Seizure onset location shapes dynamics of initiation. Issue 8 (August 2020)

• Record Type: Journal Article
• Authors: Salami, Pariya; Peled, Noam; Nadalin, Jessica K.; Martinet, Louis-Emmanuel; Kramer, Mark A.; Lee, Jong W.; Cash, Sydney S.
• Is Part Of: Clinical neurophysiology. Volume 131:Issue 8(2020:Aug.)
• Page Start: 1782
• Page End: 1797
• Publication Date: 2020-08
• Subjects: Seizure generation -- Seizure onset-pattern -- Infraslow-activity -- High-frequency oscillation -- Phase-amplitude coupling; CFC cross-frequency coupling -- ELA electrode labeling algorithm -- HFOs high-frequency oscillations -- HYP hypersynchronous spiking -- IRB Institutional Review Board -- ISA infraslow activity -- LVF low-voltage fast activity -- MMVT multi-modality visualization tool -- PAC phase-amplitude coupling -- SPM Statistical Parametric Mapping; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2020.04.168
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: High-frequency oscillations and phase-amplitude coupling have region-specific dynamics. Infraslow activity occurs throughout the brain during seizures regardless of seizure onset zone. Onset region is best considered with pattern and other aspects when studying seizure mechanism. Abstract: Objective: Ictal electrographic patterns are widely thought to reflect underlying neural mechanisms of seizures. Here we studied the degree to which seizure patterns are consistent in a given patient, relate to particular brain regions and if two candidate biomarkers (high-frequency oscillations, HFOs; infraslow activity, ISA) and network activity, as assessed with cross-frequency interactions, can discriminate between seizure types. Methods: We analyzed temporal changes in low and high frequency oscillations recorded during seizures, as well as phase-amplitude coupling (PAC) to monitor the interactions between delta/theta and ripple/fast ripple frequency bands at seizure onset. Results: Seizures of multiple electrographic patterns were observed in a given patient and brain region. While there was an increase in HFO rate across different electrographic patterns, there are specific relationships between types of HFO activity and onset region. Similarly, changes in PAC dynamics were more closely related to seizure onset region than they were to electrographic patterns while ISA was a poor indicator for seizure onset. Conclusions: Our findings suggest that the onset region sculpts neurodynamics at seizure initiation and that unique features of the cytoarchitecture and/or connectivity of that region play a significant role in determining seizure mechanism. Significance: To learn how seizures are initiated, researchers would do well to consider other aspects of their manifestation, in addition to their electrographic patterns. Examination of onset pattern in conjunction with the interactions between different oscillatory frequencies in the context of different brain regions might be more informative and lead to more reliable clinical inference as well as novel therapeutic approaches.