Changes in interictal spike features precede the onset of temporal lobe epilepsy (original) (raw)
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Neurobiology of Disease, 2014
Mesial temporal lobe epilepsy (MTLE) is characterized in humans and in animal models by a seizure-free latent phase that follows an initial brain insult; this period is presumably associated to plastic changes in temporal lobe excitability and connectivity. Here, we analyzed the occurrence of interictal spikes and high frequency oscillations (HFOs; ripples: 80-200 Hz and fast ripples: 250-500 Hz) from 48 h before to 96 h after the first seizure in the rat pilocarpine model of MTLE. Interictal spikes recorded with depth EEG electrodes from the hippocampus CA3 area and entorhinal cortex (EC) were classified as type 1 (characterized by a spike followed by a wave) or type 2 (characterized by a spike with no wave). We found that: (i) there was a switch in the distribution of both types of interictal spikes before and after the occurrence of the first seizure; during the latent phase both types of interictal spikes predominated in the EC whereas during the chronic phase both types of spikes predominated in CA3; (ii) type 2 spike duration decreased in both regions from the latent to the chronic phase; (iii) type 2 spikes associated to fast ripples occurred at higher rates in EC compared to CA3 during the latent phase while they occurred at similar rates in both regions in the chronic phase; and (iv) rates of fast ripples outside of spikes were higher in EC compared to CA3 during the latent phase. Our findings demonstrate that the transition from the latent to the chronic phase is paralleled by dynamic changes in interictal spike and HFO expression in EC and CA3. We propose that these changes may represent biomarkers of epileptogenicity in MTLE.
Time-domain features of epileptic spikes as potential bio-markers of the epileptogenesis process
2010 Annual International Conference of the IEEE Engineering in Medicine and Biology, 2010
Epilepsy is a neurological disorder characterized by recurrent seizures which affects about 1 people worldwide. During the past % decades, some mechanisms involved in ictogenesis (generation of seizures) have been identified and, to some extent, partially understood. However, regarding epileptogenesis (process by which a neuronal system becomes epileptic), underlying mechanisms remain elusive. This difficulty is mostly related to the fact that epileptogenesis can only be addressed using experimental models. In this study, we have analyzed the shape of a specific electrophysiological pattern, referred to as epileptic spike , encountered during " " the epileptogenesis process in an model of temporal lobe epilepsy (mouse, kainate). Results show that the features of these in vivo transient events (duration and amplitude) change as a function of time as the brain evolves towards the chronic epileptic state characterized by the appearance of spontaneous seizures. Using a detailed computational model of the hippocampus (CA1 sub-field), an interpretation of observed modifications is provided, in relationship with possible alterations that take place in underlying neuronal circuits.
Interictal spikes and epileptic seizures: their relationship and underlying rhythmicity
Brain, 2016
We report on a quantitative analysis of electrocorticography data from a study that acquired continuous ambulatory recordings in humans over extended periods of time. The objectives were to examine patterns of seizures and spontaneous interictal spikes, their relationship to each other, and the nature of periodic variation. The recorded data were originally acquired for the purpose of seizure prediction, and were subsequently analysed in further detail. A detection algorithm identified potential seizure activity and a template matched filter was used to locate spikes. Seizure events were confirmed manually and classified as either clinically correlated, electroencephalographically identical but not clinically correlated, or subclinical. We found that spike rate was significantly altered prior to seizure in 9 out of 15 subjects. Increased pre-ictal spike rate was linked to improved predictability; however, spike rate was also shown to decrease before seizure (in 6 out of the 9 subjects). The probability distribution of spikes and seizures were notably similar, i.e. at times of high seizure likelihood the probability of epileptic spiking also increased. Both spikes and seizures showed clear evidence of circadian regulation and, for some subjects, there were also longer term patterns visible over weeks to months. Patterns of spike and seizure occurrence were highly subject-specific. The pre-ictal decrease in spike rate is not consistent with spikes promoting seizures. However, the fact that spikes and seizures demonstrate similar probability distributions suggests they are not wholly independent processes. It is possible spikes actively inhibit seizures, or that a decreased spike rate is a secondary symptom of the brain approaching seizure. If spike rate is modulated by common regulatory factors as seizures then spikes may be useful biomarkers of cortical excitability.
Electrocorticographic Dynamics as a Novel Biomarker in Five Models of Epileptogenesis
The Journal of neuroscience : the official journal of the Society for Neuroscience, 2017
Postinjury epilepsy (PIE) is a devastating sequela of various brain insults. While recent studies offer novel insights into the mechanisms underlying epileptogenesis and discover potential preventive treatments, the lack of PIE biomarkers hinders the clinical implementation of such treatments. Here we explored the biomarker potential of different electrographic features in five models of PIE. Electrocorticographic or intrahippocampal recordings of epileptogenesis (from the insult to the first spontaneous seizure) from two laboratories were analyzed in three mouse and two rat PIE models. Time, frequency, and fractal and nonlinear properties of the signals were examined, in addition to the daily rate of epileptiform spikes, the relative power of five frequency bands (theta, alpha, beta, low gamma, and high gamma) and the dynamics of these features over time. During the latent pre-seizure period, epileptiform spikes were more frequent in epileptic compared with nonepileptic rodents; ho...
