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Focal brain lesions such as cortical dysplasia and glioneural tumors generate epileptic activity and thus may be synaptically connected with normal cortex. To test this hypothesis, we compared event-related potentials recorded directly from the medial temporal lobe (MTL) and a dysplastic lesion in eight patients with intractable temporal lobe epilepsy. The P3 component, related to visual target detection, showed different peak latencies in four patients and a larger intralesional amplitude compared to established anterior-MTL-generators in two patients. Semantic processing was identified by the N400 component and showed a different latency in four patients and larger intralesional amplitudes in two patients. These results are compatible with the hypothesis that cortical lesions interact with synaptic pathways related to cognitive functions such as visual target detection, and verbal processing.

This overview summarizes findings obtained from analyzing electroencephalographic (EEG) recordings from epilepsy patients with methods from the theory of nonlinear dynamical systems. The last two decades have shown that nonlinear time series analysis techniques allow an improved characterization of epileptic brain states and help to gain deeper insights into the spatial and temporal dynamics of the epileptic process. Nonlinear EEG analyses can help to improve the evaluation of patients prior to neurosurgery, and with an unequivocal identification of precursors of seizures, they can be of great value in the development of seizure warning and prevention techniques. [ABSTRACT FROM AUTHOR]

The framework of the theory of nonlinear dynamics provides powerful concepts and algorithms to study complicated dynamics such as brain electrical activity (electroencephalogram, EEG). Although different influencing factors render the use of nonlinear measures in a strict sense problematic, converging evidence from various investigations now indicates that nonlinear EEG analysis provides a means to reliably characterize different states of physiological and pathophysiological brain function. We here focus on applications of nonlinear EEG analysis in epileptology. Epilepsy affects more than 50 million individuals worldwide – approximately 1% of the world's population. The disease is characterized by a recurrent and sudden malfunction of the brain that is termed seizure. Nonlinear EEG analysis techniques allow to reliably identify the seizure generating structure (epileptic focus) in different areas of the brain even during seizure-free intervals, to disentangle complex spatio-temporal interactions between the epileptic focus and other areas of the brain, and to define a specific state predictive of an impending seizure. Nonlinear EEG analysis provides supplementary information about the epileptogenic process in humans, contributes to an improvement of the presurgical evaluation of epilepsy patients, and offers a basis for the development of new therapy concepts for seizure prevention. [ABSTRACT FROM AUTHOR]

Summary: The First International Collaborative Workshop on Seizure Prediction was held at the Department of Epileptology, University of Bonn, in Bonn, Germany on April 24–28, 2002. Organized by the Universities of Pennsylvania and Bonn, and funded by grants from the American Epilepsy Society, the German Section of the International League against Epilepsy, and the German Section of the International Federation of Clinical Neurophysiology, the workshop was attended by 51 researchers from 16 centers in seven countries. There were four major goals for the workshop: (1) to host a one-day didactic session on the science of seizure prediction, with lectures by leaders in the field; (2) to assess the current state of the field by applying current methods used to predict seizures to a shared set of continuous intracranial EEG data and discussing the strengths and weaknesses of each approach; (3) to establish a consensus on minimal data requirements, a common nomenclature, and objective methods for comparing system performance across platforms and laboratories for seizure prediction research; and most importantly (4) to establish a multi-laboratory, international working group dedicated to understanding seizure generation and making on-line, prospective seizure prediction a reality. Following the didactic course, each participating group presented their results, after applying their seizure prediction methods to five common data sets agreed upon in advance and distributed before the meeting. What follows is a description of the shared data set used for analysis, a summary of the major discussion points from the workshop, and points of consensus among the group. The brief discussion serves as a common introduction to the research papers that follow in this issue, and the description of the shared data is referenced in each of these papers. Participants in the workshop are listed at the end of the Conclusions section, in alphabetical order. [Copyright &y& Elsevier]

