Epilepsy is a disease affecting millions of people worldwide. Despite over 50 years of research, the mechanisms that generate and sustain ictal discharges, a key neural hallmark of seizures, remain unknown. While once thought to be caused by hypersynchronous neuronal firing, we now recognize that the activity underlying ictal discharges is much more complex. With the development of microelectrode arrays (MEAs) suitable for use in humans, it is possible to observe neural activity at fine spatiotemporal scales in human patients with epilepsy. However, the diversity of seizure characteristics and limited patient population has led to a number of conflicting observations and theories. The purpose of this work is to elucidate mechanisms underlying ictal discharges in humans by applying statistical analyses and computational modeling to MEA recordings from human patients with epilepsy.
We approach this aim in two projects. In the first project, we unify two seemingly conflicting theories surrounding cortical sources of ictal discharges. According to the ictal wavefront theory, ictal discharges are seeded at an expanding narrow front of high neuronal firing that delineates the boundary between regions of cortex with compromised functionality, and surrounding territory where the seizure is observable in electrical recordings, but cortical function remains intact. A second theory posits that discharges are predominantly seeded from a stationary localized cortical source. The two theories are based on observations from MEA recordings of seizures in two different small cohorts of patients. In this project, we analyze and model the discharge propagation patterns in a combined dataset from both cohorts. We show that discharges are seeded at the ictal wavefront in addition to other–possibly stationary–locations.
In the second project, we characterize spatiotemporal patterns in the secondary transients of complex ictal discharges. Electrographic recordings of ictal discharges often have complex waveforms. Existing analyses focus on the spatiotemporal dynamics of the first, high-amplitude transient. In this project, we establish that ictal discharges often comprise multiple transients separated by ≈60 ms. Surprisingly, and contrary to our initial hypothesis, we find that individual transients within a complex discharge may propagate with different speeds, suggesting that different mechanisms are involved in the propagation of different transients.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48080 |
| Date | 12 February 2024 |
| Creators | Schlafly, Emily |
| Contributors | Kramer, Mark |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution-ShareAlike 4.0 International, http://creativecommons.org/licenses/by-sa/4.0/ |
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