Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Department of Neurosurgery, Hospital Foundation Adolphe de Rothschild, Paris, France.
Nat Commun. 2024 Jun 17;15(1):5153. doi: 10.1038/s41467-024-48746-8.
Despite decades of research, we still do not understand how spontaneous human seizures start and spread - especially at the level of neuronal microcircuits. In this study, we used laminar arrays of micro-electrodes to simultaneously record the local field potentials and multi-unit neural activities across the six layers of the neocortex during focal seizures in humans. We found that, within the ictal onset zone, the discharges generated during a seizure consisted of current sinks and sources only within the infra-granular and granular layers. Outside of the seizure onset zone, ictal discharges reflected current flow in the supra-granular layers. Interestingly, these patterns of current flow evolved during the course of the seizure - especially outside the seizure onset zone where superficial sinks and sources extended into the deeper layers. Based on these observations, a framework describing cortical-cortical dynamics of seizures is proposed with implications for seizure localization, surgical targeting, and neuromodulation techniques to block the generation and propagation of seizures.
尽管经过了几十年的研究,我们仍然不了解自发性人类癫痫发作是如何开始和扩散的——尤其是在神经元微电路的水平上。在这项研究中,我们使用层状微电极阵列在人类局灶性癫痫发作期间同时记录大脑皮层六个层面的局部场电位和多单位神经活动。我们发现,在发作起始区内,发作期间产生的放电仅在亚颗粒层和颗粒层内产生电流汇和源。在发作起始区外,发作放电反映了上颗粒层内的电流流动。有趣的是,这些电流流动模式在发作过程中发生了演变——尤其是在发作起始区外,浅部汇和源延伸到更深的层面。基于这些观察结果,提出了一个描述癫痫发作的皮质-皮质动力学的框架,该框架对癫痫定位、手术靶点和神经调节技术具有重要意义,可以阻止癫痫的产生和传播。