Can epileptic seizures be predicted and prevented?

Q & A with Professor Berj L. Bardakjian

In honour of Epilepsy Awareness Month, Erin Vollick sat down with a leading neurological researcher at the University of Toronto, Berj L. Bardakjian.

A biomedical engineering Professor at the Institute of Biomaterials & Biomedical Engineering (IBBME) and the Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), Bardakjian works with a team of neurological specialists to classify different brain states using recordings of its electrical rhythms, and from there, to pinpoint seizure zones in the epileptic brain – research that could reduce the amount of tissue cut during corrective surgical procedures, as well as lead to better surgical outcomes.

What is epilepsy?

Contrary to what most people imagine, epilepsy is not considered a disease, but a disorder characterized by changes in the brain that lead to seizures. But epilepsy actually covers a wide range of disorders. There is not just one type of epilepsy, but many.

Our present theory is that seizures are caused when the brain is in a state of hyper-excitability. I think of the brain as a symphony. The electrical activity in the brain is polyrhythmic, as there are many interacting rhythms, and none of them are “regular”. But with an epileptic seizure, suddenly, all the cells in the brain start synchronizing together and they enter a singular, regular rhythm, which means that all the other normal functions of the brain are not occurring.

What are some of the historical associations surrounding epilepsy?

Epilepsy used to imply “possession.” Historically, people who suffered epileptic seizures were thought to be possessed by the devil, or were entering mythical or mystical states. Personally, I wonder about many of our geniuses – Napoleon Bonaparte, Beethoven, and Van Gogh, for instance, all had epilepsy. Was their genius related to their epilepsy? Is hyper-excitability what gave us Beethoven’s 9th symphony?

What causes hyper-excitability?

Hyper-excitability occurs due to possible chemical environment changes in the brain, at times even visual changes. A few years ago, for instance, people in Japan who were watching TV were getting seizures from the flickering lights in their television programs.

How is epilepsy managed?

There are three main courses of treatment. Children who have epilepsy can be put on a “ketogenic diet” – it’s a horrible diet, very high in fat, but it can help control the seizures.

Drugs are the next step, and these drugs are designed to reduce the excitation of the brain that leads to this synchronous brain activity and seizures.

Drugs don’t work for some people, so surgery is an option. Surgeons will try to cut out that part of the brain that is the focal point of the seizures. But there are some areas of the brain that can’t be cut, such as those vital cognition areas. Also, you can only perform surgery if the epilepsy is “focal” to one region, and not “generalized” in multiple sites of the brain.

What kind of research is your team conducting?

The big buzz word right now is ‘Deep Brain Stimulation’.  We’re trying to create implantable devices that can predict seizures and stimulate the brain in such a way as to prevent seizures. Via electrodes, we want to input into the brain high complexity electrical signals – like a symphony – that would mimic the rhythmic signals that normal, functioning brains produce. The simulator we’re working on is a model of the electrical rhythmic activities of the functioning brain.

This kind of therapy wouldn’t have the drawbacks that drugs have. For one thing, this is a more localized treatment, and this kind of therapy would sidestep any drug sensitivity and side-effect issues.

But currently we’re trying to pinpoint those regions in the brain where seizures are occurring with a greater degree of accuracy.

How can you pinpoint or predict seizures?

We record the electrical activity of the brain and then classify the various state transitions between these activities. We then look for differences in pre-seizure states. Sometimes we simply detect the seizures.

What has changed in epilepsy research in the last 20 years?

What’s new about our research, and the best part of the research we’re conducting right now, is that we work as part of a team: neurologists at Toronto Western Hospital, neurosurgeons, pharmacologists, neurophysiologists, physicians, and neural (biomedical) engineers.

What breakthroughs do you think are imminent or potentially imminent?

First, and we’re nearly there: we’re trying to help surgeons cut out the focal region in the brain that needs to be removed to stop seizures. Currently, surgeons just cut as much as they can rather than what needs to be cut, and even that doesn’t guarantee they cut out the right region.

