As a student, neurologist Greg Scott had little interest in a career in medicine. Computer use was the focus of his studies.
One day he had a grand mal seizure. It is also called a tonic-clonic seizure and causes loss of consciousness and severe muscle contractions.
“It came out of the blue,” he told the newspaper Observer last week. “I was taken to hospital, where a scan showed I had a brain tumor. It was then removed during an operation during which part of it was fully conscious,” said the researcher from Imperial College London.
“Later I was able to view the operation during a case presentation. So I can say that I have seen my own brain. I was 19 and the experience changed the trajectory of my career.”
Scott was inspired to study medicine and has put his computational background to good use in his research. “I became fascinated by brain activity and the idea of using AI and other technologies to understand how it generates consciousness and cognition.”
Scott is particularly concerned with delirium, a common but often misdiagnosed condition that is often confused with dementia.
His research, which is funded by the National Institute for Health and Care Research, aims to develop an easy-to-wear device that can quickly detect whether someone is suffering from this debilitating condition.
“Delirium is a huge problem,” says Scott, who works at Imperial’s Dementia Research Institute. “Around 20% of adults in hospitals – around 20,000 NHS patients – suffer from delirium, which can be caused by many different things: the impact of surgery, a urinary tract infection, a respiratory infection, the side effects of medicines or drugs – or alcohol abuse.”
The result is confused thinking and a lack of awareness of one’s surroundings, symptoms that can often occur quickly – sometimes within a few hours. However, to diagnose the condition, doctors must make subjective decisions.
“We urgently need a simple, straightforward objective test that can tell doctors unequivocally within minutes whether someone is suffering from delirium – because that could prompt them to look for the underlying cause of their condition and ensure that it is can be treated more quickly and effectively,” Scott added.
The key to this work lies in the use of electroencephalograms (EEGs) to record the brain’s electrical activity. Brain waves were first measured a century ago by German psychiatrist Hans Berger, whose work was met with disbelief and ridicule when first published. The use of EEGs has since become standard in diagnosing epilepsy and other conditions.
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However, it can take a long time to apply the approximately twenty electrodes to a patient’s head and more time for another doctor to interpret the recording. “The whole process is very time-consuming, very labor intensive and poorly available on the NHS. We have to find ways to change that.”
This is the goal of Scott’s research, which focuses on limiting the amount of signals produced by EEGs so that only those associated with delirium can be detected. “That will give us a handle on the rapid diagnosis of the condition,” he said.
By specifying exactly which brain waves are activated by delirium, it will be possible to develop a simple device that can easily be slipped over a patient’s head.
“It doesn’t take hours to put on and within minutes it gives a readout that tells doctors if their patient has delirium and also reveals its severity. Ideally, it will also differentiate between people with dementia and those with delirium so that the right treatment can be applied from the start. That is the goal we are focusing on now.”