Tomlinson Samuel B, Kennedy Benjamin C, Marsh Eric D
Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Brain Commun. 2025 Apr 3;7(2):fcaf127. doi: 10.1093/braincomms/fcaf127. eCollection 2025.
Seizures are increasingly understood as emergent phenomena of complex, pathophysiologic networks. Interictal spikes are ubiquitous markers of paroxysmal synchronization in the epileptic brain and have been shown to co-activate between brain regions with millisecond-scale latencies, suggesting that they can spread through distributed networks of functionally inter-connected neuronal populations. In this study, we examined the relationship between interictal spike co-activation, seizure localization and resting-state EEG activity in children with medically refractory epilepsy. Twenty paediatric patients (mean age: 10.6 years) undergoing invasive EEG investigation with subdural electrodes were examined. Automated techniques were used to extract time-varying interictal spike co-activation networks from full-duration interictal recordings (mean: 108.6 h/patient). Networks were clustered into discrete node communities based on the conditional probability of spike co-activation. Patterns of regional and distributed interictal spike synchrony were investigated over time in relation to variables such as temporal proximity to nearest seizure and background oscillatory coherence. We demonstrate that the irritative neocortex comprises a network of semi-independent, highly cohesive communities with stereotyped local spike propagation patterns. Distributed coupling of spikes between communities was driven by outflow from the seizure onset zone and fluctuated over time in association with inter-regional coherence and temporal proximity to seizures. These results elucidate network dynamics facilitating pathologic hypersynchrony across the epileptic neocortex and further highlight the complex relationship between interictal epileptiform discharges and seizures.
癫痫发作越来越被理解为复杂病理生理网络的突发现象。发作间期棘波是癫痫大脑中阵发性同步的普遍标志，并且已被证明在脑区之间以毫秒级潜伏期共同激活，这表明它们可以通过功能相互连接的神经元群体的分布式网络传播。在本研究中，我们研究了药物难治性癫痫患儿发作间期棘波共同激活、癫痫灶定位与静息态脑电图活动之间的关系。对20例接受硬膜下电极侵入性脑电图检查的儿科患者（平均年龄：10.6岁）进行了检查。使用自动化技术从全时长发作间期记录（平均：108.6小时/患者）中提取随时间变化的发作间期棘波共同激活网络。根据棘波共同激活的条件概率将网络聚类为离散的节点群落。研究了区域和分布式发作间期棘波同步模式随时间与诸如距最近发作的时间接近度和背景振荡相干性等变量的关系。我们证明刺激性新皮层由具有刻板局部棘波传播模式的半独立、高度凝聚的群落网络组成。群落之间棘波的分布式耦合由癫痫发作起始区的流出驱动，并随时间波动，与区域间相干性和距发作的时间接近度相关。这些结果阐明了促进癫痫新皮层病理超同步的网络动力学，并进一步突出了发作间期癫痫样放电与癫痫发作之间的复杂关系。
