My Editor’s Choice

Professor Ulf Ziemann,Editor-in-Chief, Clinical Neurophysiology

Professor Ulf Ziemann
Editor-in-Chief, Clinical Neurophysiology

The Editor’s Choice—

Highly consistent temporal lobe interictal spike networks revealed from foramen ovale electrodes

Clinical Neurophysiology Volume 132, Issue 9 (September 2021)

Maharathi B, Patton J, Serafini A, Slavin K, Loeb JA (2021) Highly consistent temporal lobe interictal spike networks revealed from foramen ovale electrodes Clinical Neurophysiology 132: 2065–2074

Temporal lobe epilepsy (TLE) is one of the most prevalent types of drug-resistant epilepsy. Surgical removal of the epileptogenic zone can lead to seizure freedom in the large majority of patients. Good surgical outcome requires accurate location of the epileptogenic zone. Invasive methods such as stereo-EEG or subdural grid electrodes are usually necessary, as scalp EEG is largely insensitive to signals from the mesial temporal lobe. A less invasive approach to assess mesial temporal structures are foramen ovale (FO) electrodes. Growing evidence suggests that epilepsy is a disease of abnormal neuronal activity propagation in networks in the interictal state that predisposes the brain to seizures. In this issue of Clinical Neurophysiology, Maharathi and colleagues use long-term FO EEG recordings in 10 TLE patients to examine for the first time the propagation of interictal spikes, a hallmark of TLE. They employ a measure of functional connectivity, the direct directed transfer function, to discover highly reproducible and patient-specific interictal spike causal networks. Combined with high-resolution MRI, they show strong relationships between an individual’s unique interictal spike network and both structural brain abnormalities and seizure onset zones. Interictal spike connectivity is a novel approach to map epileptic networks that may have the potential to help advance surgical and non-invasive epilepsy treatments.

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