Ahmed Omar J, John Tibin T
Epilepsy Curr. 2019 Mar-Apr;19(2):115-116. doi: 10.1177/1535759719835349.
Loss of Neuronal Network Resilience Precedes Seizures and Determines the Ictogenic Nature of Interictal Synaptic Perturbations Chang WC, Kudlacek J, Hlinka J, et al. Nat Neurosci. 2018; 21(12):1742-1752. doi:10.1038/s41593-018-0278-y. PMID: 30482946. The mechanism of seizure emergence and the role of brief interictal epileptiform discharges (IEDs) in seizure generation are 2 of the most important unresolved issues in modern epilepsy research. We found that the transition to seizure is not a sudden phenomenon, but is instead a slow process that is characterized by the progressive loss of neuronal network resilience. From a dynamical perspective, the slow transition is governed by the principles of critical slowing, a robust natural phenomenon that is observable in systems characterized by transitions between dynamical regimes. In epilepsy, this process is modulated by synchronous synaptic input from IEDs. The IEDs are external perturbations that produce phasic changes in the slow transition process and exert opposing effects on the dynamics of a seizure-generating network, causing either antiseizure or proseizure effects. We found that the multifaceted nature of IEDs is defined by the dynamical state of the network at the moment of the discharge occurrence.
神经网络弹性丧失先于癫痫发作并决定发作间期突触扰动的致痫性质 张WC、库德拉克J、赫林卡J等。《自然神经科学》。2018年；21(12):1742 - 1752。doi:10.1038/s41593 - 018 - 0278 - y。PMID: 30482946。癫痫发作的出现机制以及短暂发作间期癫痫样放电（IEDs）在癫痫发作产生中的作用是现代癫痫研究中两个最重要的未解决问题。我们发现向癫痫发作的转变不是一个突然的现象，而是一个缓慢的过程，其特征是神经网络弹性的逐渐丧失。从动力学角度来看，这种缓慢转变受临界慢化原理支配，这是一种在以动力学状态转变为特征的系统中可观察到的强大自然现象。在癫痫中，这个过程由IEDs的同步突触输入调节。IEDs是外部扰动，在缓慢转变过程中产生阶段性变化，并对癫痫发作产生网络的动力学施加相反的影响，导致抗癫痫或促癫痫作用。我们发现IEDs的多方面性质由放电发生时刻网络的动力学状态定义。
