BRIEF RESEARCH REPORT article
Front. Netw. Physiol.
Sec. Networks in the Brain System
Volume 5 - 2025 | doi: 10.3389/fnetp.2025.1602124
This article is part of the Research TopicStimulation Strategies Targeting Plasticity Mechanisms in Diseased Brain NetworksView all 4 articles
Interictal Spikes and Evoked Cortical Potentials Share Common Spatiotemporal Constraints in Human Epilepsy
Provisionally accepted
Samuel B. Tomlinson1*
Patrick Davis2Caren Armstrong2,3Michael E. Baumgartner1Benjamin C. Kennedy1,4
Eric D. Marsh2,5,6- 1Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- 2Division of Neurology, Children's Hospital of Philadelphia, Philadlephia, Pennsylvania, United States
- 3Department of Neurology, School of Medicine, University of California, Davis, Sacramento, California, United States
- 4Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
- 5Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- 6Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Interictal epileptiform discharges (IEDs) are pathologic hallmarks of epilepsy which frequently arise and spread through networks of functionally-connected brain regions. Recent studies demonstrate that the sequential recruitment of brain regions by propagating IEDs is highly conserved across repeated discharges, suggesting that IED propagation is spatiotemporally constrained by features of the underlying epileptic network. Understanding how repetitive IED sequences relate to the spatiotemporal organization of the epileptic network may reveal key insights into the pathophysiological role of IEDs during epileptogenesis. Delivery of exogenous electrical current allows for direct experimental probing of epileptic network circuitry and correlation with spontaneous epileptiform activity (e.g., IEDs). In this pilot study of human subjects with refractory epilepsy, we performed cortical stimulation via invasive depth electrodes to test whether spatiotemporal patterns observed during spontaneous IEDs are reproduced by evoked cortical potentials. We found that evoked potentials were accentuated following stimulation of earlyactivating "upstream" IED regions (anterograde) and attenuated with stimulation of late-activating "downstream" IED regions (retrograde). Concordance between IED latencies and evoked potentials suggests that these distinct network phenomena share common spatiotemporal constraints in the human epileptic brain.
Keywords: Interictal epileptiform discharge, Epilepsy, seizure, network, stimulation
Received: 28 Mar 2025; Accepted: 08 May 2025.
Copyright: © 2025 Tomlinson, Davis, Armstrong, Baumgartner, Kennedy and Marsh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Samuel B. Tomlinson, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, Pennsylvania, United States
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