Abhishek Bhutada was conducting research at the University of California, San Francisco, with epilepsy patients when he first learned about a new cutting-edge brain imaging technology being tested across the country that had the potential to support effective, noninvasive clinical treatment.

Magnetoencephalogography (MEG) measures magnetic fields above the scalp that are generated by neuronal current flows of the brain. It is used to map patients’ brains to determine where to surgically place electrodes to treat drug-resistant epilepsy. However, conventional MEG setups come with high maintenance costs and operate within restrictive scanning environments because they use cryogenically cooled sensors. A new generation of MEG uses Optically Pumped Magnetometers (OPM), wearable sensors that do not require cryogenic cooling and can be placed directly on the scalp.

The opportunity to work alongside the handful of world-class researchers pioneering this treatment was a large part of why Bhutada was drawn to move across the country and attend the Virginia Tech Carilion School of Medicine (VTCSOM) in Roanoke.

“Currently there are only about five of these OPM-MEG machines in the whole world, and there is one at the Fralin Biomedical Research Institute at VTC,” said Bhutada. “Coming to VTCSOM for medical school provided me with an amazing opportunity to be part of the team building this from the ground up.”

Bhutada, now a fourth-year student at at the school, earned a Letter of Distinction for his work at the school’s 2024 Student Research Symposium.

Project overview

The objective of Bhutada’s study was to compare results of OPM-MEG scans to those using standard clinical measures, which are less accessible and more invasive for patients. He hoped to show that OPM-MEG, which is not approved by the Food and Drug Administration, is a highly effective and safe method.

Read Montague and his team at the Fralin Biomedical Research Institute established the OPM-MEG lab where Bhutada worked, and Stephen LaConte of the Fralin Biomedical Research Institute and Mark Witcher, a neurosurgeon from Carilion Clinic, served as his research mentors. They developed a strong partnership with the University of Nottingham in the United Kington, where researchers originally developed the OPM-MEG technology.

“The biggest thing that was super rewarding was that, in my previous experience, I worked at a lab that was very established. You could branch off the research that’s been done for years, but not really start something new,” Bhutada said. “This project was unique in that you are helping to pioneer the research.”

The study was the first to directly compare source localization results from OPM-MEG to standard clinical measures such as video-electroencephalgram and stereoelectroencephalography with placement of bitemporal intracranial electrodes. The team recruited a right-handed woman participant with medically refractory epilepsy and compared scans during seizure activity.

Findings

The study demonstrated the remarkable effectiveness of OPM-MEG in capturing and accurately localizing interictal epileptic activity, which corresponds to other clinical measurements. The findings provided strong evidence supporting the use of OPM-MEG as a reliable guide for treatment options in patients with complex cases of medically refractory epilepsy.

“Abhi’s work is foundational on many levels. I’m most impressed with his teamwork, leadership, and perseverance. OPM-MEG is still very far from being a turn-key technology," LaConte said. "His efforts to recruit patients, to work with Dr. Montague, Dr. Witcher, collaborators in Nottingham, and myself, and to collaborate with our post-docs and graduate students led to an impressive success in collecting and analyzing these data.”

Significance of research

Unlike other methods of brain scanning such as MRIs that can be uncomfortable and require participants to lay down and be still for extended periods of time, OPM-MEG uses a headset that allows the patient to be seated and move.

“This research primarily helps guide treatment planning for patients with drug-resistant epilepsy,” Bhutada said. “The new OPM-MEG system will be more cost-effective and much more comfortable and less invasive for the patients. Hopefully this can be approved and become the new gold standard for patients.”

In December, Bhutada presented his research at the American Epilepsy Society Annual Meeting.

Next steps

Bhutada said he hopes to pursue neurosurgery as a specialty when he graduates in May. Although his family remains largely in California, he has fallen in love with the small-town vibes and outdoors scene around Roanoke.

“It would be awesome to continue in functional research, and wherever I go, I’d like to work with epilepsy,” he said. “I really love the area and the new Department of Neurosurgery at the school is very exciting.”

 

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