4.8 Article

Human interictal epileptiform discharges are bidirectional traveling waves echoing ictal discharges

Journal

ELIFE
Volume 11, Issue -, Pages -

Publisher

eLIFE SCIENCES PUBL LTD
DOI: 10.7554/eLife.73541

Keywords

epilepsy; interictal epileptiform discharges; seizures; human; neurons; field potentials; Human

Categories

Funding

  1. National Institutes of Health NINDS [R21 NS113031, K23 NS114178]
  2. National Institutes of Health [S10 OD018211, R01 NS084142]
  3. American Epilepsy Society

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This study investigates the relationship between interictal epileptiform discharges (IEDs) and seizures. The findings demonstrate a spatiotemporal similarity between IEDs and ictal discharges, suggesting that the propagation of IEDs can provide useful information for localizing the seizure focus.
Interictal epileptiform discharges (IEDs), also known as interictal spikes, are large intermittent electrophysiological events observed between seizures in patients with epilepsy. Although they occur far more often than seizures, IEDs are less studied, and their relationship to seizures remains unclear. To better understand this relationship, we examined multi-day recordings of microelectrode arrays implanted in human epilepsy patients, allowing us to precisely observe the spatiotemporal propagation of IEDs, spontaneous seizures, and how they relate. These recordings showed that the majority of IEDs are traveling waves, traversing the same path as ictal discharges during seizures, and with a fixed direction relative to seizure propagation. Moreover, the majority of IEDs, like ictal discharges, were bidirectional, with one predominant and a second, less frequent antipodal direction. These results reveal a fundamental spatiotemporal similarity between IEDs and ictal discharges. These results also imply that most IEDs arise in brain tissue outside the site of seizure onset and propagate toward it, indicating that the propagation of IEDs provides useful information for localizing the seizure focus.

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