Abstract
Intracranial electroencephalography is a standard tool in clinical evaluation of patients with focal epilepsy. Various early electrographic seizure patterns differing in frequency, amplitude, and waveform of the oscillations are observed. The pattern most common in the areas of seizure propagation is the so-called theta-alpha activity (TAA), whose defining features are oscillations in the θ − α range and gradually increasing amplitude. A deeper understanding of the mechanism underlying the generation of the TAA pattern is however lacking. In this work we evaluate the hypothesis that the TAA patterns are caused by seizures spreading across the cortex. To do so, we perform simulations of seizure dynamics on detailed patient-derived cortical surfaces using the spreading seizure model as well as reference models with one or two homogeneous sources. We then detect the occurrences of the TAA patterns both in the simulated stereo-electroencephalographic signals and in the signals of recorded epileptic seizures from a cohort of fifty patients, and we compare the features of the groups of detected TAA patterns to assess the plausibility of the different models. Our results show that spreading seizure hypothesis is qualitatively consistent with the evidence available in the seizure recordings, and it can explain the features of the detected TAA groups best among the examined models.
Highlights
Intracranial EEG and early electrographic patternsIntracranial electroencephalography is an essential tool in clinical evaluation of patients with focal drug-resistant epilepsy and its use in neuroscientific research is steadily growing [1, 2]
At the beginning of the seizure variety of electrographic patterns can appear, whose origins and significance is not yet fully understood, which makes the interpretation of the signals difficult
We look at one of the patterns, the so-called theta-alpha activity pattern, and propose that it can be explained by epileptic seizures gradually spreading across the cortex
Summary
Intracranial EEG and early electrographic patternsIntracranial electroencephalography (iEEG) is an essential tool in clinical evaluation of patients with focal drug-resistant epilepsy and its use in neuroscientific research is steadily growing [1, 2]. The objective of exploration using iEEG is to understand the spatiotemporal organization of the patient’s epilepsy with the goal to perform resective surgery and render the patient seizure free. In epilepsy both electrocorticography (ECoG) using the subdural grids and stereoelectroencephalography (SEEG) using the depth electrodes are widely employed. Several studies attempted to classify these patterns in an effort to distinguish between local onset and propagated seizures and to link the early patterns with different pathologies or with the outcome of a resective surgery [3,4,5,6,7,8,9,10]
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