Resolving the Micro-Macro Disconnect to Address Core Features of Seizure Networks

Neuron. 2019 Mar 20;101(6):1016-1028. doi: 10.1016/j.neuron.2019.01.043.

Abstract

Current drug treatments for epilepsy attempt to broadly restrict excitability to mask a symptom, seizures, with little regard for the heterogeneous mechanisms that underlie disease manifestation across individuals. Here, we discuss the need for a more complete view of epilepsy, outlining how key features at the cellular and microcircuit level can significantly impact disease mechanisms that are not captured by the most common methodology to study epilepsy, electroencephalography (EEG). We highlight how major advances in neuroscience tool development now enable multi-scale investigation of fundamental questions to resolve the currently controversial understanding of seizure networks. These findings will provide essential insight into what has emerged as a disconnect between the different levels of investigation and identify new targets and treatment options.

Keywords: EEG; epilepsy; hippocampus; imaging; inhibition; microcircuit; network; optogenetics; seizure; vascular.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain / physiopathology*
  • Electroencephalography
  • Epilepsy / diagnostic imaging
  • Epilepsy / physiopathology*
  • Hippocampus / diagnostic imaging
  • Hippocampus / physiopathology
  • Humans
  • Neural Inhibition
  • Neural Pathways / diagnostic imaging
  • Neural Pathways / physiopathology
  • Optogenetics
  • Seizures / diagnostic imaging
  • Seizures / physiopathology