Interictal spikes have been used to diagnose idiopathic seizure disorder and localize the seizure onset zone. Interictal spikes are thought to arise primarily from large excitatory postsynaptic potentials, and the role of interictal spikes in idiopathic seizure disorder and epileptogenesis remains unclear. We evaluated how local voltage changes due to interictal spikes impact action potential generation and firing using intracellular recordings from human tissue and the Hodgkin-Huxley model. During interictal spikes, bursts of action potentials underwent variable degrees of depolarization-induced inactivation in the intracellular data. Intracellular recordings in neocortical slices of human brain tissue confirmed that bursts of inactivated action potentials occurred during spontaneous paroxysmal depolarization shifts. These ex vitro findings were predicted using the Hodgkin-Huxley model and showed inactivated action potentials being generated by large depolarizations. As the amplitude of the interictal spike increased, there was a progression from low firing rate normal action potentials to higher firing rate normal action potentials to inactivated action potentials. The results show that the Hodgkin-Huxley model confirmed the effect of large interictal spike depolarizations on action potential firing and inactivation. This supports a key element in the hypothesis that interictal spikes, and the associated action potential firing, may alter the electrical environment of the brain and contribute to idiopathic seizure disorder.
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