Human seizures self-terminate across spatial scales via a critical transition

Mark A. Kramer, Wilson Truccolo, Uri T. Eden, Kyle Q. Lepage, Leigh R. Hochberg, Emad N. Eskandar, Joseph R. Madsen, Jong W. Leek, Atul Maheshwari, Eric Halgren, Catherine J. Chu, Sydney S. Cash

Research output: Contribution to journalArticle

94 Scopus citations

Abstract

Why seizures spontaneously terminate remains an unanswered fundamental question of epileptology. Here we present evidence that seizures self-terminate via a discontinuous critical transition or bifurcation. We show that human brain electrical activity at various spatial scales exhibits common dynamical signatures of an impending critical transition - slowing, increased correlation, and flickering - in the approach to seizure termination. In contrast, prolonged seizures (status epilepticus) repeatedly approach, but do not cross, the critical transition. To support these results, we implement a computationalmodel that demonstrates that alternative stable attractors, representing the ictal and postictal states,emulate the observed dynamics. These results suggest that self-terminating seizures end through a common dynamical mechanism. This description constrains the specific biophysical mechanisms underlying seizure termination, suggests a dynamical understanding of status epilepticus, anddemonstrates an accessible systemfor studying critical transitions in nature.

Original languageEnglish (US)
Pages (from-to)21116-21121
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Volume109
Issue number51
DOIs
StatePublished - Dec 18 2012
Externally publishedYes

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Keywords

  • Critical slowing down
  • Electrocorticogram
  • Epilepsy
  • Local field potential

ASJC Scopus subject areas

  • General

Cite this

Kramer, M. A., Truccolo, W., Eden, U. T., Lepage, K. Q., Hochberg, L. R., Eskandar, E. N., Madsen, J. R., Leek, J. W., Maheshwari, A., Halgren, E., Chu, C. J., & Cash, S. S. (2012). Human seizures self-terminate across spatial scales via a critical transition. Proceedings of the National Academy of Sciences of the United States of America, 109(51), 21116-21121. https://doi.org/10.1073/pnas.1210047110