30 Participants Needed

Brain-Computer Interface for Epilepsy

LH
Overseen ByLiberty Hamilton, Professor
Age: < 65
Sex: Any
Trial Phase: Academic
Sponsor: University of Texas at Austin
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

The goal of this interventional study is to compare if the use of a brain-machine interface (BCI) therapy can improve the symptoms of attentional deficit by producing brain changes in the networks that modulate attention. The investigators intend to work with epileptic participants who do not respond to pharmacological treatment, who will undergo neurosurgery. The questions the study sets out to answer are: 1. is there an improvement of symptoms in an experimental group receiving the treatment versus a sham group receiving a simulation of the treatment? 2. does the application of the therapy before surgery reduce the recovery times of post-surgery cognitive deficits described in the literature? Making use of the information recorded from brain electrodes implanted before a participant's epilepsy surgery, the investigators will create a BCI decoder that works with the available activity sources to establish the level of attention of each participant when performing tasks. Participants: * will perform an offline phase first, which will consist of one day of evaluation, in which they will be familiarized with an attentional task. * will perform a training phase later, which will consist of several days of evaluation, where they will learn to modulate their level of attention. This modulation will be facilitated by the BCI decoder, which will classify the level of attention directly from the brain and provide visual feedback that the participant will use as a guide. If the participant is part of the experimental group (or BCI group), the feedback will work as described and should be easy to follow, but if the participant is part of the Sham group, the feedback will not work according to the brain activity of the actual participant, but according to that of another person. Because of this, a mismatch will be created between the moments a brain experiences inattention, and participants believe they are experiencing inattention. This is a randomized, double-blind study, in which the experimenters will evaluate how the effect of the attentional therapy with BCI affects an BCI group and a Sham group.

Do I need to stop my current medications for the trial?

The trial does not specify if you need to stop taking your current medications. However, since it involves participants with drug-refractory epilepsy, it seems likely that you can continue your current epilepsy medications.

What data supports the effectiveness of the treatment Invasive Brain-Computer Interfaces for epilepsy?

Research shows that invasive brain-computer interfaces, which involve implanting electrodes in the brain, help accurately locate the areas causing seizures in epilepsy patients. This precise localization can make epilepsy surgery more effective and safer, as it allows doctors to target the problematic brain regions more accurately.12345

Is the Brain-Computer Interface for Epilepsy generally safe for humans?

Research on invasive brain-computer interfaces, often used in epilepsy treatment, suggests that these devices can be safely used in humans. Studies involving subdural and depth electrodes, which are similar to brain-computer interfaces, have shown that with careful monitoring and proper use, the procedures are generally safe and effective.12678

How is the Brain-Computer Interface treatment for epilepsy different from other treatments?

The Brain-Computer Interface (BCI) treatment for epilepsy is unique because it uses invasive devices to collect and interpret brain signals directly from the cortical surface, allowing for real-time processing and insights that are not possible with traditional methods. This approach can help in precisely localizing epileptic brain regions, which is crucial for effective epilepsy surgery, especially in patients who do not respond to medication.123910

Research Team

DM

Diego Mac-Auliffe, Postdoc

Principal Investigator

The University of Texas at Austin

Eligibility Criteria

This trial is for children and adolescents aged 8-21 with drug-resistant epilepsy, scheduled for neurosurgery, who can see normally or with correction, understand instructions in English or Spanish, and give informed consent. Excluded are those with stroke history, brain injuries, color blindness, certain implants or disorders (mental/neurological), severe physical impairments or illnesses (like cancer), substance abuse issues, pregnancy, and MRI safety conflicts.

Inclusion Criteria

iEEG implants on the GK network (ventro-lateral prefrontal cortex and executive network). Also desirable in areas related with attention and Action Phase processing
Normal to corrected vision
Ability to understand instructions to follow protocols
See 4 more

Exclusion Criteria

Severe intellectual and learning disabilities
Compromised consciousness
Pregnancy
See 13 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Offline Phase

Participants perform an offline phase consisting of one day of evaluation to familiarize with an attentional task

1 day
1 visit (in-person)

Training Phase

Participants undergo several days of evaluation to learn to modulate their level of attention using the BCI decoder

1-2 weeks
Multiple visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Treatment Details

Interventions

  • Invasive Brain-Computer Interfaces
Trial OverviewThe study tests if a customized BCI decoder improves attention in epileptic patients by comparing an experimental group using the BCI feedback to a sham group receiving mismatched feedback. It's randomized and double-blind; participants first learn an attention task without feedback then train to modulate attention levels using BCI visual feedback before surgery.
Participant Groups
2Treatment groups
Experimental Treatment
Placebo Group
Group I: This arm will receive visual feedback controlled by its own BCIExperimental Treatment1 Intervention
Group II: This arm will receive visual feedback from another randomly selected participantPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials
387
Recruited
86,100+

Findings from Research

The study demonstrated that home monitoring of epilepsy patients using a subcutaneous EEG device is feasible and well tolerated, with no serious adverse events reported among the nine participants over a monitoring period of up to 3 months.
The device provided objective seizure counts that often differed significantly from patients' self-reported seizure diaries, revealing underreporting and important insights into seizure patterns and responses to antiepileptic drugs.
Ultra-long-term subcutaneous home monitoring of epilepsy-490 days of EEG from nine patients.Weisdorf, S., Duun-Henriksen, J., Kjeldsen, MJ., et al.[2021]

References

Brain computer interface (BCI) tools developed in a clinical environment. [2010]
Subdural grid and depth electrode monitoring in pediatric patients. [2018]
Brain-Computer Interface (BCI) Applications in Mapping of Epileptic Brain Networks Based on Intracranial-EEG: An Update. [2023]
Utility of adding electrodes in patients undergoing invasive seizure localization: A case series. [2023]
Subdural and depth electrodes in the presurgical evaluation of epilepsy. [2019]
Seizure-related adverse events during video-electroencephalography monitoring. [2012]
Video-EEG monitoring: safety and adverse events in 507 consecutive patients. [2014]
Ultra-long-term subcutaneous home monitoring of epilepsy-490 days of EEG from nine patients. [2021]
Ring and peg electrodes for minimally-Invasive and long-term sub-scalp EEG recordings. [2018]
10.United Statespubmed.ncbi.nlm.nih.gov
Voluntary brain regulation and communication with electrocorticogram signals. [2009]