Active paradigms of seizure anticipation: computer model evidence for necessity of stimulation

It has been shown that the analysis of electroencephalographic (EEG) signals submitted to an appropriate external stimulation (active paradigm) is efficient with respect to anticipating epileptic seizures [S. Kalitzin, Clin. Neurophysiol. 116, 718 (2005)]. To better understand how an active paradigm is able to detect properties of EEG signals by means of which proictal states can be identified, we performed a simulation study using a computational model of seizure generation of a hippocampal network. Applying the active stimulation methodology, we investigated (i) how changes in model parameters that lead to a transition from the normal ongoing EEG to an ictal pattern are reflected in the properties of the simulated EEG output signals and (ii) how the evolution of neuronal excitability towards seizures can be reconstructed from EEG data using an active paradigm, rather than passively, using only ongoing EEG signals. The simulations indicate that a stimulation paradigm combined with appropriate analytical tools, as proposed here, may yield information about the change in excitability that precedes the transition to a seizure. Such information is apparently not fully reflected in the ongoing EEG activity. These findings give strong support to the development and application of active paradigms with the aim of predicting the occurrence of a transition to an epileptic seizure.