From an ongoing research perspective, we’re trying to understand more about the hyper-excitability that leads to epileptic seizures. This is still an outstanding mystery – and we’re using various models, such as computer models, to answer those questions.

This story originally appeared in a University of Toronto publication, and is reproduced here with permission.

Tagged: Health, Blog

Share: Print

Leave Comments

Blog Posts

Love and Passwords

Patchen Barss | February 12, 2015

UOIT researcher Christopher Collins has been part of a team studying more than 32 million passwords that were released from a now-defunct hacked website called “RockYou.” This work was led by graduate student Rafael Veras and was a collaboration with Julie Thorpe, from UOIT's Faculty of Business and Information Technology. Even though passwords are one of our best-kept secrets, it turns out millions of people put a little love in their computer security. You can explore some examples of real passwords in an interactive visualization, but here are the highlights of what he found:   Research Matters; How much love did you find in people’s passwords? Christopher Collins: In our study of 32 million passwords, we found that love was the most common verb. Love is about 23 times more common than hate. In fact, we compared the occurrence rates of words in passwords against the occurrence in “normal English” and found that “love” occurs much more often in passwords than in normal English.   RM: How do people build love into their passwords? CC: Love was seen in many patterns beyond the straightforward use of the word. For example, “<3” is the second most common sequence of the form <number + special character> (“#1” is the most common).  “<3” is a shorthand for a heart (turn your head). We also see a high occurrence of “4u” as in “ilive4ubaby” compared to other two character sequences.  We found thousands of passwords containing “lover”, “loverboy”, “lovergirl”, even “latinlover.” We found that people love dogs slightly more than cats. We found interesting patterns in the objects of love.  For example, for the pattern “ilove<name>”, the name is 4 times more likely to be a man’s name than a woman’s name.  In order of probability, people expressed love for “boys”, sex (in various word forms), dad, dogs, cats, music, mum/mom, love, horses, cities, and countries, rock, girls, alcohol (various word forms), chocolate, and angels. However, as objects of “hate”, male names are only twice as likely as female names. The pattern “ihate<name>” overall is about 75 times less common than “ilove<name>,” revealing that love wins over hate – at least in our passwords.  The object of “hate” is much more likely to be what our system calls a “knowledge domain”, like “ihatemath”! The pattern “Iloveyou” is 10 times more likely than “Iloveme” – so much for rumours of our self-centred society! We also see examples of unrequited love in patterns like “iloved<name>” and “imiss<name>”.   RM: What else? CC: We see these “romantic” patterns popping up in the adjectives used in passwords as well.  Here are the top 10 adjectives: 1) sexy 2) hot 3) pink 4) blue 5) red 6) big 7) cute 8) sweet 9) cool 10) green We see pet names, like “baby” occurring often, as in “babygirl”, “babygurl”, “Babyboy”, “babycakes”, “sexybaby”.  We don’t know, but I think these are not talking about infants.   RM: Predictability would seem to be a boon to hackers. Is there a security risk in choosing a love-based password? CC: We are continuing to work to quantify the security risks raised by our work.  This is the primary focus of our analysis, however, the human-interest part of this data is exciting too.  I would advise people against using “ilove<name>” as a password, as the pattern is just too common.  Approaches to guessing passwords (called “offline guessing attacks”) make millions of guesses and would quickly try these patterns. However, breaking up the pattern with other words, with numbers and other characters can help a lot.  We are working on systems to suggest modifications to passwords to make them more “semantically secure” in our current research.   RM: Does your research teach you anything about people's inner thoughts? CC: We can’t really say much about people as computer scientists.  We didn’t  know anything about the people – not even their username.  So, while we see very evocative passwords, such as “lovehurts”, we can’t ask anyone about them. Passwords are a very personal thing – we don’t expect anyone to know them, and we select them knowing they will be repeated many times throughout our days. So, when someone chooses to name their partner, such as “ilovedan” in a password, I expect that person is making a conscious effort to reaffirm that love as a sort of mantra through the day. Or, maybe they have a crush and are trying to manifest the unrequited love. We can’t say from the data! We were also surprised at the amount of affirmation in passwords.  While we did find hateful passwords, expressing hate against particular groups, religions, or people, overall, the sentiments seem quite positive. I think that passwords are a chance to have a personal secret, to be free with what we write, and perhaps play around a bit with language. When we choose intimate passwords, I think that expresses a desire and maybe reminds us of the positive things in life throughout our day.  But, I’m a computer scientist, this is just conjecture!        

