On August 5th, 2025, the University of Campinas (UNICAMP) and BRAINN, Brazil, hosted the scientific lecture “The genotype-phenotype association of epilepsy-associated brain lesions: the 2025 update”, delivered by Professor Ingmar Blümcke, MD, from Universitätsklinikum Erlangen, Germany.

The presentation focused on the complexities involved in establishing clear genotype-phenotype correlations in epilepsy-associated brain lesions. Professor Blümcke emphasized that, in certain types of brain lesions, defining such relationships remains a major scientific and clinical challenge. This limitation highlights the ongoing need to continuously revise diagnostic classifications and clinical protocols, in parallel with the evolution of genetic research.

Throughout the lecture, recent findings were presented that support the relevance of integrating histopathological and genetic data to improve diagnostic precision.

The event contributed significantly to the academic environment by promoting discussion on the advances in epilepsy research and reinforcing the role of updated classification systems in enhancing patient care and research strategies.

Between 31 July and 3 August 2025, Campinas hosted the 15th edition of the International School of Neuropathology and Neuroimaging in Epilepsy (INES 2025), an initiative organized by the International Society of Neuropathology (ISN) in partnership with the International League Against Epilepsy (ILAE), and supported by CEPID BRAINN. The event aimed to provide advanced training for researchers and healthcare professionals in neuropathology, neuroimaging and neurosurgery applied to the diagnosis and treatment of focal epilepsy.

Program and practical activities

Activities took place at Unicamp’s Casa do Professor Visitante (CPV) and in the Neuroanatomy and Neuroimaging Laboratories, combining theoretical lectures, clinical case discussions and hands‑on sessions. The course brought together participants from a range of countries, including Brazil, Germany, Austria, Mexico, Honduras, Uruguay, Argentina, Peru, Canada, Colombia, India, Venezuela, Chile and the Dominican Republic, reinforcing the international character of the initiative and expanding the network of scientific collaboration among institutions across continents.

The scientific program was structured to cover fundamental concepts and recent advances related to the recognition, classification and characterization of brain lesions associated with focal epilepsy. Activities emphasized the integration of neuropathology, neuroimaging and neurosurgery, enabling participants to appreciate the importance of a multidisciplinary approach for accurate diagnosis and individualized therapeutic planning.

International collaborations

In addition to lectures delivered by specialists from Brazil, Germany and Austria, the course included practical sessions on magnetic resonance imaging interpretation, demonstrations of neuroanatomy applied to surgical access routes and training in the neuropathological assessment of surgical specimens. Macroscopic and microscopic analysis of samples allowed participants to correlate clinical, radiological and histopathological findings, strengthening understanding of the mechanisms involved in epileptogenesis and their relevance for clinical decision‑making.

A highlight was the participation of Prof. Ingmar Blümcke of Friedrich‑Alexander Universität Erlangen‑Nürnberg (Germany), an international authority in epilepsy neuropathology. His presence made a significant contribution to the scientific update of participants and to the reinforcement of international collaborations already established with Unicamp research groups.

After the course concluded, the researcher also delivered the lecture “The genotype‑phenotype association of epilepsy‑associated brain lesions: the 2025 update” at the Hospital de Clínicas of Unicamp to approximately 40 professionals, including physicians, residents and other healthcare staff, thereby extending the reach of the knowledge‑dissemination activities promoted during his visit.

A scientifically and academically impactful event

Compared with previous editions, INES 2025 substantially increased the number of hours devoted to practical activities, especially those related to neuroanatomy demonstrations, surgical approach planning and neuropathological evaluation of surgical specimens. These activities reinforced the importance of integration among different specialties for the diagnosis and treatment of focal epilepsy, and highlighted the role of interdisciplinary communication in the development of translational research.

In this context, the event also helped to showcase internationally the research model developed at Unicamp and CEPID BRAINN, characterized by efficient integration among neuroimaging, neurosurgery, neuropathology, neurogenetics and clinical research. Interaction among faculty, researchers and participants fostered discussion of clinical cases and research projects, promoted exchange of experiences and encouraged the establishment of new scientific collaborations.

