Kwan group

Epilepsy and Personalised Medicine

Key terms

Epilepsy, Neurology, Outcomes research, Genomics, Biomedical engineering, Translational medicine, Precision medicine, Pharmacogenetics

The group

Kwan lab
2018 Kwan group. L-R: Professor Patrick Kwan, Dr Alison Anderson, Dr Jianxiong Chan, Ms Flavia Gomez, Dr Ana Antonic-Baker, Mr Xuan Lin, Dr Zhibin (Ben) Chen, Ms Juliana Silva, Dr Michael Erlichster, Mr Sameer Sharma, Mr Abkar Sayad, Mr Shah Mukin Uddin, Ms Rashida Ali. Absent: Dr Piero Perucca, Dr Andreas Pattichis, Dr Emma Foster, Dr Anna Willard, Dr Lubna Shakhatreh, Dr Ofer Gonen, Dr John-Paul Nicolo.

Research Goal

To identify genetic, structural, metabolic and environmental factors that affect treatment outcomes in people with epilepsy and related neurological conditions (e.g. following stroke), and promote the translation of research findings into clinical practice using personalized medicine to improve treatment outcomes for patients.

Research Overview

Our group’s translational research covers a broad spectrum of areas in relation to neurological diseases such as epilepsy - ranging from basic discovery to clinical implementation and health economic analysis to provide the evidence necessary to improve patient outcomes. There is a strong focus on the use innovative approaches, e.g. pharmacogenomics, developing point of care diagnostic tools, clinical utility and cost-effectiveness, and the use of animal models to understand the effects of new treatments on patients with neurological diseases. Although the focus is on neurological diseases, particularly epilepsy, our work has broad relevance and extends to other disciplines.

Research themes

Current Project Funding

  • 2019-2020
    • Kwan, P, Armstrong, M, Flynn, D, Chan, J, John, K. Designing a Point of Care diagnostic device for clinical management of patients with epilepsy - a single test and single visit approach. Victorian Medical Research Acceleration Fund – R3 (The Alfred Hospital). Collaboration with Monash Art, Design & Architecture (MADA)
    • Kwan, P, Marzbanrad, F, Yap, L, Gong, S, Wang, Y, Zhai, Q and Cheng, W. Automated seizure detection for patients with epilepsy. 2018 Monash Institute of Medical Engineering (MIME) Seed Fund
    • Kwan, P, O’Brien, T, Cloud, G, Hand, P, Yan, B, Nicolo, J, Wright, D. Brain glutamate imaging by ultra-high-field MRI for prediction of post-stroke epilepsy. Victorian Medical Research Acceleration Fund – R2 (The Alfred Hospital). Collaboration with Royal Melbourne Hospital
  • 2018-2022
    • Scheffer, I, O’Brien, T, Kwan, KLP (Executive lead). Sanming Project. Shenzhen Children’s Hospital
  • 2018-2021
    • Kwan KLP, Petrovski S, Ratcliffe J, Winship IM & Mullen SA. NHMRC project grant APP1143934. Clinical utility and cost-effectiveness of genome sequencing for refractory epilepsy in children and adults: a multicentre randomised controlled trial. Collaboration with the University of Melbourne

