Schroeder, GM; Diehl, B; Chowdhury, FA; Duncan, JS; de Tisi, J; Trevelyan, AJ; Forsyth, R; ... Wang, Y; + view all Schroeder, GM; Diehl, B; Chowdhury, FA; Duncan, JS; de Tisi, J; Trevelyan, AJ; Forsyth, R; Jackson, A; Taylor, PN; Wang, Y; - view fewer (2020) Seizure pathways change on circadian and slower timescales in individual patients with focal epilepsy. Proceedings of the National Academy of Sciences 10.1073/pnas.1922084117.

Preview

Text 1922084117.full.pdf - Published Version Download (2MB) | Preview

Abstract

Personalized medicine requires that treatments adapt to not only the patient but also changing factors within each individual. Although epilepsy is a dynamic disorder characterized by pathological fluctuations in brain state, surprisingly little is known about whether and how seizures vary in the same patient. We quantitatively compared within-patient seizure network evolutions using intracranial electroencephalographic (iEEG) recordings of over 500 seizures from 31 patients with focal epilepsy (mean 16.5 seizures per patient). In all patients, we found variability in seizure paths through the space of possible network dynamics. Seizures with similar pathways tended to occur closer together in time, and a simple model suggested that seizure pathways change on circadian and/or slower timescales in the majority of patients. These temporal relationships occurred independent of whether the patient underwent antiepileptic medication reduction. Our results suggest that various modulatory processes, operating at different timescales, shape within-patient seizure evolutions, leading to variable seizure pathways that may require tailored treatment approaches.

Download activity - last month

Export as JSONXMLCSV

Download activity - last 12 months

Export as JSONCSVXML

Downloads by country - last 12 months

Export as JSONCSVXML

Archive Staff Only

View Item