Breath test helps tailor precise treatments for epilepsy

Researchers from the University of Basel have developed a new test method to measure treatment success in epilepsy patients — one which they hope will enable doctors to react more precisely when treating the disease. Their method has been described in the journal Communications Medicine.

Pharmaceutical treatment of epilepsy is difficult, as the dose must be tailored precisely to the individual patient. As explained by Pablo Sinues, Botnar Research Professor of Pediatric Environmental Medicine at the University of Basel and University Children’s Hospital Basel (UKBB), “Slightly too little and it isn’t effective. Slightly too much and it becomes toxic.”

Together with colleagues from University Hospital Zurich (UHZ), Prof Sinues spent two and a half years looking for a way to tailor the dosage of drugs administered to epilepsy patients as precisely as possible, which he ultimately achieved with the help of a breath test. The advantage is that monitoring does not require a blood sample, which can always be a stress factor for children. And as the sample doesn’t need to be sent to the laboratory first, the results are available immediately.

“You can think of it as being like the alcohol test that police use when they stop drivers,” Prof Sinues said, the difference being that this breath measurement device is actually a big machine. “Because alcohol is present at high concentrations in breath, one only needs a small device. But we’re searching for a droplet in 20 swimming pools.”

The researchers want to use the results to determine whether the active substances are present at the right concentrations in the body and whether they have the desired effect on the disease. The group reported that the breath tests produced the same results as conventional blood tests, both among young patients at UKBB and the adult reference group at the University Hospital Zurich.

This means that in addition to blood tests, there is a second way of monitoring epilepsy treatment — and the method also provides further information on the patient’s metabolism that doctors can use in the therapy. The rapid availability of test results is a particular advantage for young patients, who require constant adjustments of their medication because their metabolism changes as they grow.

The new technology thus provides doctors with a non-invasive test that gives them immediate clues as to how well the course of therapy is going. This enables them to respond quickly if the dose has to be adjusted. And while the technique is not yet suitable for widespread use, Prof Sinues has now founded a start-up company, Deep Breath Intelligence, to achieve that very goal, and aims to obtain a licence for the measurement technique.

Image caption: The machine that Prof Sinues and his team have developed aims to be able to react more precisely in the therapy of epilepsy. Image credit: UKBB.

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