In vivo Interictal Neuronal Signatures of Human Periventricular Nodular Heterotopia
AbstractPeriventricular nodular heterotopia (PNH) is a common type of malformation of cortical development and a cause of drug-resistant epilepsy. In contrast with other cortical malformations, no consistent interictal patterns have yet been identified in PNH, and it remains controversial whether epileptic activity originates within nodules. The current study addresses the heterogeneity in LFP signatures, as well as the question of epileptogenicity of nodules, by means of microelectrode recordings implanted within PNH tissues in two epileptic patients. Microelectrodes also allowed the first in vivo recording of heterotopic neurons in humans, permitting the investigation of neuronal firing rates during patterns of interictal activity. Highly consistent interictal patterns (IPs) were identified within PNH: 1) trains of periodic slow waves and 2) isolated slow deflections, both with superimposed fast activity, and 3) epileptic spikes. Neuron firing rates were significantly modulated during all IPs, suggesting that different IPs were generated by the same local neuronal populations. To conclude, this study presents the first in vivo microscopic description of local PNH microcircuits in humans and their organization into multiple epileptic neurophysiological patterns, providing a first pathognomonic signature of human PNH.