The course’s formative impact was widely acknowledged by participants. In anonymous evaluations conducted at the end of the event, many students emphasized the opportunity to learn directly from international experts and the relevance of the content for their academic and professional activities. Reports indicated that the knowledge gained has direct application in research projects and clinical practice, particularly in the areas of imaging diagnostics, neuropathology and surgical treatment of epilepsy. The practical sessions in neuroanatomy and neuroimaging were especially valued by participants, who highlighted the quality of the available infrastructure and the opportunity to correlate theoretical concepts with real‑world situations encountered in care and research.

Results from the satisfaction survey conducted by the ILAE showed a high level of approval for the event, with more than 90% of participants rating the experience as extremely positive and indicating that their expectations were met or exceeded.

Thus, INES 2025 consolidated itself as an important initiative for human resource training, internationalization and dissemination of scientific knowledge, contributing to the capacity building of professionals and researchers from different countries and strengthening the role of CEPID BRAINN and Unicamp as centers of excellence in research, teaching and innovation in the field of epilepsies.

originally published at King´s College London

MELD Graph is an AI tool that could drastically change the care for 30,000 patients in the UK and 4 million worldwide with one cause of epilepsy, researchers say.

The study, published today in JAMA Neurology by a team at King’s College London and University College London (UCL), shows how the tool significantly improves the detection of focal cortical dysplasia’s (FCDs) which is a leading cause of epilepsy.

Researchers say the tool will speed up diagnosis times, get patients the surgical treatment they need quicker, and reduce costs to the NHS by up to £55,000 per patient.

In the UK, 1 in 100 people are affected by epilepsy and seizures often present in childhood. 1 in 5 people with epilepsy have seizures caused by a structural abnormality (“lesion”) in the brain. FCDs are a common structural cause of epilepsy and in people with this type of epilepsy, seizures are usually not able to be controlled with medications. Surgery to remove the lesion can be an effective and safe way to stop the seizures. However, the challenge is that FCDs can be subtle and difficult to see with the human eye and up to half of these lesions are missed by radiologists. Delays to diagnosis and surgery mean more seizures, more visits to A&E, and more disruption to school, work and home life.

In the study, the researchers pooled MRI data from 1185 participants – including 703 people with FCD and 482 controls – from 23 epilepsy centres around the world in the Multicentre Epilepsy Lesion Detection project (MELD). Half of the dataset is from children. They then trained the artificial intelligence tool, MELD Graph, on the scans to detect these subtle brain abnormalities that might otherwise go undetected.

Project lead-author, Dr Konrad Wagstyl, from King’s College London, said: “Radiologists are currently inundated with images they have to review. Using an AI-powered tool like MELD Graph can support them with their decisions, making the NHS more efficient, speeding time to treatment for patients and relieving them of unnecessary and costly tests and procedures.”

Co-author Dr Luca Palma, from Bambino Gesù Children’s Hospital, Italy, said: “MELD Graph identified a subtle lesion missed by many radiologists in a 12-year-old boy who had daily seizures and had tried nine anti-seizure medications with no improvement to his condition. This tool could identify patients with surgically operable epilepsy and help with surgical planning – reducing risks, saving money, improving outcomes.”

While the tool is not yet clinically available, the research team have released the AI-tool as an open-source software. They are running workshops to train clinicians and researchers around the world, including Great Ormond Street Hospital and the Cleveland Clinic, in how to use it.

First author, Dr Mathilde Ripart from UCL, said “One of the highlights for me is hearing from doctors around the world, including the UK, Chile, India and France have been able to use our tools to help their own patients.”

Co-author Professor Helen Cross, Prince of Wales’s Chair of Childhood Epilepsy, President of the International League Against Epilepsy, Consultant Epileptologist at Great Ormond Street Hospital, and Director of the UCL Great Ormond Street Institute of Child Health, OBE said: “Many of the children I see have experienced years of seizures and investigations before we find a lesion. The epilepsy community is searching for ways to speed up diagnosis and treatment. Initiatives such as MELD have the potential to rapidly identify abnormalities that can be removed and potentially cure the epilepsy.”

Co-lead Dr Sophie Adler from UCL said: “This type of research is only possible with international collaboration. We were privileged to work with 75 researchers and clinicians towards this common goal of “no missed epilepsy lesions worldwide”.”

