Why seizures spontaneously terminate remains an unanswered fundamental question of epileptology. Here we present evidence that seizures self-terminate via a discontinuous critical transition or bifurcation. We show that human brain electrical activity at various spatial scales exhibits common dynamical signatures of an impending critical transition-slowing, increased correlation, and flickering-in the approach to seizure termination. In contrast, prolonged seizures (status epilepticus) repeatedly approach, but do not cross, the critical transition. To support these results, we implement a computational model that demonstrates that alternative stable attractors, representing the ictal and postictal states, emulate the observed dynamics. These results suggest that self-terminating seizures end through a common dynamical mechanism. This description constrains the specific biophysical mechanisms underlying seizure termination, suggests a dynamical understanding of status epilepticus, and demonstrates an accessible system for studying critical transitions in nature.critical slowing down | epilepsy | electrocorticogram | local field potential A lthough extensive observations and research have elucidated some mechanism of seizure initiation and maintenance, how seizures spontaneously terminate remains one of the most important, but still unanswered, questions in epileptology (1). Some of the potential mechanisms of seizure termination (2) include glutamate depletion (3), dynamic changes in ion concentrations (4-6), persistent activation of a hyperpolarization-activated cation conductance (7), changing synaptic effectiveness (5, 8), modulatory effects from subcortical structures and the cerebellum (9), and reduced pH (10). Together, these studies suggest distinct pathways to seizure termination through specific biophysical mechanisms.We propose here a dynamical understanding of seizure termination that encompasses and constrains these and other hypothesized biophysical mechanisms. Specifically, we propose that focal seizures with secondary generalization terminate in a manner consistent with crossing a critical transition or bifurcation in which the system traverses a critical threshold and shifts suddenly to an alternative, attracting dynamical regime (11). Such regime shifts between alternative stable states have been described in many real-world systems (12-14) and exhibit a repertoire of early warning indicators (15-17). The seizing brain provides a unique living system for studying the signatures of an impending critical transition as well as one in which interventions can have profound practical import.We characterize the features of seizure termination in both multiscale in vivo data from patients with epilepsy and a computational model of cortical field activity. We show that population electrical activity-observed at macroscopic spatial scales-exhibits numerous signatures of an impending critical transition, whereas spatially localized recordings of neural spiking activity possess different dynamics. These insi...

The polyomavirus JC (JCV) is the etiologic agent of progressive multifocal leukoencephalopathy (PML) and of JCV granule cell neuronopathy(JCV GCN). We present an HIV-negative patient who developed multiple cortical lesions, aphasia and progressive cognitive decline after chemotherapy for non-small-cell lung cancer. Brain biopsy and CSF PCR demonstrated JCV and she had a rapidly fatal outcome. Post-mortem analysis showed diffuse cortical lesions and areas of necrosis at the graywhite junction. Immunostaining revealed a productive JCV-infection of cortical pyramidal neurons, confirmed by electron microscopy, with limited demyelination. This novel gray matter syndrome expands the scope of JCV clinical presentation and pathogenesis.

Allosteric modification of ligand binding is central to LacI transcription control. Recently, the conformational change between LacI operator- and inducer-bound states was simulated with targeted molecular dynamics (TMD) [Flynn, T. C., Swint-Kruse, L., Kong, Y., Booth, C., Matthews, K. S., and Ma, J. (2003) Protein Sci., 12, 2523-2541]. Atomic-level analyses of TMD results indicate the structural importance of the core pivot region that connects the N- and C-subdomains flanking the inducer-binding site. Further, a number of LacI mutations in the core pivot have been identified recently by their altered behaviors in phenotypic screens. Biochemical characterization of three of these variants-L148F, S151P, and P320A-provides an opportunity to directly explore the role of the core pivot in repressor function. For L148F, inducer IPTG binding affinity is strengthened, whereas O(1) operator DNA binding is diminished approximately 30-fold. In contrast, O(1) binding is increased for S151P, whereas IPTG binding is decreased. UV-difference spectroscopy and urea denaturation indicate long-range effects in both variants. Interestingly, P320A binds to DNA approximately 4-fold more tightly than wild-type, yet inducer binding is unaffected. To examine linkage between the core pivot and DNA binding domains, the L148F substitution was combined with Q60G, a previously known mutant with enhanced operator affinity. The double mutant exhibits the properties of both parent proteins, resulting in near wild-type DNA binding affinity and enhanced inducer sensitivity. These features may render Q60G/L148F more cost-effective in technological applications than wild-type repressor. As a group, the behaviors of the core pivot mutants are consistent with the allosteric structural role predicted for this region by TMD and reflect the significant long-range impact that single substitutions can elicit on protein function.

Paradoxical seizure exacerbation by anti-epileptic medication is a well-known clinical phenomenon in epilepsy, but the cellular mechanisms remain unclear. One possibility is enhanced network disinhibition by unintended suppression of inhibitory interneurons. We investigated this hypothesis in the stargazer mouse model of absence epilepsy, which bears a mutation in stargazin, an AMPA receptor trafficking protein. If AMPA signaling onto inhibitory GABAergic neurons is impaired, their activation by glutamate depends critically upon NMDA receptors. Indeed, we find that stargazer seizures are exacerbated by NMDA receptor blockade with CPP (3-[(R)-2-carboxypiperazin-4-yl]-prop-2-enyl-1-phosphonic acid) and MK-801, whereas other genetic absence epilepsy models are sensitive to these antagonists. To determine how an AMPA receptor trafficking defect could lead to paradoxical network activation, we analyzed stargazin and AMPA receptor localization and found that stargazin is detected exclusively in parvalbumin-positive (PV +) fast-spiking interneurons in somatosensory cortex, where it is co-expressed with the AMPA receptor subunit GluA4. PV + cortical interneurons in stargazer show a near twofold decrease in the dendrite:soma GluA4 expression ratio compared to wild-type (WT) littermates. We explored the functional consequence of this trafficking defect on network excitability in neocortical slices. Both NMDA receptor antagonists suppressed 0 Mg 2 +-induced network discharges in WT but augmented bursting in stargazer cortex. Interneurons mediate this paradoxical response, since the difference between genotypes was masked by GABA receptor blockade. Our findings provide a cellular locus for AMPA receptor-dependent signaling defects in stargazer cortex and define an interneuron-dependent mechanism for paradoxical seizure exacerbation in absence epilepsy.