Publications

See recent publications on Pubmed and Google Scholar

  • Naganur VD, Kusmakar S, Chen Z, Palaniswami MS, Kwan P, O'Brien TJ. The utility of an automated and ambulatory device for detecting and differentiating epileptic and psychogenic non-epileptic seizures. Epilepsia Open. 2019 May 13;4(2):309-317. doi: 10.1002/epi4.12327.
  • Alsfouk BA, Alsfouk AA, Chen Z, Kwan P, Brodie MJ. Pharmacological outcomes in teenagers with newly diagnosed epilepsy: A 30-year cohort study. Epilepsia. 2019 Jun;60(6):1083-1090. doi: 10.1111/epi.15664.
  • Foster E, Holper S, Chen Z, Kwan P. Presentation and management of community-onset vs hospital-onset first seizures. Neurol Clin Pract. 2018 Oct;8(5):421-428. doi: 10.1212/CPJ.0000000000000524.
  • Wong JKL, Gui H, Kwok M, Ng PW, Lui CHT, Baum L, Sham PC, Kwan P, Cherny SS. Rare variants and de novo variants in mesial temporal lobe epilepsy with hippocampal sclerosis. Neurol Genet. 2018 Jun 11;4(3):e245. doi: 10.1212/NXG.0000000000000245.
  • Krauss GL, Perucca E, Kwan P, Ben-Menachem E, Wang X-F, Shih JJ, Patten A, Yang H, Williams B, Laurenza A. Final safety, tolerability, and seizure outcomes in patients with focal epilepsy treated with adjunctive perampanel for up to 4 years in an open-label extension of phase III randomized trials: Study 307. Epilepsia. 2018; 59 (4): 866 – 876.
  • Sivathamboo S, Perucca P, Velakoulis D, Jones NC, Goldin J, Kwan P, O’Brien TJ. Sleep disordered breathing in epilepsy: Epidemiology, mechanisms and treatment. Sleep. 2018; doi: 10.1093/sleep/zsy015. [Epub ahead of print].
  • Thevathasan A, Naylor J, Churilov L, Mitchell PJ, Dowling RJ, Yan B, Kwan P. Association between hemorrhagic transformation after endovascular therapy and poststroke seizures. Epilepsia. 2018; 59 (2): 403-409.
  • Chen Z, Churilov L, Chen Z, Naylor J, Koome M, Yan B, Kwan P. Association between implementation of a code stroke system and poststroke epilepsy. Neurology. 2018; 90(13): e1126-e1133. doi: 10.1212/WNL.0000000000005212.
  • McCormack M…..EPIGEN Consortium;, Pirmohamed M, Carleton BC; Canadian Pharmacogenomics Network for Drug Safety;, Cendes F, Lopes-Cendes I, Liao WP, O'Brien TJ, Sisodiya SM; EpiPGX Consortium;, Cherny S, Kwan P, Baum L; International League Against Epilepsy Consortium on Complex Epilepsies;, Cavalleri GL. Genetic variation in CFH predicts phenytoin-induced maculopapular exanthema in European-descent patients. Neurology. 2018; 90(4):e332-e341. doi: 10.1212/WNL.0000000000004853.
  • Soraya GV, Chan J, Nguyen TC, Hyunh DC, Abeyrathne CD, Chana G, Todaro M, Skafidas E, Kwan P. An Interdigitated Electrode Biosensor Platform for Rapid HLA-B*15:02 Genotyping for Prevention of Drug Hypersensitivity. Biosensors Bioelectronics. 2018; 111:174-183. doi: 10.1016/j.bios.2018.01.063.
  • Chen, Z., Brodie, M.J., Liew, D., Kwan, P. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs a 30-year longitudinal cohort study. JAMA Neurology. 2018; 75(3):279-286. doi: 10.1001/jamaneurol.2017.3949.
  • Liu S, Shen Y, Shultz SR, Nguyen A, Hovens C, Adlard PA, Bush AI, Chan J, Kwan P, O’Brien TJ, Jones NC. Accelerated kindling epileptogenesis in Tg4510 tau transgenic mice, but not in tau knockout mice. Epilepsia. Accepted 20 June 2017.
  • Shi YW, Min FL, Zhou D, Qin B, Wang J, Hu FY, Cheung YK, Zhou JH, Hu XS, Zhou JQ, Zhou LM, Zheng ZZ, Pan J, He N, Liu ZS, Hou YQ, Lim KS, Ou YM, Hui-Ping Khor A, Ng CC, Mao BJ, Liu XR, Li BM, Kuan YY, Yi YH, He XL, Deng XY, Su T, Kwan P, Liao WP. HLA-A*24:02 as a common risk factor for antiepileptic drug-induced cutaneous adverse reactions. Neurology. 2017; 88(23):2183-2191. doi: 10.1212/WNL.0000000000004008.
  • Perucca P, Scheffer IE, Harvey AS, James PA, Lunke S, Thorne N, Gaff C, Regan BM, Damiano JA, Hildebrand MS, Berkovic SF, O'Brien TJ, Kwan P. Real-world utility of whole exome sequencing with targeted gene analysis for focal epilepsy. Epilepsy Res. 2017; 131:1-8. doi: 10.1016/j.eplepsyres.2017.02.001.
  • Chen Z, Liew D, Kwan P.  Real-world cost-effectiveness of pharmacogenetic screening for epilepsy treatment. Neurology 2016; 86(12), 1086-94.
  • Chan J, Jones NC, Bush AI, O’Brien TJ and Kwan P. A mouse model of Alzheimer's disease displays increased susceptibility to kindling and seizure-associated death. Epilepsia. 2015; 56(6): e73-7. doi: 10.1111/epi.12993.