We investigate assortativity of functional brain networks before, during, and after one-hundred epileptic seizures with different anatomical onset locations. We construct binary functional networks from multi-channel electroencephalographic data recorded from 60 epilepsy patients; and from time-resolved estimates of the assortativity coefficient, we conclude that positive degree-degree correlations are inherent to seizure dynamics. While seizures evolve, an increasing assortativity indicates a segregation of the underlying functional network into groups of brain regions that are only sparsely interconnected, if at all. Interestingly, assortativity decreases already prior to seizure end. Together with previous observations of characteristic temporal evolutions of global statistical properties and synchronizability of epileptic brain networks, our findings may help to gain deeper insights into the complicated dynamics underlying generation, propagation, and termination of seizures. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To test whether increasing synchronization of neuronal activity might be causally related to seizure termination. Methods: Neuronal synchronization was assessed by the relative changes of the eigenvalue spectrum of the equal-time correlation matrix computed from a short window sliding along multi-channel EEGs, recorded with either intracranial or surface electrodes. Results: Synchronization dynamics of six status epilepticus EEG recordings from six patients were assessed. In all six recordings EEG synchronization fluctuated around relatively low levels during ongoing epileptiform activity. Synchronization only persistently increased before, or in one case, at the end of status epilepticus. Ongoing seizure activity stopped without pharmacological intervention in one patient. In four of the five other cases, the persistent increase of synchronization followed administration of anticonvulsant drugs. Conclusions: Our findings support the hypothesis that increasing synchronization of neuronal activity may be considered as an emergent self-regulatory mechanism for seizure termination. Significance: The traditional concept is challenged that increasing neuronal synchronization during epileptic seizures is always pathological and should be suppressed. On the contrary, our findings imply that therapeutic interventions to increase synchronization during seizures might be beneficial. [Copyright &y& Elsevier]

Abstract: Debates on six controversial topics were held during the Fourth International Workshop on Seizure Prediction (IWSP4) convened in Kansas City, KS, USA, July 4–7, 2009. The topics were (1) Ictogenesis: Focus versus Network? (2) Spikes and Seizures: Step-relatives or Siblings? (3) Ictogenesis: A Result of Hyposynchrony? (4) Can Focal Seizures Be Caused by Excessive Inhibition? (5) Do High-Frequency Oscillations Provide Relevant Independent Information? (6) Phase Synchronization: Is It Worthwhile as Measured? This article, written by the IWSP4 organizing committee and the debaters, summarizes the arguments presented during the debates. [ABSTRACT FROM AUTHOR]

Abstract: Objective: An important issue in epileptology is the question whether information extracted from the EEG of epilepsy patients can be used for the prediction of seizures. Several studies have claimed evidence for the existence of a pre-seizure state that can be detected using different characterizing measures. In this paper, we evaluate the predictability of seizures by comparing the predictive performance of a variety of univariate and bivariate measures comprising both linear and non-linear approaches. Methods: We compared 30 measures in terms of their ability to distinguish between the interictal period and the pre-seizure period. After completely analyzing continuous inctracranial multi-channel recordings from five patients lasting over days, we used ROC curves to distinguish between the amplitude distributions of interictal and preictal time profiles calculated for the respective measures. We compared different evaluation schemes including channelwise and seizurewise analysis plus constant and adaptive reference levels. Particular emphasis was placed on statistical validity and significance. Results: Univariate measures showed statistically significant performance only in a channelwise, seizurewise analysis using an adaptive baseline. Preictal changes for these measures occurred 5–30min before seizures. Bivariate measures exhibited high performance values reaching statistical significance for a channelwise analysis using a constant baseline. Preictal changes were found at least 240min before seizures. Linear measures were found to perform similar or better than non-linear measures. Conclusions: Results provide statistically significant evidence for the existence of a preictal state. Based on our findings, the most promising approach for prospective seizure anticipation could be a combination of bivariate and univariate measures. Significance: Many measures reported capable of seizure prediction in earlier studies are found to be insignificant in performance, which underlines the need for statistical validation in this field. [Copyright &y& Elsevier]