Abstracts

Rationale: Previous studies [Topolnik et al., Cereb Cortex 2003; 13: 883; Schindler et al., Brain 2007; 130: 65] indicate that the termination of focal onset seizures may be causally related to an increase of global neuronal correlation during the second half of the seizures. This increase was observed to occur earlier in complex partial seizures than in secondarily generalized seizures. We here address the question whether such an increase of neuronal correlation prior to seizure end is indeed a global phenomenon, involving both hemispheres or whether there are side-specific differences. Methods: We analyzed 20 focal onset seizures (10 complex partial, 10 secondarily generalized seizures) recorded in 13 patients who underwent presurgical evaluation of focal epilepsies of different origin. EEG was recorded intracranially from bilaterally implanted subdural strip and intrahippocampal depth electrodes. Utilizing a moving window approach, we investigated the evolution of the maximum cross correlation for all channel combinations during seizures. For each moving window the mean value of the maximum cross correlation (MCC) between all electrode contacts was computed separately for each hemisphere. After normalization of seizure durations, MCC values of the ipsi- and contralateral hemisphere for all seizures were determined. Results: We observed that the MCC of the contralateral hemisphere in complex partial seizures increased during the first half of the seizure, whereas, for the same time interval, the MCC of the ipsilateral hemisphere even declined below the level of the pre-seizure period. In contrast, no significant differences between both hemispheres could be observed for secondarily generalized seizures where both hemispheres showed a simultaneous increase of MCC during the second half of the seizures. The level of MCC for the contralateral hemisphere was higher for complex partial seizures than for secondarily generalized seizures during the first half of the seizure. Conclusions: Our findings indicate that there are indeed lateralized differences in the evolution of global neuronal correlation during complex partial and secondarily generalized seizures. The observed contralateral increase of neuronal correlation during complex partial seizures might indicate an emerging self-organizing mechanism for preventing the spread of seizure activity.