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Padmasola GP, Friscourt F, Rigoni I, Vulliémoz S, Schaller K, Michel CM, Sheybani L, Quairiaux C. Involvement of the contralateral hippocampus in ictal-like but not interictal epileptic activities in the kainate mouse model of temporal lobe epilepsy. Epilepsia 2024; 65:2082-2098. [PMID: 38758110 DOI: 10.1111/epi.17970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Animal and human studies have shown that the seizure-generating region is vastly dependent on distant neuronal hubs that can decrease duration and propagation of ongoing seizures. However, we still lack a comprehensive understanding of the impact of distant brain areas on specific interictal and ictal epileptic activities (e.g., isolated spikes, spike trains, seizures). Such knowledge is critically needed, because all kinds of epileptic activities are not equivalent in terms of clinical expression and impact on the progression of the disease. METHODS We used surface high-density electroencephalography and multisite intracortical recordings, combined with pharmacological silencing of specific brain regions in the well-known kainate mouse model of temporal lobe epilepsy. We tested the impact of selective regional silencing on the generation of epileptic activities within a continuum ranging from very transient to more sustained and long-lasting discharges reminiscent of seizures. RESULTS Silencing the contralateral hippocampus completely suppresses sustained ictal activities in the focus, as efficiently as silencing the focus itself, but whereas focus silencing abolishes all focus activities, contralateral silencing fails to control transient spikes. In parallel, we observed that sustained focus epileptiform discharges in the focus are preceded by contralateral firing and more strongly phase-locked to bihippocampal delta/theta oscillations than transient spiking activities, reinforcing the presumed dominant role of the contralateral hippocampus in promoting long-lasting, but not transient, epileptic activities. SIGNIFICANCE Altogether, our work provides suggestive evidence that the contralateral hippocampus is necessary for the interictal to ictal state transition and proposes that crosstalk between contralateral neuronal activity and ipsilateral delta/theta oscillation could be a candidate mechanism underlying the progression from short- to long-lasting epileptic activities.
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Affiliation(s)
- Guru Prasad Padmasola
- Functional Brain Mapping Lab, Department of Basic Neuroscience, University of Geneva, Geneva, Switzerland
| | - Fabien Friscourt
- Functional Brain Mapping Lab, Department of Basic Neuroscience, University of Geneva, Geneva, Switzerland
- Neurosurgery Clinic, Department of Clinical Neuroscience, University Hospital Geneva, Geneva, Switzerland
| | - Isotta Rigoni
- EEG and Epilepsy Unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland
| | - Serge Vulliémoz
- EEG and Epilepsy Unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland
| | - Karl Schaller
- Neurosurgery Clinic, Department of Clinical Neuroscience, University Hospital Geneva, Geneva, Switzerland
| | - Christoph M Michel
- Functional Brain Mapping Lab, Department of Basic Neuroscience, University of Geneva, Geneva, Switzerland
| | - Laurent Sheybani
- Neurology Clinic, Department of Clinical Neuroscience, University Hospital Geneva, Geneva, Switzerland
- Department of Clinical and Experimental Epilepsy, Queen's Square Institute of Neurology, London, UK
| | - Charles Quairiaux
- Functional Brain Mapping Lab, Department of Basic Neuroscience, University of Geneva, Geneva, Switzerland
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Ferrero JJ, Hassan AR, Yu Z, Zhao Z, Ma L, Wu C, Shao S, Kawano T, Engel J, Doyle W, Devinsky O, Khodagholy D, Gelinas JN. Closed-loop electrical stimulation to prevent focal epilepsy progression and long-term memory impairment. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.09.579660. [PMID: 38405990 PMCID: PMC10888806 DOI: 10.1101/2024.02.09.579660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Interictal epileptiform discharges (IEDs) are ubiquitously expressed in epileptic networks and disrupt cognitive functions. It is unclear whether addressing IED-induced dysfunction could improve epilepsy outcomes as most therapeutics target seizures. We show in a model of progressive hippocampal epilepsy that IEDs produce pathological oscillatory coupling which is associated with prolonged, hypersynchronous neural spiking in synaptically connected cortex and expands the brain territory capable of generating IEDs. A similar relationship between IED-mediated oscillatory coupling and temporal organization of IEDs across brain regions was identified in human subjects with refractory focal epilepsy. Spatiotemporally targeted closed-loop electrical stimulation triggered on hippocampal IED occurrence eliminated the abnormal cortical activity patterns, preventing spread of the epileptic network and ameliorating long-term spatial memory deficits in rodents. These findings suggest that stimulation-based network interventions that normalize interictal dynamics may be an effective treatment of epilepsy and its comorbidities, with a low barrier to clinical translation. One-Sentence Summary Targeted closed-loop electrical stimulation prevents spread of the epileptic network and ameliorates long-term spatial memory deficits.
