Department of Developmental Epileptology, Institute of Physiology, Academy of Sciences of Czech Republic, Prague 4-Krc, Czech Republic.
J Physiol. 2013 Feb 15;591(4):787-97. doi: 10.1113/jphysiol.2012.239590. Epub 2012 Nov 26.
Epilepsy has been historically seen as a functional brain disorder associated with excessive synchronization of large neuronal populations leading to a hypersynchronous state. Recent evidence showed that epileptiform phenomena, particularly seizures, result from complex interactions between neuronal networks characterized by heterogeneity of neuronal firing and dynamical evolution of synchronization. Desynchronization is often observed preceding seizures or during their early stages; in contrast, high levels of synchronization observed towards the end of seizures may facilitate termination. In this review we discuss cellular and network mechanisms responsible for such complex changes in synchronization. Recent work has identified cell-type-specific inhibitory and excitatory interactions, the dichotomy between neuronal firing and the non-local measurement of local field potentials distant to that firing, and the reflection of the neuronal dark matter problem in non-firing neurons active in seizures. These recent advances have challenged long-established views and are leading to a more rigorous and realistic understanding of the pathophysiology of epilepsy.
癫痫在历史上被视为一种功能性脑疾病，与大量神经元群体过度同步有关，导致超同步状态。最近的证据表明，癫痫样现象，特别是癫痫发作，是由神经元网络之间的复杂相互作用引起的，其特征是神经元放电的异质性和同步的动态演变。去同步通常发生在癫痫发作之前或早期；相反，在癫痫发作结束时观察到的高水平同步可能有助于终止。在这篇综述中，我们讨论了导致这种复杂同步变化的细胞和网络机制。最近的工作已经确定了细胞类型特异性的抑制性和兴奋性相互作用、神经元放电与远离该放电的局部场电位的非局部测量之间的二分法，以及在癫痫发作中活跃的非放电神经元中神经元暗物质问题的反映。这些新的进展挑战了长期存在的观点，正在导致对癫痫病理生理学的更严格和现实的理解。
