Predicting and improving motor outcomes of hemispherectomy in children
Research type
Research Study
Full title
Improving the outcomes of hemispherectomy in children with intractable epilepsy: a novel approach based on movement analysis
IRAS ID
119664
Contact name
Faraneh Vargha-Khadem
Contact email
Sponsor organisation
Great Ormond Street Hospital for Children NHS Foundation Trust & The UCL Institute of Child Health
Research summary
Hemispherectomy, or removal/disconnection of an entire cerebral hemisphere, is an effective method of arresting or ameliorating intractable epilepsy in children, but carries the risk of inflicting or exacerbating a significant loss of motor function in one side of the body, especially the upper limb. In order to improve outcomes post-surgery, progress must be made in both our understanding of the problems that underlie the patient’s poor motor function and their relation to abnormalities in the patient’s motor system and the design of effective therapies for motor rehabilitation. This study is designed to radically improve on current knowledge in these areas by addressing the following objectives: (1) To determine the structural and physiological correlates of a hemispherectomised patient’s post-surgical motor outcome; (2) To develop a comprehensive, accurate and appropriate assessment of the patient’s motor function; (3) To use our measures to predict long-term motor function.
To measure the effect of surgery and long-term outcomes we will carry out a research protocol on three groups: patients who are due to undergo hemispherectomy or other surgical excisions for treatment of epilepsy; patients who have previously undergone such surgery; typical participants with no history of medical illness. Using specialised cameras, motion trackers and electrodes placed on the skin we will record the participant’s movements and muscle contractions carried out in task-oriented experiments and special video-games that promote active arm engagement. We will then relate these to measures of the participant’s brain activity and structure using electroencephalography and MRI. Our results will converge to give a detailed picture of the patient’s motor function, impairments and changes to their motor system. Future work should then build on our findings to develop improved forms of therapy that can improve the motor outcomes of the patients.
REC name
London - Bromley Research Ethics Committee
REC reference
13/LO/0271
Date of REC Opinion
24 May 2013
REC opinion
Further Information Favourable Opinion