Quantifying seizure termination patterns reveals limited pathways to seizure end.

Asynchronous ending Burst suppression Seizure termination Synchronous ending

Journal

Neurobiology of disease
ISSN: 1095-953X
Titre abrégé: Neurobiol Dis
Pays: United States
ID NLM: 9500169

Informations de publication

Date de publication:
04 2022
Historique:
received: 21 07 2021
revised: 06 01 2022
accepted: 26 01 2022
pubmed: 2 2 2022
medline: 8 4 2022
entrez: 1 2 2022
Statut: ppublish

Résumé

Despite their possible importance in the design of novel neuromodulatory approaches and in understanding status epilepticus, the dynamics and mechanisms of seizure termination are not well studied. We examined intracranial recordings from patients with epilepsy to differentiate seizure termination patterns and investigated whether these patterns are indicative of different underlying mechanisms. Seizures were classified into one of two termination patterns: (a) those that end simultaneously across the brain (synchronous), and (b) those whose termination is piecemeal across the cortex (asynchronous). Both types ended with either a burst suppression pattern, or continuous seizure activity. These patterns were quantified and compared using burst suppression ratio, absolute energy, and network connectivity. Seizures with electrographic generalization showed burst suppression patterns in 90% of cases, compared with only 60% of seizures which remained focal. Interestingly, we found similar absolute energy and burst suppression ratios in seizures with synchronous and asynchronous termination, while seizures with continuous seizure activity were found to be different from seizures with burst suppression, showing lower energy during seizure and lower burst suppression ratio at the start and end of seizure. Finally, network density was observed to increase with seizure progression, with significantly lower densities in seizures with continuous seizure activity compared to seizures with burst suppression. Based on this spatiotemporal classification scheme, we suggest that there are a limited number of seizure termination patterns and dynamics. If this bears out, it would imply that the number of mechanisms underlying seizure termination is also constrained. Seizures with different termination patterns exhibit different dynamics even before their start. This may provide useful clues about how seizures may be managed, which in turn may lead to more targeted modes of therapy for seizure control.

Identifiants

pubmed: 35104646
pii: S0969-9961(22)00036-5
doi: 10.1016/j.nbd.2022.105645
pmc: PMC8860887
mid: NIHMS1776241
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

105645

Subventions

Organisme : NINDS NIH HHS
ID : R01 NS102190
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS062092
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS084142
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS102574
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS107291
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS110669
Pays : United States
Organisme : NINDS NIH HHS
ID : K24 NS088568
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG064312
Pays : United States

Informations de copyright

Copyright © 2022. Published by Elsevier Inc.

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Auteurs

Pariya Salami (P)

Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: psalami@mgh.harvard.edu.

Mia Borzello (M)

Department of Cognitive Science, University of California, San Diego, CA, USA; Computational Neurobiology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, USA.

Mark A Kramer (MA)

Department of Mathematics and Statistics, Boston University, Boston, MA, USA.

M Brandon Westover (MB)

Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Sydney S Cash (SS)

Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

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