Imaging Focal Epilepsy in Children: A Developmental Perspective (360G-Wellcome-206675_Z_17_Z)

Focal cortical dysplasias are common causes of treatment-resistant epilepsy in childhood, but are persistently difficult to detect on clinical magnetic resonance imaging (MRI) scans by routine visual inspection. This is especially true in children, where pathology may be masked by the dynamically changing background of the developing brain. My fellowship will investigate focal epilepsy in the context of the developing human brain. I will build analytical tools from clinical MRI data to better detect subtle MRI lesions and, using quantitative MRI (qMRI), translate these tools so they can be applied across clinical sites and in other neurodevelopmental and neurological disorders. I propose to build a continuous time-space model of brain development using large population MRI data from typically developing children. Using this model, I will test the specificity of abnormality maps in individual patients to confirmed epileptic pathology in a training- and test-dataset from two large epilepsy neurosurgery programmes. To generalise this model to standard clinical sequences, I will collect qMRI and synthesise scanner-independent MR images to tailor this growth model to any local protocol. Finally, I will extend these structural findings to identify networks associated with focal epilepsies, and investigate whether they can predict a successful outcome from surgery.