Cat and rabbit: a ...

Sandra Annett | February 1, 2015

  In 2003, a trio of South Korean artists known as “SamBakZa” or “The Three Beats” posted a short Flash animation to their website, recounting a story of forbidden love between a cat and a rabbit. The story was so upbeat, the pace so frenetic that the cartoon borders on manic. Still, There She Is!! (which comprise the original cartoon plus four follow-ups) touched nerves all around the world: The cartoon has been watched more than 12 million times since its release. There She Is!! is based on a manhwa (comic) called One Day which was drawn by SamBakZa member Sogong. What is it about this odd little cartoon series that struck such resonance? In this excerpt from her book Anime Fan Communities: Transcultural Flows and Frictions (Palgrave Macmillan, 2014) Sandra Annett explores the cartoon's viewer community through the hundreds of posts and comments they've left behind. She theorizes that the medium itself might be the mechanism that allowed this story to reach so many people.   “Love at First Site”: these words are the subject line of a post made to the SamBakZa.net bulletin board on February 2, 2006. The poster, “Rae,” has just seen the music-video-style Flash cartoon “There She Is!!” (2003), which will come to form the first episode of a five-part series also called There She Is!! S/he has also just discovered that the site has a public bulletin board moderated by the SamBakZa team’s lead animator, Amalloc. At this point, there are 767 Original Posts (OPs) on the board, some with dozens of comments. Rae decides to post as well. Writing in English, Rae is slightly in the minority: over half of the posters coming to the board in 2006 write in Korean (398 OPs), though English trails not too far behind (276), and Japanese is relatively well-represented (89 posts, compared to just 3 in Spanish). “Love at First Site,” Rae puns (or simply misspells?) in the subject line. The post continues: I just happen to come across your site in the wee hours of the night . . . stumbled across a video that was made, and let me just say I fell in love! Though I don’t understand the lyrics, the music is wonderful, the art is beautifully done, and it made me very happy just watching it. Thank you for such a wonderful site, and keep up the good work! (Ellipses in orig.) Rae never became a regular commenter, but the sentiment expressed here and the particular way of expressing it is common for the SamBakZa.net bulletin board. This unremarkable, everyday sort of fan posting has two features which are among the key aspects of transcultural animation fan communities online: first, a mixture of emotional engagement and reflexivity, and second, a focus on issues of language. In the first case, notice how along with praising the art and animators, Rae also remarks on the online environment itself. The post begins with an account of finding the website—“stumbling across it” at random—and concludes with thanks, not just for the animation but for the “wonderful site.” The text and the conditions of its viewing meld into one affective experience: “it made me very happy just watching it.” This experience is spontaneous and immediate in its visuality, happening at first sight, and yet it is also self-consciously mediated and linguistic, as it happens on a site, with Rae bringing attention to the act of viewing a video and then expressing opinions on the board. At the same time, the experience is not limited by language, as Rae adores the short even without understanding the lyrics of the Korean pop song that structures it. Commenters posting in other languages express similar ideas. In November 2004, a regular Japanese poster called “Chiumi” suggested that Flash, by going beyond words, can allow all the people of the world to be deeply moved, so that by coming to this page they can feel as if a “new language” (“atarashii gengo”) is coming into being. So I very, very much respect Mr. Amalloc for being able to use that “new language.” Like Rae, Chiumi remarks on both the Flash animation and the act of “coming to this page,” which allow an affective coming-together “beyond words.” Chiumi’s portrayal of Flash animation as “going beyond words” is grounded in a reading of SamBakZa’s animation, since all five shorts have no dialogue and tell their stories through a combination of visuals and musical rhythms. It is also a perfect example of the kind of longing for a visual language capable of connecting “all the people of the world” that has accompanied the emergence of new media from film to the Internet. -from Anime Fan Communities: Transcultural Flows and Frictions (Palgrave Macmillan: 2014), pages 149-150. © Sandra Annett, 2014. Republished with permission.

