Antal Berényi has combined a boyhood passion for electronics with years of medical training to build a device that, once implanted under the skin, can detect and stop epileptic attacks just as a defibrillator corrects heart arrhythmia. Like its inventor, the prototype device, which is being readied for trials in the United States, has all the makings of a big future.
Berényi left Szeged University in Hungary for the US with a plan. He wanted to design and build a device to detect and stop epileptic attacks without drugs and without major brain surgery. To the estimated 50 million people worldwide who suffer seizures due to epilepsy – a chronic neurobiological disorder – this simple plan could transform their lives.
Working with the renowned scientist Dr György Buzsáki of the Center for Molecular and Behavioral Neuroscience at Rutgers, the State University of New Jersey (US), he not only built the prototype device, but he has also already proven that it works in rats. The next step is a number of preliminary safety experiments to test the device’s therapeutic potential in humans.
European Union funding for Dr Berényi's international project, called TSPUMMNRPS (Temporal spiking precision underlying memory measured by neuronal recordings and photo-stimulation), helped him to quickly bring the prototype together. Many of the pieces were ordered and manufactured in Hungary, then assembled in the US. The prototype took just half a year to design and construct.
Electrical activity is happening in our brain all the time. A seizure occurs due to a sudden burst of intense electrical activity that disrupts the way the brain works. This brain activity can be monitored and recorded by electroencephalography, using electrodes fixed to the scalp. The prototype brain 'defibrillator' detects abnormal brain activity that characterises the start of a fit and delivers electrical current to restore it to a normal state, stopping the seizure just as it starts.
The small device implanted beneath the skin on the outside of the skull proved successful in laboratory tests on rats, reducing the duration of 'absence' seizures - epileptic episodes that are most common among adolescents - by around 60 per cent, from 11-12 seconds to 3-4 seconds.
"I think that being a trained medical doctor helped me work out what was really needed in terms of the electronics," the researcher suggested, "which sped up the whole design and testing phase." The novel device detects when an epileptic seizure is coming and applies tiny, on-demand electric pulses which help the brain return to normal functioning. It works in much the same way as an implantable cardiac defibrillator applies shocks automatically to the heart after detecting minor cardiac rhythm disturbances.
Implants are already used to regulate electrical activity in the brain to treat drug-resistant cases of Parkinson's disease and depression. But they involve continuous stimulation from a device implanted deep in the brain. The TSPUMMNRPS project uses a far less invasive treatment and delivers electrical stimulation only when needed.
"A small circuit is continuously monitoring brain activity and, if it detects a 'failure', it transmits a special electric pulse through the brain. As the pulse travels from one temple to the other, it interferes in a good way with the areas causing the seizure," Dr Berényi explained.
In animal tests, the device was implanted under the rat's skin, at the top of the skull. This approach, if validated for human use, would mean less invasive and more cost-effective procedures, lower risks of infection and improved overall outcomes, especially for the 30 per cent of people with epilepsy who cannot be treated with drugs.
The fact that the device can be implanted in a minimally invasive way is crucial, according to the researcher. "Every medical intervention is judged on a cost-benefit basis,” he explained. “Since this device is implanted on the outer surface of the skull, there is no need to open up the bone during surgery."
This can dramatically reduce complications (such as infections and intra-cerebral bleeding) because the brain tissue is not exposed directly to any manipulation, Dr Berényi suggested. "In addition, shorter, less complex surgeries usually lead to faster post-operative recovery in general," he added.
Patents have been filed for the TSPUMMNRPS device and the project's work has gained wider attention following last November's publication in Science magazine of the team's findings on 'Closed-loop control of epilepsy by trans-cranial electrical stimulation'. In the article, the researchers reported that the transcranial electrical stimulation, 'at the intensities used, neither induced arousal effects when applied during sleep nor affected overt behaviour during waking'.
With regard to commercial interest, Dr Berényi explained that since the device is in a preclinical experimental stage, there was currently no industrial demand for it. “But once its effectiveness is proved on human patients and approved [by the authorities], hopefully we'll find an industrial partner with vision to take it to the market," he noted.
Now that the 'outgoing' phase of his fellowship is over, Dr Berényi will combine his medical experience and skills gained in the US with his knowledge of electronics and information technology to establish an electrophysiology laboratory back at Szeged University in Hungary.
"As a boy, I was so eager to see how things work that I immediately dissembled all my gifts," he recalled. "Of course, I could never fix them again. Now, either the toys or my skills have improved, but things have clearly changed for the better."
© European Union, 2013