Epilepsia^® Prize 2018 Basic Science

An interview with Kyle Thomson, 2018 Epilepsia Prize Winner for Basic Science Research. Read the winning article “The impact of nonadherence to antiseizure drugs on seizure outcomes in an animal model of epilepsy” at https://onlinelibrary.wiley.com/doi/abs/10.1111/epi.13742

Who are you?

I am currently a Post-Doctoral Fellow in the Anticonvulsant Drug Development (ADD) program at the University of Utah and am working to establish new chronic models for screening potential new therapeutics. I received my Ph.D. in Bioengineering in 2015 from the University of Utah, after receiving my Bachelors and Masters degrees in Electrical Engineering from Michigan State University.

What got you interested in epilepsy research?

I had not originally planned to study epilepsy. During a research project in graduate school, I had the opportunity to work directly with epilepsy patients who were undergoing surgical implants of depth electrodes to locate their seizure focus. This gave me a chance to interact with patients and become personally connected with how their lives were affected by the disease. One particular patient I had worked with and grown close to over the course of a month experienced a tonic-clonic seizure in front of me. This experience deeply impacted me and has inspired my research since.

Explain for our general readership what question your study addressed and how you went about designing you study?

We created an animal model to determine the impact of patient nonadherence of prescribed antiseizure drugs on seizure control. While the clinical study of nonadherence has been researched for quite some time, this is the first time it was modeled in animals. This provides the ability to answer questions about the practice of nonadherence which would be unethical or impossible to perform in humans. This study was enabled by my combined engineering and biological background, as I was able to implement a system that allowed for variable dosing using a drug-in-food model.

What were the results and how do you interpret your findings?

The practice of nonadherence, as outlined in our model, resulted in such poor seizure control that seizure frequency in the nonadherence group was similar to that of the medication-free group. Thus, it is of paramount importance to the patient that we, as a research community, consider the reality that patients are very frequently nonadherent to their prescribed medication. It is my personal opinion that if we acknowledge that patients will not always take their medication as prescribed, this practice of nonadherence will be acknowledged and incorporated into epilepsy research design, beginning from preclinical stages of drug development and progressing beyond, to the clinical treatment of patients. It also must be included during the analysis of the efficacy of treatment.

Additionally, another graduate student has taken up this work, and continued to use this newly established model to answer new, deeper questions about how epilepsy is affected in the presence of nonadherence. We are working together on another manuscript, and hope to see it in press soon!

What next steps in epilepsy research are you taking and what are your career goals?

I am currently in the process of developing my automated feeding system, used in this manuscript, to establish a chronic model for testing the efficacy of novel anti-seizure compounds. We hypothesized that this approach will be translationally relevant to the human patient’s condition, and will allow us here at the ADD program to make a better model for the screening of investigational compounds. I hope this model helps differentiate the next generation of antiseizure therapeutics, and the data generated from this model inspires these new therapies to be pushed forward into clinical trials. I hope to continue to progress in the field of epilepsy research by developing innovative new drug delivery models that demonstrate translational relevance to better allow for screening compounds in the future.

What does the Epilepsia Prize mean for you, your laboratory, research institute, and your future?

The 2018 Epilepsia Prize for Basic Science Research is a great honor for me. I have to thank my coauthors, Dr. Avani Modi, Dr. Tracy Glauser, Dr. Joseph Rasuch, and especially my former mentor, Dr. H. Steve White, as this research would not have been possible without them. This award validates the efforts the ADD program make in investments into new avenues of epilepsy research. Additionally, we hope that this acknowledgement will serve to increase awareness of the reality of nonadherence and its consequences.

Astrid Nehlig and Michael Sperling
Editors-in-Chief, Epilepsia