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Lookup NU author(s): Gabrielle Schroeder, Professor Andrew Trevelyan, Dr Rob ForsythORCiD, Professor Andrew Jackson, Professor Peter TaylorORCiD, Professor Yujiang WangORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Personalised medicine requires that treatments adapt to not only the patient, but changing factors within each individual. Although epilepsy is a dynamic disorder characterised by pathological fluctuations in brain state, surprisingly little is known about whether and how seizures vary in the same patient. We quantitatively compared within-patient seizure network evolutions using intracranial electroencephalographic (iEEG) recordings of over 500 seizures from 31 patients with focal epilepsy (mean 16.5 seizures/patient). In all patients, we found variability in seizure paths through the space of possible network dynamics.. Seizures with similar pathways tended to occur closer together in time, and a simple model suggested that seizure pathways change on circadian and/or slower timescales in the majority of patients. These temporal relationships occurred independent of whether the patient underwent antiepileptic medication reduction. Our results suggest that various modulatory processes, operating at different timescales, shape within-patient seizure evolutions, leading to variable seizure pathways that may require tailored treatment approaches.
Author(s): Schroeder GM, Diehl B, Chowdhury FA, Duncan JS, de Tisi J, Trevelyan A, Forsyth R, Jackson A, Taylor PN, Wang Y
Publication type: Article
Publication status: Published
Journal: Proceedings of the National Academy of Sciences of the United States of America
Year: 2020
Volume: 117
Issue: 20
Pages: 11048-11058
Print publication date: 19/05/2020
Online publication date: 04/05/2020
Acceptance date: 25/03/2020
Date deposited: 21/04/2020
ISSN (print): 0027-8424
ISSN (electronic): 1091-6490
Publisher: National Academy of Sciences
URL: https://doi.org/10.1073/pnas.1922084117
DOI: 10.1073/pnas.1922084117
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