Abstract

Acute in vitro models have revealed a great deal of information about mechanisms underlying many types of epileptiform activity. However, few examples exist that shed light on spike-and-wave (SpW) patterns of pathological activity. SpW are seen in many epilepsy syndromes, both generalized and focal, and manifest across the entire age spectrum. They are heterogeneous in terms of their severity, symptom burden, and apparent anatomical origin (thalamic, neocortical, or both), but any relationship between this heterogeneity and underlying pathology remains elusive. In this study we demonstrate that physiological delta-frequency rhythms act as an effective substrate to permit modeling of SpW of cortical origin and may help to address this issue. For a starting point of delta activity, multiple subtypes of SpW could be modeled computationally and experimentally by either enhancing the magnitude of excitatory synaptic events ascending from neocortical layer 5 to layers 2/3 or selectively modifying superficial layer GABAergic inhibition. The former generated SpW containing multiple field spikes with long interspike intervals, whereas the latter generated SpW with short-interval multiple field spikes. Both types had different laminar origins and each disrupted interlaminar cortical dynamics in a different manner. A small number of examples of human recordings from patients with different diagnoses revealed SpW subtypes with the same temporal signatures, suggesting that detailed quantification of the pattern of spikes in SpW discharges may be a useful indicator of disparate underlying epileptogenic pathologies.NEW & NOTEWORTHY Spike-and-wave-type discharges (SpW) are a common feature in many epilepsies. Their electrographic manifestation is highly varied, as are available genetic clues to associated underlying pathology. Using computational and in vitro models, we demonstrate that distinct subtypes of SpW are generated by lamina-selective disinhibition or enhanced interlaminar excitation. These subtypes could be detected in at least some noninvasive patient recordings, suggesting more detailed analysis of SpW may be useful in determining clinical pathology.

Highlights

  • Spike-and-wave discharges (SpW) are seen in a broad range of different epilepsies

  • In the present study we focus on the two above-mentioned neuronal control systems to further understand differential mechanisms underlying the heterogeneity of spike manifestation within SpW

  • Using experimental animal and computational models of physiologically relevant slow oscillations, we found that distinct patterns of multiple spikes per SpW seen in patients could be selectively generated by either predominantly superficial cortical layer disinhibition or enhanced ascending excitation

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Summary

Introduction

Spike-and-wave discharges (SpW) are seen in a broad range of different epilepsies They are a common feature in idiopathic generalized epilepsies (Panayiotopoulos, 2005) and are associated with absences, where they dominate the EEG interictally and during seizures (Crunelli and Leresche 2002; Tenney and Glauser 2013). They manifest in juvenile and adult myoclonic and generalized tonic-clonic seizures (Panayiotopoulos 2005) In this context they appear as large-amplitude waves, often with one or more spikes nested within this wave, so-called spike-and-wave discharges (SpW) (Crunelli and Leresche 2002). SpW are seen in focal epilepsies, (though not exclusively) in extratemporal areas such as frontal, parietal, and occipital cortices (Takahashi et al 2015; Taylor et al 2003; Westmoreland 1998)

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