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A Novel Spatiotemporal Analysis of Peri-Ictal Spiking to Probe the Relation of Spikes and Seizures in Epilepsy

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Abstract

The relation between epileptic spikes and seizures is an important but still unresolved question in epilepsy research. Preclinical and clinical studies have produced inconclusive results on the causality or even on the existence of such a relation. We set to investigate this relation taking in consideration seizure severity and spatial extent of spike rate. We developed a novel automated spike detection algorithm based on morphological filtering techniques and then tested the hypothesis that there is a pre-ictal increase and post-ictal decrease of the spatial extent of spike rate. Peri-ictal (around seizures) spikes were detected from intracranial EEG recordings in 5 patients with temporal lobe epilepsy. The 94 recorded seizures were classified into two classes, based on the percentage of brain sites having higher or lower rate of spikes in the pre-ictal compared to post-ictal periods, with a classification accuracy of 87.4%. This seizure classification showed that seizures with increased pre-ictal spike rate and spatial extent compared to the post-ictal period were mostly (83%) clinical seizures, whereas no such statistically significant (α = 0.05) increase was observed peri-ictally in 93% of sub-clinical seizures. These consistent across patients results show the existence of a causal relation between spikes and clinical seizures, and imply resetting of the preceding spiking process by clinical seizures.

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Acknowledgments

This research was partially supported by research grants from NIH (R21 NS061310), NSF (Cyber Systems ECCS-1102390) and DoD (Concept Award PT090712).

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Authors and Affiliations

  1. Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

    Balu Krishnan

  2. Biomedical Engineering, College of Engineering and Science, Louisiana Tech University, Ruston, LA, USA

    Ioannis Vlachos & Leonidas Iasemidis

  3. Harrington Department of Biomedical Engineering, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA

    Aaron Faith

  4. Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA

    Steven Mullane

  5. Phoenix Children’s Hospital, Pediatric Neurology/Epilepsy, Phoenix, AZ, USA

    Korwyn Williams

  6. Cleveland Clinic Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA

    Andreas Alexopoulos

  7. Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, USA

    Leonidas Iasemidis

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  1. Balu Krishnan
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Correspondence to Balu Krishnan.

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Associate Editor K. A. Athanasiou oversaw the review of this article.

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Krishnan, B., Vlachos, I., Faith, A. et al. A Novel Spatiotemporal Analysis of Peri-Ictal Spiking to Probe the Relation of Spikes and Seizures in Epilepsy. Ann Biomed Eng 42, 1606–1617 (2014). https://doi.org/10.1007/s10439-014-1004-x

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