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Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG

Domantė Kučikienė1, Johannes Jungilligens2,3, Stefan Wolking1

  • 1Department of Epileptology and Neurology, RWTH Aachen University, Aachen, Germany.

Epilepsy & Behavior Reports
|August 4, 2025
PubMed
Summary

Functional/dissociative seizures (FDS) involve shorter EEG microstate durations, particularly microstate D, suggesting disrupted frontoparietal network activity. This supports theories of arousal-mediated network disruptions during FDS.

Keywords:
EEG microstatesFunctional neurological disorderFunctional/dissociative seizuresPsychogenic nonepileptic seizures

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Area of Science:

  • Neuroscience
  • Clinical Neurology
  • Psychiatry

Background:

  • The underlying pathophysiology of functional/dissociative seizures (FDS), also known as psychogenic nonepileptic seizures, is not fully understood.
  • Existing theories propose arousal-mediated disruptions in brain network dynamics affecting self-awareness and behavioral control during FDS.
  • Direct electrophysiological evidence supporting these theories is limited.

Purpose of the Study:

  • To explore ictal changes in electroencephalogram (EEG) microstates during functional/dissociative seizures (FDS).
  • To investigate EEG microstate dynamics as potential indicators of disrupted brain network activity in FDS.
  • To provide electrophysiological evidence for arousal-mediated network disruption theories in FDS.

Main Methods:

  • A pilot study involving 13 FDS patients.
  • Analysis of EEG microstates, defined as quasi-stable electrical activity patterns (50-70 ms duration).
  • Comparison of microstate characteristics (contribution, occurrence, global field power, duration) between baseline and ictal recordings.

Main Results:

  • Four microstates, resembling canonical maps A-D, showed high global explained variance (76.2%).
  • No significant differences were found in microstate contribution, occurrence, or global field power between baseline and ictal states.
  • A significant reduction in microstate duration was observed during FDS compared to baseline (p=0.007).
  • Microstate D duration showed a significant decrease during FDS (Cohen's d=0.75, p=0.044), potentially reflecting frontoparietal network changes.

Conclusions:

  • Shorter EEG microstate durations during FDS suggest altered brain network dynamics.
  • The findings support theories linking arousal-mediated disruptions in frontoparietal networks to reduced cognitive and behavioral control in FDS.
  • This pilot study provides preliminary electrophysiological evidence for the pathophysiology of FDS.