The ictal wavefront is the spatiotemporal source of discharges during spontaneous human seizures

Elliot H. Smith, Jyun You Liou, Tyler S. Davis, Edward M. Merricks, Spencer S. Kellis, Shennan A. Weiss, Bradley Greger, Paul A. House, Guy M. McKhann, Robert R. Goodman, Ronald G. Emerson, Lisa M. Bateman, Andrew J. Trevelyan, Catherine A. Schevon

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


The extensive distribution and simultaneous termination of seizures across cortical areas has led to the hypothesis that seizures are caused by large-scale coordinated networks spanning these areas. This view, however, is difficult to reconcile with most proposed mechanisms of seizure spread and termination, which operate on a cellular scale. We hypothesize that seizures evolve into self-organized structures wherein a small seizing territory projects high-intensity electrical signals over a broad cortical area. Here we investigate human seizures on both small and large electrophysiological scales. We show that the migrating edge of the seizing territory is the source of travelling waves of synaptic activity into adjacent cortical areas. As the seizure progresses, slow dynamics in induced activity from these waves indicate a weakening and eventual failure of their source. These observations support a parsimonious theory for how large-scale evolution and termination of seizures are driven from a small, migrating cortical area.

Original languageEnglish (US)
Article number11098
JournalNature communications
StatePublished - Mar 29 2016

ASJC Scopus subject areas

  • General Chemistry
  • General Biochemistry, Genetics and Molecular Biology
  • General Physics and Astronomy


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