Interictal activity fluctuations follow rather than precede seizures on multiple time scales in a mouse model of focal cortical dysplasia

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Abstract The unpredictability of seizure occurrence is a major debilitating factor for people with epilepsy. A seizure forecasting system would greatly improve their quality of life. Successful seizure forecasting necessitates a comprehensive understanding of the factors influencing seizure timing at multiple temporal scales. In this study, we investigated multiscale properties of interictal epileptiform discharges (IEDs) and seizure parameters in a highly realistic mouse model of focal cortical dysplasia-related epilepsy. We analyzed the properties’ evolution at four timescales, ranging from epilepsy progression and seizure clusters to circadian and peri-ictal changes. We discovered that the FCD-related epilepsy syndrome was progressive in terms of interictal activity rate and seizure characteristics. Sixty percent of seizures occurred in clusters. During the clusters, the seizure duration, seizure power, and IED rate were increasing. Circadian rhythm influenced seizure occurrence with the peak seizure probability at 4 p.m. under a standard 12/12 light dark cycle with lights-on at 6 a.m. Peri-ictal analysis revealed no significant change in IED rate preceding individual seizures; however, a consistent two-peak pattern of IED elevation was observed following seizures. Specifically, an initial peak in IED rate emerged 5–10 minutes post-seizure, returning to baseline within two hours, followed by a secondary peak 6–12 hours later, which again subsided to baseline levels in 24–48 hours. This pattern could be fitted with a sum of three exponentials. Using the three-exponential pattern, we simulated IED rate fluctuations in each animal. The smoothed simulated IED rates showed good agreement with the smoothed real recorded IED rates, suggesting that the cumulative effect of post-ictal IED patterns can account for long-term fluctuations in IED rate. Our results indicate that, in our model of FCD-related epilepsy, consistent IED rate fluctuations follow rather than precede individual seizures. Therefore, fluctuations in IED rate can be viewed as a reflection of cyclic seizure occurrence. This implies that either IED rate fluctuations or accurate seizure records may be equally valuable for seizure risk forecasting. Highlights FCD-related epilepsy model displays a progressive nature and fluctuations between high and low seizure risk. Seizures occur with higher probability in the day time which corresponds to sleep-related seizures commonly occurring in human patients with FCD. IED rate increases significantly after seizures, indicating a postictal effect rather than a preictal one, with the post-ictal phase displaying a two-peak pattern of fast and slow IED rate increase. Long-term changes in the IED rate could be attributed to the time-dependent cumulative effect of the two-peak seizure-related increase in IED rate.

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