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Ye H, Ye L, Hu L, Yang Y, Ge Y, Chen R, Wang S, Jin B, Ming W, Wang Z, Xu S, Xu C, Wang Y, Ding Y, Zhu J, Ding M, Chen Z, Wang S, Chen C. Widespread slow oscillations support interictal epileptiform discharge networks in focal epilepsy. Neurobiol Dis 2024; 191:106409. [PMID: 38218457 DOI: 10.1016/j.nbd.2024.106409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/01/2024] [Accepted: 01/09/2024] [Indexed: 01/15/2024] Open
Abstract
Interictal epileptiform discharges (IEDs) often co-occur across spatially-separated cortical regions, forming IED networks. However, the factors prompting IED propagation remain unelucidated. We hypothesized that slow oscillations (SOs) might facilitate IED propagation. Here, the amplitude and phase synchronization of SOs preceding propagating and non-propagating IEDs were compared in 22 patients with focal epilepsy undergoing intracranial electroencephalography (EEG) evaluation. Intracranial channels were categorized into the irritative zone (IZ) and normal zone (NOZ) regarding the presence of IEDs. During wakefulness, we found that pre-IED SOs within the IZ exhibited higher amplitudes for propagating IEDs than non-propagating IEDs (delta band: p = 0.001, theta band: p < 0.001). This increase in SOs was also concurrently observed in the NOZ (delta band: p = 0.04). Similarly, the inter-channel phase synchronization of SOs prior to propagating IEDs was higher than those preceding non-propagating IEDs in the IZ (delta band: p = 0.04). Through sliding window analysis, we observed that SOs preceding propagating IEDs progressively increased in amplitude and phase synchronization, while those preceding non-propagating IEDs remained relatively stable. Significant differences in amplitude occurred approximately 1150 ms before IEDs. During non-rapid eye movement (NREM) sleep, SOs on scalp recordings also showed higher amplitudes before intracranial propagating IEDs than before non-propagating IEDs (delta band: p = 0.006). Furthermore, the analysis of IED density around sleep SOs revealed that only high-amplitude sleep SOs demonstrated correlation with IED propagation. Overall, our study highlights that transient but widely distributed SOs are associated with IED propagation as well as generation in focal epilepsy during sleep and wakefulness, providing new insight into the EEG substrate supporting IED networks.
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Affiliation(s)
- Hongyi Ye
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Nanhu Brain-computer Interface Institute, Hangzhou, China
| | - Lingqi Ye
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingli Hu
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuyu Yang
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Ge
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ruotong Chen
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shan Wang
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bo Jin
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenjie Ming
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhongjin Wang
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sha Xu
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cenglin Xu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yi Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yao Ding
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Junming Zhu
- Department of Neurosurgery and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Meiping Ding
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhong Chen
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuang Wang
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Nanhu Brain-computer Interface Institute, Hangzhou, China.
| | - Cong Chen
- Department of Neurology and Epilepsy Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Sheybani L, Vivekananda U, Rodionov R, Diehl B, Chowdhury FA, McEvoy AW, Miserocchi A, Bisby JA, Bush D, Burgess N, Walker MC. Wake slow waves in focal human epilepsy impact network activity and cognition. Nat Commun 2023; 14:7397. [PMID: 38036557 PMCID: PMC10689494 DOI: 10.1038/s41467-023-42971-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Slow waves of neuronal activity are a fundamental component of sleep that are proposed to have homeostatic and restorative functions. Despite this, their interaction with pathology is unclear and there is only indirect evidence of their presence during wakefulness. Using intracortical recordings from the temporal lobe of 25 patients with epilepsy, we demonstrate the existence of local wake slow waves (LoWS) with key features of sleep slow waves, including a down-state of neuronal firing. Consistent with a reduction in neuronal activity, LoWS were associated with slowed cognitive processing. However, we also found that LoWS showed signatures of a homeostatic relationship with interictal epileptiform discharges (IEDs): exhibiting progressive adaptation during the build-up of network excitability before an IED and reducing the impact of subsequent IEDs on network excitability. We therefore propose an epilepsy homeostasis hypothesis: that slow waves in epilepsy reduce aberrant activity at the price of transient cognitive impairment.
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Affiliation(s)
- Laurent Sheybani
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Umesh Vivekananda
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Roman Rodionov
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Beate Diehl
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Fahmida A Chowdhury
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Andrew W McEvoy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Anna Miserocchi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - James A Bisby
- Division of Psychiatry, University College London, London, UK
| | - Daniel Bush
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
| | - Neil Burgess
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
- Institute of Cognitive Neuroscience, University College London, London, UK.
| | - Matthew C Walker
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
- NIHR University College London Hospitals Biomedical Research Centre, London, UK.
