Schroeder Gabrielle M, Karoly Philippa J, Maturana Matias, Panagiotopoulou Mariella, Taylor Peter N, Cook Mark J, Wang Yujiang
CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne NE4 5TG, UK.
Graeme Clark Institute and St Vincent's Hospital, University of Melbourne, Parkville, Victoria 3010, Australia.
Brain Commun. 2023 Jul 19;5(5):fcad205. doi: 10.1093/braincomms/fcad205. eCollection 2023.
Many biological processes are modulated by rhythms on circadian and multidien timescales. In focal epilepsy, various seizure features, such as spread and duration, can change from one seizure to the next within the same patient. However, the specific timescales of this variability, as well as the specific seizure characteristics that change over time, are unclear. Here, in a cross-sectional observational study, we analysed within-patient seizure variability in 10 patients with chronic intracranial EEG recordings (185-767 days of recording time, 57-452 analysed seizures/patient). We characterized the seizure evolutions as sequences of a finite number of patient-specific functional seizure network states. We then compared seizure network state occurrence and duration to (1) time since implantation and (2) patient-specific circadian and multidien cycles in interictal spike rate. In most patients, the occurrence or duration of at least one seizure network state was associated with the time since implantation. Some patients had one or more seizure network states that were associated with phases of circadian and/or multidien spike rate cycles. A given seizure network state's occurrence and duration were usually not associated with the same timescale. Our results suggest that different time-varying factors modulate within-patient seizure evolutions over multiple timescales, with separate processes modulating a seizure network state's occurrence and duration. These findings imply that the development of time-adaptive treatments in epilepsy must account for several separate properties of epileptic seizures and similar principles likely apply to other neurological conditions.
许多生物过程受到昼夜节律和多日时间尺度上的节律调节。在局灶性癫痫中,同一患者的不同发作之间,各种发作特征,如扩散和持续时间,可能会发生变化。然而,这种变异性的具体时间尺度以及随时间变化的具体发作特征尚不清楚。在此,我们进行了一项横断面观察性研究,分析了10例慢性颅内脑电图记录患者的患者内发作变异性(记录时间为185 - 767天,每位患者分析57 - 452次发作)。我们将发作演变特征化为有限数量的患者特异性功能性发作网络状态序列。然后,我们将发作网络状态的发生和持续时间与(1)植入后的时间以及(2)发作间期棘波率的患者特异性昼夜节律和多日周期进行比较。在大多数患者中,至少一种发作网络状态的发生或持续时间与植入后的时间相关。一些患者有一个或多个与昼夜节律和/或多日棘波率周期阶段相关的发作网络状态。给定发作网络状态的发生和持续时间通常与同一时间尺度无关。我们的结果表明,不同的随时间变化的因素在多个时间尺度上调节患者内的发作演变,有不同的过程调节发作网络状态的发生和持续时间。这些发现意味着癫痫中时间适应性治疗的发展必须考虑癫痫发作的几个不同特性,并且类似原则可能适用于其他神经系统疾病。