook explains.

This marriage of the medical and material sciences moved the project forward at a rapid pace. Under Professor Cook’s leadership, researchers devised a way of feeding the long-term electrical signals recorded on the NeuroVista device to a second device implanted under the skin of the user’s chest. This transmits the information to a wireless hand-held device, calculating the probability of a seizure. The device, small enough to carry in a handbag or pocket, uses lights to warn patients of a low, moderate or high risk of impending seizure.

A small proof-of-concept study took place involving 15 people suffering between two and 12 seizures a month – with profound results.

The system accurately predicted seizures with a high warning 65 per cent of the time, and worked to a level better than 50 per cent in 11 of the 15 patients. Eight of the 11 had their seizures predicted between 56 per cent and 100 per cent of the time.

The time between the alert and the seizure varied from eight minutes to four hours, with the average time being about 100 minutes.

“It had never been established that you could predict seizures, so this was groundbreaking,” Professor Cook says. He now hopes to replicate the study in larger clinical trials with less invasive devices.

“I can imagine these devices will be used to allow the supply of some treatment, maybe electrical stimulation of the brain, maybe a short acting medication that’s delivered directly to the brain, while also allowing for the practical aspects of prediction so people can make their environment safe,” he says.

Collaboration has been central to Professor Cook’s success. He describes his work with the engineering department as “absolutely crucial”.

“New developments in materials, computing, engineering – areas that perhaps we wouldn’t have thought too much of once before – actually turn out to be really important components of the systems we’re working with. We lack that perspective if we approach the problem entirely from the biological end of things.”

The University and St Vincent’s Hospital, recognising the enormous potential around Professor Cook’s work, recently announced he would be the inaugural Sir John Eccles Chair of Medicine. 

Sir John, like Professor Cook, possessed an innovative approach to medicine, graduated from the University of Melbourne and spent his clinical years at St Vincent’s.

The University and St Vincent’s are aiming to raise over $3 million as part of Believe – The Campaign for the University of Melbourne to endow the Chair and ensure that Professor Cook’s long-term vision is realised. He has already received donations from those who truly understand the value of his research – his patients.

“If we can have a higher level of commitment to this work we can get things done better and faster,” he says. “No question about that.”