Do interictal spikes sustain seizures and epileptogenesis?
Epilepsy currents, 2006
Interictal spiking is seen in the EEG of epileptic patients between seizures. To date, the roles played by interictal events in seizure occurrence and in epileptogenesis remain elusive. While interictal spikes may herald the onset of electrographic seizures, experimental data indicate that hippocampus-driven interictal events prevent seizure precipitation. Even less clear than the role of interictal events in seizure occurrence is whether and how interictal spikes contribute to epileptogenesis. Thus, while plastic changes within limbic neuronal networks may result from ongoing interictal activity, experimental evidence supports the view that epileptogenesis is accompanied by a decrease in hippocampus-driven interictal activity.
On the Origin of Interictal Activity in Human Temporal Lobe Epilepsy in Vitro
Science, 2002
The origin and mechanisms of human interictal epileptic discharges remain unclear. Here, we describe a spontaneous, rhythmic activity initiated in the subiculum of slices from patients with temporal lobe epilepsy. Synchronous events were similar to interictal discharges of patient electroencephalograms. They were suppressed by antagonists of either glutamatergic or γ-aminobutyric acid (GABA)–ergic signaling. The network of neurons discharging during population events comprises both subicular interneurons and a subgroup of pyramidal cells. In these pyramidal cells, GABAergic synaptic events reversed at depolarized potentials. Depolarizing GABAergic responses in neurons downstream to the sclerotic CA1 region contribute to human interictal activity.
Epilepsy as a dynamical system, a most needed paradigm shift in epileptology
Epilepsy & Behavior, 2019
Márcio Flávio Dutra Moraes, Daniel de Castro Medeiros, Flávio Afonso Gonçalves Mourao, Sergio Augusto Vieira Cancado, Vinicius Rosa Cota - The idea of the epileptic brain being highly excitable and facilitated to synchronic activity has guided pharmacological treatment since the early twentieth century. Although tackling epilepsy's seizure-prone feature, by tonically modifying overall circuit excitability and/or connectivity, the last 50 years of drug development has not seen a substantial improvement in seizure suppression of refractory epilepsies. This review presents a new conceptual framework for epilepsy in which the temporal dynamics of the disease plays a more critical role in both its understanding and therapeutic strategies. The repetitive epileptiform pattern (characteristic during ictal activity) and other well-defined electrographic signatures (i.e., present during the interictal period) are discussed in terms of the sequential activation of the circuit motifs. Lessons learned from the physiological activation of neural circuitry are used to further corroborate the argument and explore the transition from proper function to a state of instability. Furthermore, the review explores how interfering in the temporally dependent abnormal connectivity between circuits maywork as a therapeutic approach. We also reviewthe use of probing stimulation to access network connectivity and evaluate its power to determine transitional states of the dynamical system as it moves towards regions of instability, especially when conventional electrographic monitoring is proven inefficient. Unorthodox cases, with little or no scalp electrographic correlate, in which ictogenic circuitry and/or seizure spread is temporally restricted to neurovegetative, cognitive, and motivational areas are shown as possible explanations for sudden death in epilepsy (SUDEP) and other psychiatric comorbidities. In short, this review presents a paradigm shift in the way that we address the disease and is aimed to encourage debate rather than narrow the rationale epilepsy is currently engaged in.
Identification of epileptogenic foci from causal analysis of ECoG interictal spike activity
Clinical Neurophysiology, 2009
Objective-In patients with intractable epilepsy, the use of interictal spikes as surrogate markers of the epileptogenic cortex has generated significant interest. Previous studies have suggested that the cortical generators of the interictal spikes are correlated with the epileptogenic cortex as identified from the ictal recordings. We hypothesize that causal analysis of the functional brain networks during interictal spikes are correlated with the clinically-defined epileptogenic zone. Methods-We employed a time-varying causality measure, the adaptive directed transfer function (ADTF), to identify the cortical sources of the interictal spike activity in eight patients with medically intractable neocortical onset epilepsy. The results were then compared to the foci identified by the epileptologists. Results-In all eight patients, the majority of the ADTF-calculated source activity was observed within the clinically-defined SOZs. Furthermore, in 3 of the 5 patients with two separate epileptogenic foci, the calculated source activity was correlated with both cortical sites. Conclusions-The ADTF method identified the cortical sources of the interictal spike activity as originating from the same cortical locations as the recorded ictal activity. Significance-Evaluation of the sources of the cortical networks obtained during interictal spikes may provide information as to the generators underlying the ictal activity.