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Published March 29, 2016 | Published + Supplemental Material
Journal Article Open

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

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.

Additional Information

© 2016 Macmillan Publishers Limited. This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Received 16 September 2015; Accepted 19 February 2016; Published 29 March 2016. We thank Lawrence F. Abbott and Charles E. Schroeder for helpful advice on the development of this manuscript. This work funded by NIH/NINDS R01 NS084142 (C.A.S.). These authors contributed equally to this work. Andrew J. Trevelyan & Catherine A. Schevon Author contributions: E.H.S., A.T. and C.A.S. wrote the manuscript. E.H.S. analysed the seizure data. J.-y.L. did the computational modelling. E.H.S., C.A.S., R.G.E., T.S.D. and B.G. collected the data. C.A.S., E.M.M., B.G., L.M.B. and A.J.T. provided developmental ideas. P.A.H., R.R.G. and G.M.M. implanted the MEAs. All authors contributed in editing the manuscript. The authors declare no competing financial interests.

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Created:
August 20, 2023
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October 18, 2023