Noise induced quiescence of epileptic spike generation in patients with epilepsy

Clinical scalp electroencephalographic recordings from patients with epilepsy are distinguished by the presence of epileptic discharges i.e. spikes or sharp waves. These often occur randomly on a background of fluctuating potentials. The spike rate varies between different brain states (sleep and awake) and patients. Epileptogenic tissue and regions near these often show increased spike rates in comparison to other cortical regions. Several studies have shown a relation between spike rate and background activity although the underlying reason for this is still poorly understood. Both these processes, spike occurrence and background activity show evidence of being at least partly stochastic processes. In this study we show that epileptic discharges seen on scalp electroencephalographic recordings and background activity are driven at least partly by a common biological noise. Furthermore, our results indicate noise induced quiescence of spike generation which, in analogy with computational models of spiking, indicate spikes to be generated by transitions between semi-stable states of the brain, similar to the generation of epileptic seizure activity. The deepened physiological understanding of spike generation in epilepsy that this study provides could be useful in the electrophysiological assessment of different therapies for epilepsy including the effect of different drugs or electrical stimulation.