title: The role of resting state networks in focal neocortical seizures.
abstract: OBJECTIVE
  The role of resting state functional networks in epilepsy is incompletely understood. While some pathologic diagnoses have been shown to have maintained but altered resting state connectivity, others have implicated resting state connectivity in disease progression. However little is known about how these resting state networks influence the behavior of a focal neocortical seizure.
  
  
  METHODS
  Using data taken from invasively monitored patients with intractable focal neocortical epilepsy, we evaluated network connectivity (as determined by oscillatory covariance of the slow cortical potential (<0.5 Hz)) as it relates to neocortical seizure foci both in the interictal and ictal states.
  
  
  RESULTS
  Similar to what has been shown in the past for sleep and anesthesia, electophysiologic resting state networks that are defined by this slow cortical potential covariance maintain their topographic correlation structure throughout an ictal event. Moreover, in the context of focal epilepsy in which the seizure has a specific site of onset, seizure propagation is not chaotic or random. Rather, the seizure (reflected by an elevation of high frequency power) preferentially propagates along the network that contains the seizure onset zone.
  
  
  CONCLUSIONS
  Taken together, these findings further undergird the fundamental role of resting state networks, provide novel insights into the network-influenced behavior of seizures, and potentially identify additional targets for surgical disconnection including informing the location for the completion of multiple subpial transections (MSPTs).
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United States of America.
authors.forename: S Kathleen
authors.initials: SK
authors.lastname: Bandt
authors.affiliation: Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.
authors.forename: David T
authors.initials: DT
authors.lastname: Bundy
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United States of America.
authors.forename: Ammar H
authors.initials: AH
authors.lastname: Hawasli
authors.affiliation: Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America; Washington University School of Medicine, St. Louis, Missouri, United States of America; Department of Biomedical Engineering, Oxford University, Oxford, United Kingdom.
authors.forename: Kareem W
authors.initials: KW
authors.lastname: Ayoub
authors.affiliation: Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.
authors.forename: Mohit
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America; Washington University School of Medicine, St. Louis, Missouri, United States of America.
authors.forename: Carl D
authors.initials: CD
authors.lastname: Hacker
authors.affiliation: Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.
authors.forename: Mrinal
authors.initials: M
authors.lastname: Pahwa
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United States of America; Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America; Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, Missouri, United States of America.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Leuthardt
mesh_terms: D000328:Adult; D003344:Cortical Synchronization; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019579:Neocortex / Q000503:physiopathology*; D009415:Nerve Net / Q000503:physiopathology*; D012640:Seizures / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome