Case study: Brain impairment in the earliest stages of human epilepsy
Researchers in the Institute of Systems, Molecular and Integrative Biology (ISMIB) used the LiMRIC shared research facility to demonstrate that brain impairments are present as soon as epilepsy is diagnosed and, strikingly, these impairments are related to patients’ cognition and mood. This work calls for more rigorous brain imaging and cognitive assessment of people with newly diagnosed epilepsy.
Research challenge and facility involvement
LiMRIC was central to the success of this five-year Medical Research Council (MRC)-funded programme of research.
The research team, through the Walton Centre for Neurology and Neurosurgery, recruited 104 people with a new diagnosis of epilepsy, and 45 healthy patients to act as controls. These participants underwent advanced MRI scanning, cognitive and mood assessment and blood sampling at LiMRIC.
The 3 tesla Siemens Prisma MRI system enabled the team to acquire data using advanced MRI sequences in rapid time, including some experimental sequences. The team found the quality of the MRI data to be outstanding. The expertise of LIMRIC’s radiographers was instrumental, and Kieran Murphy (as a qualified phlebotomist) also took the blood samples.
The research team were able to perform neurocognitive and mood assessments in the same building as the MRI, enabling them to acquire, in an integrated setting, the great majority of the data for this programme of research. The research team were also supported by Sue Monaghan (LIV-SRF administrator) in administrative processes, including organising participant payments.
The LIMRIC booking system worked perfectly, and the team were able to schedule the study of multiple participants in a single day.
The advanced MRI protocol the team used at LiMRIC yielded data of exceptional quality, which they regard as a testament not only to the excellent MRI equipment, but also to the opportunity to trial sequences ahead of the start of the project as part of the technical development process.
Outcome and impact
This programme of research aims to follow up patients two years after their epilepsy diagnosis to determine whether imaging features can predict first-line treatment outcomes and patient clinical trajectories. However, at the time of writing (September 2025), the research team is still in the early stages, with data collection only just being completed.
Nevertheless, they have already published papers that show:
- Patients with newly diagnosed epilepsy and healthy controls show evidence of MRI lesions of unknown cause, and non-specific white matter lesions are more prevalent. It was also reported that patients have particular cognitive phenotypes (https://pubmed.ncbi.nlm.nih.gov/40342157/)
- Subcortical brain alterations relate to white matter connectivity changes and drive cognitive and mood disturbances in this cohort (https://pubmed.ncbi.nlm.nih.gov/39508641/)
- They have also published a protocol paper, including reference to LiMRIC (https://pubmed.ncbi.nlm.nih.gov/31619436/).
It is anticipated that many more publications will follow.
Professor Simon Keller’s group leveraged the deep MRI and cognitive data acquired at LiMRIC to be awarded an Epilepsy Research Institute Doctoral Training Centre. A collaboration between the University of Liverpool and University of Manchester, the centre will focus on cognition in people with epilepsy and their offspring.
The imaging data has been requested to be incorporated into the Human Epilepsy Project.
This research will likely lead to more follow-on awards, with Professor Keller planning a nationwide newly diagnosed epilepsy imaging endeavour. The imaging and cognitive data they have accumulated in newly diagnosed epilepsy, a notoriously difficult cohort of patients to recruit, will cement the group’s and the facility’s reputations as novel and world-leading (LiMRIC data is frequently mentioned by others at international epilepsy congresses).
Quick details
| Institution/Department: | Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology |
| Shared Research Facility used: | Liverpool Magnetic Resonance Imaging Centre (LiMRIC) |
| Instruments: | 3 T Prisma MRI scanner; participant assessment rooms; clinical assessment area for bloods |
| Publication/outputs: | https://pubmed.ncbi.nlm.nih.gov/40342157/ |
| https://pubmed.ncbi.nlm.nih.gov/39508641/ | |
| https://pubmed.ncbi.nlm.nih.gov/31619436/ |
The state-of-the-art imaging data acquired at LiMRIC in a large cohort of novel patients recruited from a local NHS Trust has provided the basis for a career-long research focus for me, will provide new mechanistic and clinical insights into a common neurological disorder that is particularly prevalent in the Liverpool region, and has/will build capacity in clinical neuroscience research at the University (and which aligns perfectly with the launch of the Liverpool Interdisciplinary Neuroscience Centre (LiNC)).