Slowing less than 1 Hz is decreased near the seizure onset zone

Focal slowing (<4 Hz) of brain waves is often associated with focal cerebral dysfunction and is assumed to be increased closest to the location of dysfunction. Prior work suggests that slowing may be comprised of at least two distinct neural mechanisms: slow oscillation activity (<1 Hz) may reflect primarily inhibitory cortical mechanisms while power in the delta frequency (1–4 Hz) may correlate with local synaptic strength. In focal epilepsy patients, we examined slow wave activity near and far from the seizure onset zone (SOZ) during wake, sleep, and postictal states using intracranial electroencephalography. We found that slow oscillation (0.3–1 Hz) activity was decreased near the SOZ, while delta activity (2–4 Hz) activity was increased. This finding was most prominent during sleep, and accompanied by a loss of long-range intra-hemispheric synchrony. In contrast to sleep, postictal slowing was characterized by a broadband increase of spectral power, and showed a reduced modulatory effect of slow oscillations on higher frequencies. These results suggest slow oscillation focal slowing is reduced near the seizure onset zone, perhaps reflecting reduced inhibitory activity. Dissociation between slow oscillation and delta slowing could help localize the seizure onset zone from interictal intracranial recordings.