1. Long-term seizure dynamics are determined by the nature of seizures and the mutual interactions between them.
- Author
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Kudlacek, Jan, Chvojka, Jan, Kumpost, Vojtech, Hermanovska, Barbora, Posusta, Antonin, Jefferys, John G.R., Maturana, Matias I., Novak, Ondrej, Cook, Mark J., Otahal, Jakub, Hlinka, Jaroslav, and Jiruska, Premysl
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TETANUS toxin , *TEMPORAL lobe epilepsy , *SEIZURES (Medicine) , *LIMBIC system , *PEOPLE with epilepsy - Abstract
The seemingly random and unpredictable nature of seizures is a major debilitating factor for people with epilepsy. An increasing body of evidence demonstrates that the epileptic brain exhibits long-term fluctuations in seizure susceptibility, and seizure emergence seems to be a consequence of processes operating over multiple temporal scales. A deeper insight into the mechanisms responsible for long-term seizure fluctuations may provide important information for understanding the complex nature of seizure genesis. In this study, we explored the long-term dynamics of seizures in the tetanus toxin model of temporal lobe epilepsy. The results demonstrate the existence of long-term fluctuations in seizure probability, where seizures form clusters in time and are then followed by seizure-free periods. Within each cluster, seizure distribution is non-Poissonian, as demonstrated by the progressively increasing inter-seizure interval (ISI), which marks the approaching cluster termination. The lengthening of ISIs is paralleled by: increasing behavioral seizure severity, the occurrence of convulsive seizures, recruitment of extra-hippocampal structures and the spread of electrographic epileptiform activity outside of the limbic system. The results suggest that repeated non-convulsive seizures obey the 'seizures-beget-seizures' principle, leading to the occurrence of convulsive seizures, which decrease the probability of a subsequent seizure and, thus, increase the following ISI. The cumulative effect of repeated convulsive seizures leads to cluster termination, followed by a long inter-cluster period. We propose that seizures themselves are an endogenous factor that contributes to long-term fluctuations in seizure susceptibility and their mutual interaction determines the future evolution of disease activity. • Seizure occurrence is determined by processes operating over long temporal scales. • The 'seizures beget seizures' principle contributes to seizure clustering. • Seizure severity and spatial expansion of epileptic activity determine the probability of future seizure occurrence. • Seizure clustering may be exclusively governed by seizures themselves, with no external contributing factors. • Intra-cluster evolution of seizure properties is accompanied by changes in interictal activity. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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