Lasers on the brain

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Existing treatments, such as laser ablation, and therapies currently in research and development both hold promise for patients and clinicians who seek to successfully cross the divide between living with epileptic seizures and experiencing an improved quality of life. Laser-based techniques also present a viable alternative to traditional, often risky, resection surgery, in which a portion of brain tissue containing the epileptic focus is removed. While resection remains a common procedure, the challenge is always how to cut very precisely to avoid damaging necessary neurological functioning. And modern lasers can perform some of the cleanest cuts of all.

The standard measuring stick for evaluating the outcome of epilepsy procedures is the Engel Epilepsy Surgery Outcome Scale, which is based on degrees of freedom from seizures. Class I means completely seizure free, Classes II and III represent reductions in frequency, and Class IV indicates no improvement. If Class I is achieved, then normal life activities such as driving can often resume.

Research has proven the effectiveness of diode laser ablation systems, such as Visualase and NeuroBlate, which have been on the market for years. As I write in our cover story in this brain-themed edition of BioPhotonics, the laser — guided by MRI — burns the tissue from which seizures are propagating, leaving other nearby tissue untouched. Research at Cornell University could potentially take this technology to the next level. It involves cutting the connections through which seizures spread while preserving the connections needed for other signals to be sent — those used to complete specific physical tasks, for example. Read about the future prospects of this technology here.

Other highlights in this issue include an article by Michael Wenzel and Rafael Yuste, who relate how two-photon imaging is helping to analyze changes in the brain during anesthesia. What this study uncovers could guide doctors and therapists in plotting a course of treatment that is more safe and effective. Learn more here.

Also in this issue, authors Silvia Noble Anbunesan, Alba Alfonso-Garcia, and Laura Marcu explain how fluorescence lifetime imaging has enabled the precise definition of the margins of glioblastoma, a devastating and infiltrative form of brain cancer. Follow how their work has progressed on page 36. And authors Nicolas Perez, Pegah Pouladian, and Daryl Preece describe their use of lasers to induce shock waves and employ quantitative phase imaging techniques to follow the progression of traumatic brain injury. Explore their investigation here.

Elsewhere, Ian Read articulates how NIR spectroscopy measures oxygen distribution in the brain following a stroke to discover where a blockage occurred and to target treatment. Follow these developments here. And finally, in “Biopinion,” Hanli Liu and Michael Cho argue that the use of photostimulation in treatment of various neurological conditions and diseases deserves the same attention and research funding opportunities that are afforded pharmacological therapeutics. Read about their view here.

Enjoy the issue!

Published: November 2021

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