To err is human. ...

Patchen Barss |

Recently, Brock University convened three researchers for a podcasted panel discussion on wellbeing. One of those researchers, Kathy Belicki studies how and why we forgive those who have done us wrong. Her research suggests that the effect on your wellbeing depends on why you work to forgive someone we love for hurting us. Below are excerpts from her contribution to the podcast discussion. (Headings have been added for clarity:   On the relationship between well-being and forgiveness: KB: In terms of well-being, in my research I’ve focused on emotional and physical health. Some forms of forgiveness  seem to result in better emotional and physical health. Some other forms of forgiveness definitely don’t; they can leave you feeling quite a bit worse off. Some forms of forgiveness help to restore a relationship and that could be a good thing if it’s a good relationship, but if it’s a toxic relationship that could be a very damaging thing. If we flip it around, unforgiveness is definitely not good by anyone’s standards. Feeling really angry can be empowering, but it’s not a pleasant emotion. It’s very hard on the body and it also takes a toll on relationships because no one wants to be around someone who’s angry all the time. On forgiveness and our need to be connected to those we love: KB: We are fundamentally social beings. Good social ties are connected to better emotional well-being, better physical health. For people who forgive in order to feel better, forgiveness usually means some type of process of letting go, moving on; they may never even talk to the person that hurt them. Oddly enough, we found in our research, forgiveness is not doing much for them. But it's different for  people who forgive for some reason outside of themselves – for example, “Forgiveness is good for the world so I’m going to struggle with this." They’re not forgiving to feel better, but they feel better than the people who forgive in order to feel better. On other things we work to get over:  KB: I’ve also studied trauma. Following trauma, sometimes people come to a new understanding about life that they just didn’t have before, a greater appreciation for the value of peacefulness instead of the highs, for contentment, for meaning. Not uncommonly, it’s after those awful things in life that sometimes people, for the first time, struggle to find a sense of meaning and a sense of connectedness. So these things are intangible and they sure don’t cost money; they do take effort, but they’re apparently worth the struggle. On what we can do about it all: KB: One thing we can really do for ourselves is to strengthen and develop relationships, good relationships. And then one of the realities of those relationships is if you know me long enough I’m going to hurt you. If I know you long enough you’re going to hurt me, and so we need to find some way to navigate that. When we’re the person who hurts, [that means] being prepared to apologize or do what needs to be done to mend that. If I’m the person who has been hurt, certain forms of forgiveness can be useful. In a nutshell, the reasons you choose to forgive are important. Forgiveness that is for noble reasons – for the betterment of humanity, to help this person who has hurt you or a simple recognition that all humans make errors – is the kind of forgiving that we have found associated with well-being.   These excerpts have been edited for brevity and clarity, and are published here with permission. Full transcript is available. 

The promise(s) of ...

