Therapeutics
Background
Many people with epilepsy respond well to medication, but up to 40% continue to have seizures despite treatment. For these patients, surgery to remove the seizure-causing brain area can help. Scientists have long suspected that the blood-brain barrier (BBB)—which normally protects the brain from harmful substances—may be damaged in epilepsy, contributing to treatment resistance. But until now, it wasn’t clear whether this barrier can recover after surgery.
Research
FutureNeuro researchers used advanced brain imaging (DCE-MRI) to study the BBB in seven patients with drug-resistant temporal lobe epilepsy, both before and after surgery. They also analysed tissue from 13 patients. The team found that the BBB was damaged near the seizure source before surgery. In patients who became seizure-free, follow-up scans showed partial or full restoration of the BBB. In contrast, the barrier remained leaky in those who continued to have seizures. Tissue analysis confirmed changes in genes and proteins related to BBB function and inflammation.
Potential Impact
This study is the first to show that successful epilepsy surgery can help repair the brain’s protective barrier. Measuring BBB health could become a valuable marker for predicting surgical outcomes and may guide the development of new therapies to improve recovery and seizure control in people with drug-resistant epilepsy.
Read the full publication here
