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6 November 2015

Study shows it may be possible to stop epilepsy in womb

Scientists at the University of Manchester believe they have shown for the first time that it may be possible to stop epilepsy in its tracks if it is treated early enough in the womb.

Research is in its very early stages and has so far only been applied to fruit flies, but the scientists are hopeful that in the future it may be possible to prevent epilepsy at the foetal stage where a gene mutation has been identified that is known to cause epilepsy.

Professor Richard Baines and Dr Carlo Giachello used a genetically-altered fruit fly to show that when nervous system activity is suppressed by shining yellow light through its embryo, it will not go on to develop symptoms of the disease when it gets older. This is known as optogenetics.

The technique would not be applicable in individuals who already have epilepsy.

Optogenetics and epilepsy

The revolutionary new approach, funded through the Medical Research Council, has been developed and tested over three years. The research team explained that for people whose  epilepsy is caused by a gene mutation, there is a period in the disease’s development called the epileptogenic process. Scientists have already discovered that starting treatment with antiepileptic drugs during this period can delay the inevitable onset of seizures.

However, this new procedure, which starts treatment during embryonic development and uses light to manipulate nervous system activity rather than drugs, seems to permanently prevent seizures in fruit flies.

Dr Giachello explained: 'By using this optogenetic tool, we found that if we prevent nervous system activity at a time when the fly embryo is between 80 and 90 per cent fully developed, seizures stop entirely.

'Optogenetics is a recent development in biology which is causing quite a bit of excitement, not just in the treatment of epilepsy but other illnesses too.'

Epilepsy Society comments

Epilepsy Society has cautiously welcomed the latest study but stressed that there was a long way to go with research now  needing to be replicated in mammals.

The charity's medical director Professor Ley Sander commented: 'This is exciting news from the researchers at the University of Manchester and their findings certainly hold promise for the future. Being able to switch off epilepsy at the embryonic stage would be a huge step forward but I feel this is still many years away.

‘At the moment we are still at the stage of unravelling the genetic architecture of epilepsy. In recent years the number of genes that we have been able to identify as being responsible for different forms of the condition has gone from a handful to hundreds.

‘We are recognising epilepsy syndromes, defining them genetically and we are beginning to understand them biologically.

‘Currently our focus is still looking at the extreme forms of epilepsy characterised by uncontrolled seizures and difficulties such as learning disabilities. In severe forms of epilepsy it can be easier to pinpoint the missing part of the genome which is causing the mal-functioning genes. In less severe epilepsies it can be far more difficult to pick out the genetic variants which are causing the seizures.

‘This is a challenge that the researchers in Manchester will certainly be facing with their study. At the moment their light therapy may only hold promise for a very small part of the epilepsy population. But it is still promise and hope and this is encouraging.

‘I shall look forward to future developments with their research, particularly when they move from fruit flies to mammals.’

The research from the University of Manchester was first published in Current Biology.

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