VEP

The goal of the Virtual Epileptic Patient Brain (VEP) project is to provide clinicians with novel tools that will increase surgery success and minimize invasiveness for the treatment of focal drug resistant epilepsy (DRE). The most efficient treatment of DRE is resective surgery, which is underused and has barely improved its outcome of seizure-free patients for the past 50 years. The VEP solution towards a better management of DRE is a bioinformatic approach using personalized brain models, derived from each patient’s own anatomy. A personalized virtual brain is constructed from the patient’s non-invasive neuroimaging data. Computer simulations of the virtual brain generate predictions on brain imaging and personalized surgery procedures, which will be tested in France (Timone Hospital in Marseille) and the USA (Cleveland Clinic). Virtual brain technology also proposes novel highly innovative therapeutic solutions, such as spatially distributed multi-focal laser microsurgery, which will be tested in the clinic. The Virtual Brain (TVB) Technology is at the core of the project (http://www.thevirtualbrain.org). TVB is constrained by human subject-specific anatomical information derived from anatomical MRI and diffusion tensor imaging (DTI). A large repertoire of mathematical tools enables mimicking depth EEG recordings, seizure genesis and propagation. In a preliminary study from 15 DRE patients, we computed a score estimating the difference between the Epileptogenic Zone (EZ) identified by TVB, but rejected by clinicians during pre-surgical evaluation. A large difference of the identified EZ was correlated with poor seizure prognosis according to the Engel classification, suggesting that had clinicians performed a pre-surgical patient analysis using TVB technology, they may have changed their surgical strategy.