Multiple Subcortical and Subcortico-Cortico Dynamic Network Reconfigurations Characterize Focal-To-Bilateral Tonic-Clonic Seizures

Authors

Shilpi Modi, Thomas Jefferson UniversityFollow
A. Ankeeta, Thomas Jefferson University
Walter Hinds, Thomas Jefferson UniversityFollow
Michael R. Sperling, Thomas Jefferson UniversityFollow
Xiaosong He, Thomas Jefferson UniversityFollow
Joseph I. Tracy, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

7-1-2025

Comments

This article is the author’s final published version in Scientific Reports, Volume 15, Issue 1, 2025, Article number 22182.

The published version is available at https://doi.org/10.1038/s41598-025-96418-4. Copyright © The Author(s) 2025.

Abstract

Temporal lobe epilepsy (TLE) is the most common focal epilepsy, with focal to bilateral tonic-clonic seizures (FBTCS+) a more severe form of the disorder. Evidence has underscored the critical role of the thalamus, mesial temporal region, basal ganglia and cerebellum, along with the cortex, in the propagation, termination, and modulation of seizure activity. We examined time variant patterns of interaction within and between 7 cortical and 4 subcortical systems in 55 healthy controls and 56 patients with TLE (n = 40 with FBTCS+ and 15 without), isolating those patterns most distinctive of FBTCS+ utilizing tools from dynamic network neuroscience on inter-ictal resting state fMRI data. A complex set of subcortio-cortico interactions appeared to support the secondary generalization characteristic of FBTCS+ status, specifically integrations involving the caudate and cereb-5 subcortical subsystems with the ventral attention network, suggesting motor and attention system communications are dysregulated. These abnormal subcortico-cortico dynamics were more prominent in current versus a remote history of FBTCS+. We concluded that the inter-ictal state provided a breeding ground for reconfiguring dynamic communication within and between multiple cortical-subcortical systems. These findings broaden our understanding of seizure propagation effects in TLE, pointing toward biomarkers that may mark the transition from focal seizures to the more severe form of TLE (FBTCS +).

Recommended Citation

Modi, Shilpi; Ankeeta, A.; Hinds, Walter; Sperling, Michael R.; He, Xiaosong; and Tracy, Joseph I., "Multiple Subcortical and Subcortico-Cortico Dynamic Network Reconfigurations Characterize Focal-To-Bilateral Tonic-Clonic Seizures" (2025). Department of Neurology Faculty Papers. Paper 370.
https://jdc.jefferson.edu/neurologyfp/370

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

40596625

Language

English