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Saturday, September 18, 2021

Medicine in a whole new light

There are many conventional and unconventional ways to treat ailments. Some people prefer the organic method, downing apple cider vinegar or sipping herbal tea at the first sign of a cold, while others rely solely on antibiotics. However, those who depend on approved medicinal practices and scoff at non-traditional medicine may be surprised to find that oftentimes the field of medicine goes much deeper than a bottle of pills.

Many conditions require medication because there simply is no other option to turn to. One of these conditions is epilepsy. Epilepsy affects one in 26 people, and is a condition characterized by spontaneous seizures in the brain.

“People with epilepsy have recurring, unprovoked seizures,” said Michael Rogawski, a professor in the Department of Neurology, and an epilepsy researcher at UC Davis. “The seizures can be very dramatic, such as a generalized convulsion — stiffening and jerking of the whole body — or very subtle, such as a brief loss of awareness. However, in all cases, epileptic seizures relate to abnormal electrical discharges in the brain.”

The dramatic seizure described is called a “grand mal,” while the other, less obvious seizure is called a “petit mal.” Petit mals are sometimes more dangerous because in the brief moments of unconsciousness, the individual can swerve off the road when driving, or lose body control and fall. The aftermath of a grand mal is similar to the symptoms of a petit mal.

The 2007 news story of Wesley Autrey and Cameron Hollopeter involved the aftermath of a grand mal seizure. Causes vary from brain injury to genetics but there is no known cure for epilepsy. Most people take anticonvulsants to manage their seizures.

“Some current treatment options include drugs that target brain cells, and surgery to remove the part of the brain believed to be where the seizures are starting,” said Caren Armstrong and Esther Krook-Magnuson of the UC Irvine Department of Anatomy and Neurology in a joint interview. “A major drawback of drugs is that they are basically always on rather than just at the time of the seizure, and that they lack specificity, [and] thus can have serious side effects.”

Armstrong and Krook-Magnuson added that for about 40 percent of patients, current treatment options do not provide adequate seizure control.

Recently, UC Irvine neuroscientists have come up with a way to combat epilepsy using fiber optic light signals. Ivan Soltesz, the Chancellor’s Professor and chair of the Anatomy and Neurobiology Department at UC Irvine, and his team created an electroencephalogram (EEG)-based computer system that activates optical fibers placed in the brain when a seizure is detected. Light-sensitive proteins called opsins are then activated which either stimulate or inhibit neurons during a seizure. The research team found this process was able to stop electrical seizure activity and reduce convulsions successfully in a mouse model.

“This approach is useful for understanding how seizures occur and how they can be stopped experimentally,” Soltesz said in the initial press release. “In addition, clinical efforts that affect a minimum number of cells and only at the time of a seizure may someday overcome many of the side effects and limitations of currently available treatment options.”

The research has opened up an avenue to new possibilities, but more development is necessary before pursuing this fiber optic strategy in humans. Rogawski, who discussed the novel treatment, said that light sensitive channels in the brain are needed for the fiber optic treatment to work, but it is not naturally present. Mice used for the model were genetically engineered to express the light-sensitive gene but in humans it is not that simple.

“Obviously, people can’t be bred to express engineered channels,” said Rogawski. “Another approach will need to be used.”

Rogawski went on to describe how the engineered channels could be induced using a gene therapy vector, such as a genetically engineered virus.

“A light pipe would then need to be surgically implanted [into the patient’s’ brain]. This is a very elegant strategy because it allows specific types of neurons to be activated selectively.”

The issue with the surgery is that it is very complicated, and simpler approaches to treat epilepsy are being researched. One alternative is using electrical stimulation on the brain with metal electrodes.

While the tools to attain the ultimate goal of replicating the fiber optic treatment in humans may be distant, the research still could lead to better alternatives for people with epilepsy. With any luck, fiber optics will someday be used in more than just high-definition television and night lights.

NICOLE NOGA can be reached at science@theaggie.org.

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