Dataset Information

Coalescence and fragmentation of cortical networks during focal seizures.

ABSTRACT: Epileptic seizures reflect a pathological brain state characterized by specific clinical and electrical manifestations. The proposed mechanisms are heterogeneous but united by the supposition that epileptic activity is hypersynchronous across multiple scales, yet principled and quantitative analyses of seizure dynamics across space and throughout the entire ictal period are rare. To more completely explore spatiotemporal interactions during seizures, we examined electrocorticogram data from a population of male and female human patients with epilepsy and from these data constructed dynamic network representations using statistically robust measures. We found that these networks evolved through a distinct topological progression during the seizure. Surprisingly, the overall synchronization changed only weakly, whereas the topology changed dramatically in organization. A large subnetwork dominated the network architecture at seizure onset and preceding termination but, between, fractured into smaller groups. Common network characteristics appeared consistently for a population of subjects, and, for each subject, similar networks appeared from seizure to seizure. These results suggest that, at the macroscopic spatial scale, epilepsy is not so much a manifestation of hypersynchrony but instead of network reorganization.

SUBMITTER: Kramer MA

PROVIDER: S-EPMC2927849 | biostudies-literature | 2010 Jul

REPOSITORIES: biostudies-literature

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Coalescence and fragmentation of cortical networks during focal seizures.

Kramer Mark A MA Eden Uri T UT Kolaczyk Eric D ED Zepeda Rodrigo R Eskandar Emad N EN Cash Sydney S SS

The Journal of neuroscience : the official journal of the Society for Neuroscience 20100701 30

Epileptic seizures reflect a pathological brain state characterized by specific clinical and electrical manifestations. The proposed mechanisms are heterogeneous but united by the supposition that epileptic activity is hypersynchronous across multiple scales, yet principled and quantitative analyses of seizure dynamics across space and throughout the entire ictal period are rare. To more completely explore spatiotemporal interactions during seizures, we examined electrocorticogram data from a po ...[more]

PMID: 20668192

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Project description:OBJECTIVE:Low-frequency fiber-tract stimulation has been shown to be effective in treating mesial temporal lobe epilepsies through activation of the hippocampal commissure in rodents and human patients. The corpus callosum is a major pathway connecting the two hemispheres of the brain; however, few experiments have documented corpus callosum stimulation. The objective is to determine the efficacy of corpus callosum stimulation at low frequencies to suppress cortical seizures. METHODS:4-Aminopyridine was injected in the primary motor cortex of 24 rats under anesthesia. Recording electrodes were placed in the contralateral motor cortex and hippocampus. Three pairs of stimulating electrodes were inserted into the corpus callosum along its longitudinal axis. Local field potentials were recorded 1 hour before, during, and after stimulation to determine the effect of stimulation on seizure duration. Stimulation was delivered from each pair of electrodes independently in separate experiments. Furthermore, electrical stimulation was applied to the region of the corpus callosum with the highest degree of innervation of the seizure focus to compare the efficacy of different stimulation frequencies (1-30 Hz) on seizure suppression. RESULTS:Corpus callosum stimulation was effective at suppressing seizures at 10 Hz by 76% (P < 0.05, n = 5) and at 20 Hz by 95% (P < 0.0001, n = 14). Stimulation at frequencies of 1 and 30 Hz did not have a significant effect on reducing the total time spent seizing (P > 0.9999, n = 5). Furthermore, stimulation was only effective at suppressing seizures when the pair of electrodes was placed within the section of corpus callosum containing fibers innervating the seizure focus. Secondarily generalized seizures in the hippocampus were eliminated when seizures in the cortical focus were suppressed. SIGNIFICANCE:Low-frequency fiber-tract stimulation of the corpus callosum suppresses both cortical and cortically induced hippocampal seizures in an acute model of focal cortical seizures. The stimulation paradigm is selective, as it is only effective when targeted to specific regions of the corpus callosum that project maximally to cortical regions generating the seizure activity. Selective placement of stimulation electrodes along the corpus callosum could be used as a patient-specific treatment for cortical epilepsies.

Project description:Generalized tonic-clonic seizures are among the most dramatic physiological events in the nervous system. The brain regions involved during partial seizures with secondary generalization have not been thoroughly investigated in humans. We used single photon emission computed tomography (SPECT) to image cerebral blood flow (CBF) changes in 59 secondarily generalized seizures from 53 patients. Images were analysed using statistical parametric mapping to detect cortical and subcortical regions most commonly affected in three different time periods: (i) during the partial seizure phase prior to generalization; (ii) during the generalization period; and (iii) post-ictally. We found that in the pre-generalization period, there were focal CBF increases in the temporal lobe on group analysis, reflecting the most common region of partial seizure onset. During generalization, individual patients had focal CBF increases in variable regions of the cerebral cortex. Group analysis during generalization revealed that the most consistent increase occurred in the superior medial cerebellum, thalamus and basal ganglia. Post-ictally, there was a marked progressive CBF increase in the cerebellum which spread to involve the bilateral lateral cerebellar hemispheres, as well as CBF increases in the midbrain and basal ganglia. CBF decreases were seen in the fronto-parietal association cortex, precuneus and cingulate gyrus during and following seizures, similar to the 'default mode' regions reported previously to show decreased activity in seizures and in normal behavioural tasks. Analysis of patient behaviour during and following seizures showed impaired consciousness at the time of SPECT tracer injections. Correlation analysis across patients demonstrated that cerebellar CBF increases were related to increases in the upper brainstem and thalamus, and to decreases in the fronto-parietal association cortex. These results reveal a network of cortical and subcortical structures that are most consistently involved in secondarily generalized tonic-clonic seizures. Abnormal increased activity in subcortical structures (cerebellum, basal ganglia, brainstem and thalamus), along with decreased activity in the association cortex may be crucial for motor manifestations and for impaired consciousness in tonic-clonic seizures. Understanding the networks involved in generalized tonic-clonic seizures can provide insights into mechanisms of behavioural changes, and may elucidate targets for improved therapies.

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Coalescence and fragmentation of cortical networks during focal seizures.

Publications

Coalescence and fragmentation of cortical networks during focal seizures.

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