Reference 

• Ripart M et al., 2025. Detection of epileptogenic focal cortical dysplasia using graph neural networks: a MELD study. JAMA Neurology, Feb 24. doi:10.1001/jamaneurol.2024.5406

April 29th 2019  | originally published at Agência FAPESP

Maria Fernanda Ziegler | Agência FAPESP – Researchers in Australia are developing implantable electronic devices for patients with epilepsy. The goal is to predict seizures, identify the pattern of seizure frequency, and even release medications to prevent further episodes. The devices are not yet marketable, but some of them are already being tested in humans.

Epilepsy affects about 1% of the world’s population, and yet it is still shrouded in stigma and mystery. In it, for some genetic or environmental reason, a group of brain cells becomes extremely active, to the point of making the electrical signals completely disorganized. This mismatch often culminates in loss of memory and convulsions.

“Epilepsy is not a rare disease and has many effects on people’s lives. Therefore, the patient needs to know that it is an electrical problem in the brain that can be predicted, monitored and treated. This takes away all the mystery of the disease which, to the unhappiness of patients, is shrouded in ignorance and superstition”, said Australian scientist Mark Cook, a professor at the University of Melbourne and director of the Department of Neurology at St. Vincent’s Hospital in Australia.

The researcher participated, in April, in the 6th BRAINN Congress, at the State University of Campinas (Unicamp). The event was conducted by the Research Institute on Neuroscience and Neurotechnology (BRAINN) – a Research, Innovation and Dissemination Center (CEPID) funded by FAPESP.

In his speech, Cook presented the new devices that, according to him, could give greater quality of life to people with epilepsy in the future. He also talked about the latest results of his research on patterns of seizures in patients with the disease.

“Each patient has a specific pattern [of seizures] – we have already proven that. Imagine, then, being able to predict when you will have one of those episodes? People could protect themselves by staying home and being accompanied, rather than engaging in some risk activity on that particular day”, Cook told Agência FAPESP.

The new devices are aimed primarily at anticipating the onset of a seizure and are being developed by the Bionics Institute through a partnership between the University of Melbourne and St. Vincent’s Hospital. The institute has donations and funds, such as the one received on the television program The Shark Tank Miami (USA) – in which Cook competed and won in a special edition on epilepsy in 2015.

Prediction

“There are two ways to detect a seizure. In one of them, it is possible to read the brain signal and detect the electrical signature that occurs before it happens. Another way is to monitor the seizures for a certain period and identify a pattern. As soon as this pattern is established, the prediction becomes very accurate”, he said.

In the first case – detecting brain electrical signals -, implantable devices that can deliver drugs are being developed. One of them was implanted two years ago in a patient in Australia, who has so far responded well to the treatment.

Researchers are also developing an equipment with implantable electrodes to apply electroshock treatment – which is another way of treating epilepsy, besides medications and surgery – but there is still no human test prediction.

To monitor seizures in order to identify patterns, devices have been developed to be inserted under the scalp or behind the ear (such as cochlear implants for the deaf).

“We realized that, if we could count the seizures reliably, it would be possible to identify each patient’s monthly, weekly, or daily patterns. This would make it safer for patients to perform everyday activities and avoid embarrassment”, said the researcher.

Based on comprehensive databases (from the SeizureTracker and NeuroVista applications), Cook and his team identified striking periodicities between one seizure and another. According to the study, more than 80% of patients had one-day intervals between seizures. Cycles of one week or three weeks or more have also been observed.

“Understanding these patterns can have significant implications for managing people’s lives and predicting crises. Typically, patients are encouraged to write journals or use cell phone applications to track the seizures. However, this has proven to be very imprecise, as seizures can cause memory loss and unconsciousness. Many times, the patient does not realize that there was a small lapse”, Cook explained.

Much more accurate than the journals, implantable devices can be used for a long time, making it possible to cross information with external conditions that may be related to seizures, such as temperature, air humidity or even stress, food and medication. Clinical testing for this device should begin in the second half of 2019. According to Cook, all devices were designed for the study of epilepsy cases, but could also be used for other conditions, such as controlling the blood sugar of diabetics, for example.