Maxine Myre |

“I will be more attentive to you in private and public so you realize how much I care” “I will sacrifice some time I would usually spend with other friends or my hobbies to be with you. “I will surprise you with loving gestures such as sending affectionate texts, offering backrubs, making dinner, buying you a favourite food or beverage” These are just some examples of promises often made in romantic relationships. In this Q and A, Johanna Peetz, a researcher at Carleton University, talks about her research of such  promises, and what makes people more likely to keep them. Research Matters: How exactly do you define a close relationship? Johanna Peetz: Usually when we say close relationships, we think romantic relationships. I would argue that the same processes apply to almost any close relationships, including a close friend or a close family member. In our studies, we limited to romantic partners because we are very sure that they want to make each other happy. RM: What are the main factors that you found contribute to overpromising? JP: Love for the partner, loving feelings, motivation to make them happy… all that warm and fuzzy stuff predicts if you will promise a lot. But personality variables such as conscientiousness predict whether or not you actually do the things you promise. People who report to love their partner a lot promise a lot but are not more likely to follow through. Overpromising is actually linked to loving your partner more. This is counterintuitive, right? Because if someone breaks their promise to you, you think they don’t love you enough, but they might just love you too much and that’s why they’re making promises they can’t possibly keep. RM: Why do you think that happens? JP: Well I think that happens because we underestimate all the other factors that affect our behavior. We construct the best-case scenario of how we will accomplish our goals, we get seduced by all our intentions, and forget about all the other things that might affect what we want to do. As an example, for the promise ‘I will call you every night when I’m gone on vacation’, you might really intend to call your partner every night. But then there’s just never time. You’re with other people. There’s no way out of the social situation. The phone service in a different country doesn’t work. Things that you didn’t foresee  prevent you from fulfilling your promise. RM: Is there a type of person that does consider all these different factors? JP: Yes. Conscientious people. They’re characterized both by being more cautious in promising and also by being better able to follow through. They plan for contingencies, and form plans to deal with those contingencies. They might sign up in advance for a plan that allows them to call from another country. The higher you are on conscientiousness personality traits, the better you are at following through. RM: How common are people with these personality traits? JP: About a third of our sample  didn’t fall short all that much on their promises. RM: So we’re not all doomed to break our promises in love? JP: Not at all. I don’t want to give you the impression that it’s a negative message. When your partner breaks a promise, you might want to jump to the conclusion they don’t love you. Instead, you might think about what they promised: was it a something that requires sustained behaviour over a long period of time? If yes, then it might not have been they were unmotivated. Their personality might be such that they find it difficult to follow through on long-term goals. So you might want to give them some slack!

Bad backs and good ...

University of Waterloo staff |

  Newly published findings from the University of Waterloo are giving women with bad backs renewed hope for better sex lives. The findings—part of the first-ever study to document how the spine moves during sex—outline which sex positions are best for women suffering from different types of low back pain.  The new recommendations follow on the heels of comparable guidelines for men released last month. Published in European Spine Journal, the female findings debunk the popular belief that spooning—where couples lie on their sides curled in the same direction—is the best sex position for all women with low back pain. “Traditionally, spooning was recommended by physicians to all individuals with back pain because it was thought to reduce nerve tension and load on the tissues,” said Natalie Sidorkewicz, the PhD candidate at Waterloo who led the study. “But when we examined spine motion and muscle activity, we found that spooning can actually be one of the worst positions for certain types of back pain.” The pioneering research combined infrared and electromagnetic motion capture systems, like those used by filmmakers for full computer graphic character animation, to track how 10 couples’ spines moved when attempting five common sex positions. The findings were used to create an atlas, or illustrated set of guidelines that recommends different sex positions based on what movements trigger a patient’s pain. The atlas suggests that women who are extension-intolerant, meaning those whose back pain is made worse by arching their backs or lying on their stomachs, for example, replace spooning with the missionary position. Adding a low-back support, such as a pillow, can also help keep the spine in a more neutral position. For women who are flexion-intolerant, typically those whose back pain is made worse by touching their toes or sitting for long periods of time, the atlas recommends spooning or doggy-style sex where the woman is supporting her upper body with her hands, not her elbows. “What we know now is that sex positions that are suitable for one type of back pain are not appropriate for another kind of pain,” said Sidorkewicz. “These guidelines have the potential to improve quality of life—and love life—for many couples.” According to Statistics Canada, four of every five people will experience at least one episode of disabling low-back pain in their lifetime. Up to 84 per cent of men with low-back pain and 73 per cent of women report a significant decrease in the frequency of intercourse when suffering back pain. “Primary care physicians report it is common for couples to seek their advice regarding how to manage their back pain during and after sex. Many couples will remain celibate because the pain resulting from one night of lovemaking lasts months,” said Professor Stuart McGill, of the Faculty of Applied Health Sciences at Waterloo. “Now doctors have solid science to guide their recommendations.” The next phase of the study will involve recruiting patients with different categories of back and hip pain, as well as additional sex positions, to further develop the recommendations.
More Blogs »