title: Exploring human epileptic activity at the single-neuron level.
abstract: Today, localization of the seizure focus heavily relies on EEG monitoring (scalp or intracranial). However, current technology enables much finer resolutions. The activity of hundreds of single neurons in the human brain can now be simultaneously explored before, during, and after a seizure or in association with an interictal discharge. This technology opens up new horizons to understanding epilepsy at a completely new level. This review therefore begins with a brief description of the basis of the technology, the microelectrodes, and the setup for their implantation in patients with epilepsy. Using these electrodes, recent studies provide novel insights into both the time domain and firing patterns of epileptic activity of single neurons. In the time domain, seizure-related activity may occur even minutes before seizure onset (in its current, EEG-based definition). Seizure-related neuronal interactions exhibit complex heterogeneous dynamics. In the seizure-onset zone, changes in firing patterns correlate with cell loss; in the penumbra, neurons maintain their spike stereotypy during a seizure. Hence, investigation of the extracellular electrical activity is expected to provide a better understanding of the mechanisms underlying the disease; it may, in the future, serve for a more accurate localization of the seizure focus; and it may also be employed to predict the occurrence of seizures prior to their behavioral manifestation in order to administer automatic therapeutic interventions.
authors.affiliation: Center for Study of Movement, Cognition and Mobility, Department of Neurology and Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel; Department of Neurology and Neurosurgery, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel. Electronic address: arielta@gmail.com.
authors.forename: Ariel
authors.initials: A
authors.lastname: Tankus
mesh_terms: D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D004569:Electroencephalography; D004827:Epilepsy / Q000503:physiopathology*; D006801:Humans; D008839:Microelectrodes; D008991:Monitoring, Physiologic; D009474:Neurons / Q000502:physiology*; D012640:Seizures / Q000503:physiopathology*
keywords: Epilepsy; Interictal activity; Microelectrode recordings; Neurophysiology; Postictal state; Seizure prediction; Single neurons