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Gavin Winston

Talk title

What can clinical neurology learn from the brain’s neural networks and vice versa?

In this lecture, I will begin by outlining the historical aspects of localisation in clinical neurology and how the concept of brain disorders arising from networks rose then fell out of favour before being revived again over the last 200 years.

I will give a brief introduction to epilepsy, my field of research and an excellent prototype for a network disorder, and highlight the difference between focal and generalised seizures. I will emphasise the importance of the study of neural networks in this population by the multiple lines of evidence, including neuropathology, electrophysiology, neuropsychology and neuroimaging that have demonstrated that “focal” epilepsy is anything but and should rather be considered a disease of brain networks.

I will then present research studies looking at cognitive aspects of the most common focal epilepsy, temporal lobe epilepsy, to show how neuroimaging has led to a better understanding the networks underlying language and memory before discussing the progress that has been made using graph-theory based “connectomic” approaches. Finally, I will show how this understanding is beginning to impact on clinical practice in epilepsy and neurology.


Dr Gavin Winston is an MRC Clinician Scientist in the Epilepsy Society MRI Unit, Chalfont St Peter and Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London. He is an Honorary Consultant Neurologist at the National Hospital for Neurology & Neurosurgery, Queen Square, London and Chalfont Centre for Epilepsy where he runs epilepsy and general neurology clinics.

His research concentrates on the role of neuroimaging in patients with refractory focal epilepsy undergoing neurosurgical treatment. In previous work, he sought to understand the adverse cognitive effects of temporal lobe epilepsy and how brain reorganisation and plasticity affect surgical outcomes. He has also worked in conjunction with the UCL Centre for Medical Image Computing to implement real-time image-guided surgery to reduce the risk of adverse effects. His present research interest is improving the detection of the underlying epileptogenic abnormality in patients with normal conventional MRI scans by novel acquisition techniques and computational analysis.

Dr Winston received the Sir Peter Mansfield Prize for innovative technical developments in the field of magnetic resonance in medicine and biology from the British Chapter of the ISMRM in 2011 and his work has featured in the BBC television programme "How Science Changed Our World" describing the top ten scientific breakthroughs in the past 50 years. He is a member of UCL Academic Board, serves as a peer reviewer for numerous international journals and has been on the editorial board of Quantitative Imaging in Medicine and Surgery since its inception. He has chaired sessions at international conferences, given invited lectures internationally and also spoken at events aimed at the general public.

His institutional profile is available at:

Suggested Readings

Disconnection syndromes

Catani M, ffytche DH (2005). The rises and falls of disconnection syndromes.

Changing definitions of epileptic seizures

International League Against Epilepsy (1981). Proposal for revised clinical and electroencephalographic classification of epileptic seizures.

Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005–2009.

Cognitive effects of epilepsy

Leyden KM, Kucukboyaci NE, Puckett OK, Lee D, Loi RQ, Paul B, McDonald CR (2015). What does diffusion tensor imaging (DTI) tell us about cognitive networks in temporal lobe epilepsy?

Working memory (as an example)

Stretton J, Winston G, Sidhu M, Centeno M, Vollmar C, Bonelli S, Symms M, Koepp M, Duncan JS, Thompson PJ (2012). Neural correlates of working memory in temporal lobe epilepsy – an fMRI study.

Winston GP, Stretton J, Sidhu MK, Symms MR, Thompson PJ, Duncan JS (2013). Structural correlates of impaired working memory in hippocampal sclerosis.

Stretton J, Winston GP, Sidhu M, Bonelli S, Centeno M, Vollmar C, Cleary RA, Williams E, Symms MR, Koepp MJ, Thompson PJ, Duncan JS (2013). Disrupted segregation of working memory networks in temporal lobe epilepsy.

Stretton J, Sidhu MK, Winston GP, Bartlett P, McEvoy AW, Symms MR, Koepp MJ, Thompson PJ, Duncan JS (2014). Working memory network plasticity after anterior temporal lobe resection: a longitudinal functional magnetic resonance imaging study.

Graph theory approaches

Bernhardt BC, Bonihla L, Gross DW (2015). Network analysis for a network disorder: The emerging role of graph theory in the study of epilepsy.

Chiang S, Haneef Z (2014). Graph theory findings in the pathophysiology of temporal lobe epilepsy.

Other approaches

Van Graan LA, Lemieux L, Chaudhary UJ (2015). Methods and utility of EEG-fMRI in epilepsy.

Caciagli L, Bernhardt BC, Hong SJ, Bernasconi A, Bernasconi N (2014). Functional network alterations and their structural substrate in drug-resistant epilepsy.

Centeno M, Carmichael DW (2014). Network connectivity in epilepsy: resting state fMRI and EEG-fMRI contributions.

Conference Presentation

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Page Manager: Daniel Ruhe|Last update: 8/21/2015

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