title: Dynamic Network Drivers of Seizure Generation, Propagation and Termination in Human Neocortical Epilepsy.
abstract: The epileptic network is characterized by pathologic, seizure-generating 'foci' embedded in a web of structural and functional connections. Clinically, seizure foci are considered optimal targets for surgery. However, poor surgical outcome suggests a complex relationship between foci and the surrounding network that drives seizure dynamics. We developed a novel technique to objectively track seizure states from dynamic functional networks constructed from intracranial recordings. Each dynamical state captures unique patterns of network connections that indicate synchronized and desynchronized hubs of neural populations. Our approach suggests that seizures are generated when synchronous relationships near foci work in tandem with rapidly changing desynchronous relationships from the surrounding epileptic network. As seizures progress, topographical and geometrical changes in network connectivity strengthen and tighten synchronous connectivity near foci-a mechanism that may aid seizure termination. Collectively, our observations implicate distributed cortical structures in seizure generation, propagation and termination, and may have practical significance in determining which circuits to modulate with implantable devices.
authors.affiliation: Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Ankit N
authors.initials: AN
authors.lastname: Khambhati
authors.affiliation: Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Davis
authors.affiliation: Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Oommen
authors.affiliation: Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Stephanie H
authors.initials: SH
authors.lastname: Chen
authors.affiliation: Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Lucas
authors.affiliation: Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Litt
authors.affiliation: Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Danielle S
authors.initials: DS
authors.lastname: Bassett
mesh_terms: D000200:Action Potentials; D003198:Computer Simulation; D004827:Epilepsy / Q000503:physiopathology*; D006801:Humans; D008959:Models, Neurological; D019579:Neocortex / Q000503:physiopathology*; D009415:Nerve Net / Q000503:physiopathology*; D009433:Neural Inhibition; D012640:Seizures / Q000503:physiopathology*; D009435:Synaptic Transmission