Format

Send to

Choose Destination
Nat Commun. 2016 Mar 29;7:11098. doi: 10.1038/ncomms11098.

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

Author information

1
Department of Neurological Surgery, Columbia University Medical Center, New York, New York 10032, USA.
2
Department of Physiology and Cellular Biophysics, Columbia University, New York, New York 10032, USA.
3
Department of Neurosurgery, University of Utah, Salt Lake City, Utah 84132, USA.
4
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
5
California Institute of Technology, Division of Biology and Biological Engineering, Pasadena, California 91125, USA.
6
Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California 90095, USA.
7
School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85287, USA.
8
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA.
9
Department of Neurology, Weill Cornell Medical College, New York, New York 10021, USA.
10
Department of Neurology, Columbia University Medical Center, New York, New York 10032, USA.

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.

PMID:
27020798
PMCID:
PMC4820627
DOI:
10.1038/ncomms11098
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center