Predicting the spatiotemporal diversity of seizure
propagation and termination in human focal
, Viktor K. Jirsa
, Fabrice Bartolomei
, Maxime Guye
& Wilson Truccolo
Recent studies have shown that seizures can spread and terminate across brain areas via a
rich diversity of spatiotemporal patterns. In particular, while the location of the seizure onset
area is usually invariant across seizures in an individual patient, the source of traveling (2–3
Hz) spike-and-wave discharges during seizures can either move with the slower propagating
ictal wavefront or remain stationary at the seizure onset area. Furthermore, although many
focal seizures terminate synchronously across brain areas, some evolve into distinct ictal
clusters and terminate asynchronously. Here, we introduce a unifying perspective based on a
new neural ﬁeld model of epileptic seizure dynamics. Two main mechanisms, the
co-existence of wave propagation in excitable media and coupled-oscillator dynamics,
together with the interaction of multiple time scales, account for the reported diversity. We
conﬁrm our predictions in seizures and tractography data obtained from patients with
pharmacologically resistant epilepsy. Our results contribute toward patient-speciﬁc seizure
Department of Neuroscience, Brown University, Providence, RI 02912, USA.
Institute for Brain Science, Brown University, Providence, RI 02912, USA.
Center for Neurorestoration & Neurotechnology, U.S. Department of Veterans Affairs, Providence, RI 02912, USA.
Institut de Neurosciences des Systèmes
(INS), Inserm, Aix Marseille Univ, Marseille 13005, France.
CNRS, CRMBM UMR 7339, Aix Marseille Univ, Marseille 13005, France. Correspondence and
requests for materials should be addressed to W.T. (email: email@example.com)