Microscale dynamics of electrophysiological markers of epilepsy

Clin Neurophysiol. 2021 Nov;132(11):2916-2931. doi: 10.1016/j.clinph.2021.06.024. Epub 2021 Aug 2.

Abstract

Objective: Interictal discharges (IIDs) and high frequency oscillations (HFOs) are established neurophysiologic biomarkers of epilepsy, while microseizures are less well studied. We used custom poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) microelectrodes to better understand these markers' microscale spatial dynamics.

Methods: Electrodes with spatial resolution down to 50 µm were used to record intraoperatively in 30 subjects. IIDs' degree of spread and spatiotemporal paths were generated by peak-tracking followed by clustering. Repeating HFO patterns were delineated by clustering similar time windows. Multi-unit activity (MUA) was analyzed in relation to IID and HFO timing.

Results: We detected IIDs encompassing the entire array in 93% of subjects, while localized IIDs, observed across < 50% of channels, were seen in 53%. IIDs traveled along specific paths. HFOs appeared in small, repeated spatiotemporal patterns. Finally, we identified microseizure events that spanned 50-100 µm. HFOs covaried with MUA, but not with IIDs.

Conclusions: Overall, these data suggest that irritable cortex micro-domains may form part of an underlying pathologic architecture which could contribute to the seizure network.

Significance: These results, supporting the possibility that epileptogenic cortex comprises a mosaic of irritable domains, suggests that microscale approaches might be an important perspective in devising novel seizure control therapies.

Keywords: High Frequency Oscillations; Interictal Discharges; Microelectrode.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Brain / physiopathology*
  • Brain / surgery
  • Brain Mapping / methods*
  • Electroencephalography / instrumentation
  • Electroencephalography / methods*
  • Epilepsy / diagnosis
  • Epilepsy / physiopathology*
  • Epilepsy / surgery
  • Female
  • Humans
  • Intraoperative Neurophysiological Monitoring / instrumentation
  • Intraoperative Neurophysiological Monitoring / methods*
  • Male
  • Microelectrodes*
  • Middle Aged
  • Young Adult