title: Human seizures couple across spatial scales through travelling wave dynamics.
abstract: Epilepsy-the propensity toward recurrent, unprovoked seizures-is a devastating disease affecting 65 million people worldwide. Understanding and treating this disease remains a challenge, as seizures manifest through mechanisms and features that span spatial and temporal scales. Here we address this challenge through the analysis and modelling of human brain voltage activity recorded simultaneously across microscopic and macroscopic spatial scales. We show that during seizure large-scale neural populations spanning centimetres of cortex coordinate with small neural groups spanning cortical columns, and provide evidence that rapidly propagating waves of activity underlie this increased inter-scale coupling. We develop a corresponding computational model to propose specific mechanisms-namely, the effects of an increased extracellular potassium concentration diffusing in space-that support the observed spatiotemporal dynamics. Understanding the multi-scale, spatiotemporal dynamics of human seizures-and connecting these dynamics to specific biological mechanisms-promises new insights to treat this devastating disease.
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: L-E
authors.initials: LE
authors.lastname: Martinet
authors.affiliation: Graduate Program in Neuroscience, Boston University, Boston, Massachusetts 02215, USA.
authors.forename: G
authors.initials: G
authors.lastname: Fiddyment
authors.affiliation: Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Madsen
authors.affiliation: Department of Neurosurgery and Nayef Al-Rodhan Laboratories for Cellular Neurosurgery and Neurosurgical Technology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: E N
authors.initials: EN
authors.lastname: Eskandar
authors.affiliation: Department of Neuroscience &Institute for Brain Science, Brown University, Providence, Rhode Island 02912, USA.|U.S. Department of Veterans Affairs, Center for Neurorestoration and Neurotechnology, Providence, Rhode Island 02912, USA.
authors.forename: W
authors.initials: W
authors.lastname: Truccolo
authors.affiliation: Department of Mathematics and Statistics, Boston University, Boston, Massachusetts 02215, USA.
authors.forename: U T
authors.initials: UT
authors.lastname: Eden
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Cash
authors.affiliation: Department of Mathematics and Statistics, Boston University, Boston, Massachusetts 02215, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Kramer
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000378:metabolism / Q000503:physiopathology*; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000378:metabolism / Q000503:physiopathology*; D005110:Extracellular Space / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009474:Neurons / Q000378:metabolism / Q000502:physiology*; D011188:Potassium / Q000378:metabolism; D012640:Seizures / Q000378:metabolism / Q000503:physiopathology*; D062211:Spatio-Temporal Analysis; D055815:Young Adult
chemical_list: D011188:Potassium