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

Elliot H. Smith, Jyun-you Liou, Tyler S. Davis, Edward M. Merricks, Spencer S. Kellis, Shennan A. Weiss, Bradley Greger, Paul A. House, Guy M. McKhann, Robert R. Goodman, Ronald G. Emerson, Lisa M. Bateman, Andrew J. Trevelyan and Catherine A. Schevon ()
Additional contact information
Elliot H. Smith: Columbia University Medical Center
Jyun-you Liou: Columbia University
Tyler S. Davis: University of Utah
Edward M. Merricks: Institute of Neuroscience, Newcastle University
Spencer S. Kellis: California Institute of Technology
Shennan A. Weiss: UCLA David Geffen School of Medicine
Bradley Greger: School of Biological and Health Systems Engineering, Arizona State University
Paul A. House: University of Utah
Guy M. McKhann: Columbia University Medical Center
Robert R. Goodman: Icahn School of Medicine at Mount Sinai
Ronald G. Emerson: Weill Cornell Medical College
Lisa M. Bateman: Columbia University Medical Center
Andrew J. Trevelyan: Institute of Neuroscience, Newcastle University
Catherine A. Schevon: Columbia University Medical Center

Nature Communications, 2016, vol. 7, issue 1, 1-12

Abstract: 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.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:nat:natcom:v:7:y:2016:i:1:d:10.1038_ncomms11098

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DOI: 10.1038/ncomms11098

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