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The ictal wavefront is the spatiotemporal source of discharges during spontaneous human seizures

Lookup NU author(s): Dr Edward Merricks, Professor Andrew Trevelyan

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Abstract

The extensive distribution and simultaneous termination of seizures across cortical areas has led to the hypothesis that seizures are caused by large-scale coordinated networks spanning these areas. This view, however, is difficult to reconcile with most proposed mechanisms of seizure spread and termination, which operate on a cellular scale. We hypothesize that seizures evolve into self-organized structures wherein a small seizing territory projects high-intensity electrical signals over a broad cortical area. Here we investigate human seizures on both small and large electrophysiological scales. We show that the migrating edge of the seizing territory is the source of travelling waves of synaptic activity into adjacent cortical areas. As the seizure progresses, slow dynamics in induced activity from these waves indicate a weakening and eventual failure of their source. These observations support a parsimonious theory for how large-scale evolution and termination of seizures are driven from a small, migrating cortical area.

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Author(s): Smith EH, Liou JY, Davis TS, Merricks EM, Kellis SS, Weiss SA, Greger B, House PA, McKhann GM, Goodman RR, Emerson RG, Bateman LM, Trevelyan AJ, Schevon CA

Publication type: Article

Publication status: Published

Journal: Nature Communications

Year: 2016

Volume: 7

Print publication date: 01/03/2016

Online publication date: 29/03/2016

Acceptance date: 19/02/2016

ISSN (electronic): 2041-1723

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/ncomms11098

DOI: 10.1038/ncomms11098

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