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Seizure pathways change on circadian and slower timescales in individual patients with focal epilepsy.


ABSTRACT: Personalized medicine requires that treatments adapt to not only the patient but also changing factors within each individual. Although epilepsy is a dynamic disorder characterized by pathological fluctuations in brain state, surprisingly little is known about whether and how seizures vary in the same patient. We quantitatively compared within-patient seizure network evolutions using intracranial electroencephalographic (iEEG) recordings of over 500 seizures from 31 patients with focal epilepsy (mean 16.5 seizures per patient). In all patients, we found variability in seizure paths through the space of possible network dynamics. Seizures with similar pathways tended to occur closer together in time, and a simple model suggested that seizure pathways change on circadian and/or slower timescales in the majority of patients. These temporal relationships occurred independent of whether the patient underwent antiepileptic medication reduction. Our results suggest that various modulatory processes, operating at different timescales, shape within-patient seizure evolutions, leading to variable seizure pathways that may require tailored treatment approaches.

SUBMITTER: Schroeder GM 

PROVIDER: S-EPMC7245106 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Seizure pathways change on circadian and slower timescales in individual patients with focal epilepsy.

Schroeder Gabrielle M GM   Diehl Beate B   Chowdhury Fahmida A FA   Duncan John S JS   de Tisi Jane J   Trevelyan Andrew J AJ   Forsyth Rob R   Jackson Andrew A   Taylor Peter N PN   Wang Yujiang Y  

Proceedings of the National Academy of Sciences of the United States of America 20200504 20


Personalized medicine requires that treatments adapt to not only the patient but also changing factors within each individual. Although epilepsy is a dynamic disorder characterized by pathological fluctuations in brain state, surprisingly little is known about whether and how seizures vary in the same patient. We quantitatively compared within-patient seizure network evolutions using intracranial electroencephalographic (iEEG) recordings of over 500 seizures from 31 patients with focal epilepsy  ...[more]

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