Differential cortical layer engagement during seizure initiation and spread in humans

Pierre Bourdillon (), Liankun Ren, Mila Halgren, Angelique C. Paulk, Pariya Salami, István Ulbert, Dániel Fabó, Jean-Rémi King, Kane M. Sjoberg, Emad N. Eskandar, Joseph R. Madsen, Eric Halgren and Sydney S. Cash
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Pierre Bourdillon: Massachusetts General Hospital and Harvard Medical School
Liankun Ren: Capital Medical University
Mila Halgren: Massachusetts Institute of Technology
Angelique C. Paulk: Massachusetts General Hospital and Harvard Medical School
Pariya Salami: Massachusetts General Hospital and Harvard Medical School
István Ulbert: Institute of Cognitive Neuroscience and Psychology
Dániel Fabó: Semmelweis University
Jean-Rémi King: PSL University, CNRS
Kane M. Sjoberg: Massachusetts General Hospital and Harvard Medical School
Emad N. Eskandar: Albert Einstein College of Medicine – Montefiore Medical Center
Joseph R. Madsen: Harvard Medical School
Eric Halgren: University of California, San Diego
Sydney S. Cash: Massachusetts General Hospital and Harvard Medical School

Nature Communications, 2024, vol. 15, issue 1, 1-13

Abstract: Abstract Despite decades of research, we still do not understand how spontaneous human seizures start and spread – especially at the level of neuronal microcircuits. In this study, we used laminar arrays of micro-electrodes to simultaneously record the local field potentials and multi-unit neural activities across the six layers of the neocortex during focal seizures in humans. We found that, within the ictal onset zone, the discharges generated during a seizure consisted of current sinks and sources only within the infra-granular and granular layers. Outside of the seizure onset zone, ictal discharges reflected current flow in the supra-granular layers. Interestingly, these patterns of current flow evolved during the course of the seizure – especially outside the seizure onset zone where superficial sinks and sources extended into the deeper layers. Based on these observations, a framework describing cortical-cortical dynamics of seizures is proposed with implications for seizure localization, surgical targeting, and neuromodulation techniques to block the generation and propagation of seizures.

Date: 2024
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DOI: 10.1038/s41467-024-48746-8

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