The ictal wavefront is the spatiotemporal source of discharges during spontaneous human seizures.
The ictal wavefront is the spatiotemporal source of discharges during spontaneous human seizures.
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DOI：
10.1038/ncomms11098
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发表时间：
2016-03-29
影响因子：
16.6
通讯作者：
Schevon CA
中科院分区：
文献类型：
--
作者：
Smith EH;Liou JY;Davis TS;Merricks EM;Kellis SS;Weiss SA;Greger B;House PA;McKhann GM 2nd;Goodman RR;Emerson RG;Bateman LM;Trevelyan AJ;Schevon CA
癫痫发作在皮层区域的广泛分布和同时终止导致了癫痫发作是由跨越这些区域的大规模协调网络引起的假设。然而，这种观点很难与大多数提出的癫痫发作扩散和终止机制相一致，这些机制在细胞尺度上起作用。我们假设癫痫发作演变成自组织结构，其中一个小的扣押领土项目高强度的电信号在广泛的皮质区。在这里，我们调查人类癫痫发作的大小电生理尺度。我们发现，迁移边缘的抢占领土的突触活动的行波到相邻的皮质区的来源。随着癫痫发作的进展，这些波的诱导活动的缓慢动力学表明其来源的减弱和最终失败。这些观察结果支持了一个简约的理论，即癫痫发作的大规模演变和终止是如何从一个小的迁移皮层区域驱动的。 癫痫患者的大脑表现出抑制性抑制，表现为同步活动的传播时间延迟。在这里，Elliot Smith及其同事展示了快速移动的行波，其起源于癫痫患者发作波前的边缘，随后在癫痫患者的癫痫发作脑区域中进行去极化和多单位放电。
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. Epileptic brains display inhibitory restraint as manifested by the spread of synchronized activities being delayed in timing. Here, Elliot Smith and colleagues show fast-moving traveling wave that originates from the edge of ictal wavefront with subsequent depolarization and multiunit firing in the seizing brain regions in epileptic patients.