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Medvedeva TM, Sysoeva MV, Sysoev IV, Vinogradova LV. Intracortical functional connectivity dynamics induced by reflex seizures. Exp Neurol 2023; 368:114480. [PMID: 37454711 DOI: 10.1016/j.expneurol.2023.114480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 06/13/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
Functional connectivity analysis is gaining more interest due to its promising clinical applications. To study network mechanisms underlying seizure termination and postictal depression, we explore dynamics of interhemispheric functional connectivity near the offset of focal and bilateral seizures in the experimental model of reflex audiogenic epilepsy. In the model, seizures and spreading depression are induced by sound stimulation of genetically predisposed rodents. We characterize temporal evolution of seizure-associated coupling dynamics in the frontoparietal cortex during late ictal, immediate postictal and interictal resting states, using two measures applied to local field potentials recorded in awake epileptic rats. Signals were analyzed with mean phase coherence index in delta (1-4 Hz), theta (4-10 Hz) beta (10-25 Hz) and gamma (25-50 Hz) frequency bands and mutual information function. The study shows that reflex seizures elicit highly dynamic changes in interhemispheric functional coupling with seizure-, region- and frequency-specific patterns of increased and decreased connectivity during late ictal and immediate postictal periods. Also, secondary generalization of recurrent seizures (kindling) is associated with pronounced alterations in resting-state functional connectivity - an early wideband decrease and a subsequent beta-gamma increase. The findings show that intracortical functional connectivity is dynamically modified in response to seizures on short and long timescales, suggesting the existence of activity-dependent plastic network alterations that may promote or prevent seizure propagation within the cortex and underlie postictal behavioral impairments.
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Affiliation(s)
- Tatiana M Medvedeva
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - Marina V Sysoeva
- Yuri Gagarin State Technical University of Saratov, Saratov, Russia
| | - Ilya V Sysoev
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia; Saratov State University, Saratov, Russia
| | - Lyudmila V Vinogradova
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia.
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Chloride ion dysregulation in epileptogenic neuronal networks. Neurobiol Dis 2023; 177:106000. [PMID: 36638891 DOI: 10.1016/j.nbd.2023.106000] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/25/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
GABA is the major inhibitory neurotransmitter in the mature CNS. When GABAA receptors are activated the membrane potential is driven towards hyperpolarization due to chloride entry into the neuron. However, chloride ion dysregulation that alters the ionic gradient can result in depolarizing GABAergic post-synaptic potentials instead. In this review, we highlight that GABAergic inhibition prevents and restrains focal seizures but then reexamine this notion in the context of evidence that a static and/or a dynamic chloride ion dysregulation, that increases intracellular chloride ion concentrations, promotes epileptiform activity and seizures. To reconcile these findings, we hypothesize that epileptogenic pathologically interconnected neuron (PIN) microcircuits, representing a small minority of neurons, exhibit static chloride dysregulation and should exhibit depolarizing inhibitory post-synaptic potentials (IPSPs). We speculate that chloride ion dysregulation and PIN cluster activation may generate fast ripples and epileptiform spikes as well as initiate the hypersynchronous seizure onset pattern and microseizures. Also, we discuss the genetic, molecular, and cellular players important in chloride dysregulation which regulate epileptogenesis and initiate the low-voltage fast seizure onset pattern. We conclude that chloride dysregulation in neuronal networks appears to be critical for epileptogenesis and seizure genesis, but feed-back and feed-forward inhibitory GABAergic neurotransmission plays an important role in preventing and restraining seizures as well.
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Sun Y, Song Y, Ren H, Zhu H, Wang Y, Li X, Yan W, Wang Y. Synchronization clusters located on epileptic onset zones in neocortical epilepsy. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-022-00113-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Brain function is thought to rely on complex interactions of dynamic neural systems, which depend on the integrity of structural and functional networks. Focal epilepsy is considered to result from excessive focal synchronization in the network. Synchronization analysis of multichannel electrocorticography (ECoG) contributes to the understanding of and orientation of epilepsy. The aim of this study was to explore the synchronization in multichannel ECoG recordings from patients with neocortical epilepsy and characterize neural activity inside and outside the onset zone.
Methods
Four patients with neocortical epilepsy, who became seizure-free for more than 1 year after surgery guided by ECoG monitoring, were included in this study. ECoG data recorded during pre-surgical evaluation were analyzed. Synchronizations in phase and amplitude of different frequency bands between ECoG channels was analyzed using MATLAB. We generated 100 surrogate data from the original ECoG data using Amplitude Adjusted Fourier Transform to calculate the enhanced synchronization. The relationship between synchronization characteristics and seizure onset zone was analyzed.
Results
We found synchronization clusters in the 14–30 Hz and 30–80 Hz bands around the onset areas during both interictal and the beginning of ictal periods in all four patients.
Conclusions
The enhanced-synchronization clusters play a central role in epilepsy, and may activate the onset areas and contribute to the spreading of epileptiform activity.
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Slow oscillations anticipate interictal epileptic discharges. Clin Neurophysiol 2022; 139:128-129. [DOI: 10.1016/j.clinph.2022.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/23/2022]
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9
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Reply to “Slow oscillations anticipate interictal epileptic discharges”. Clin Neurophysiol 2022; 139:130-131. [DOI: 10.1016/j.clinph.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 11/22/2022]
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