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Epileptic seizures are generally classified as either focal or generalized. It had been traditionally assumed that focal seizures imply localized brain abnormalities, whereas generalized seizures involve widespread brain pathologies. However, recent evidence suggests that large-scale brain networks are involved in the generation of focal seizures, and generalized seizures can originate in localized brain regions. Herein we study how network structure and tissue heterogeneities underpin the emergence of focal and widespread seizure dynamics. Mathematical modeling of seizure emergence in brain networks enables the clarification of the characteristics responsible for focal and generalized seizures. We consider neural mass network dynamics of seizure generation in exemplar synthetic networks and we measure the variance in ictogenicity across the network. Ictogenicity is defined as the involvement of network nodes in seizure activity, and its variance is used to quantify whether seizure patterns are focal or widespread across the network. We address both the influence of network structure and different excitability distributions across the network on the ictogenic variance. We find that this variance depends on both network structure and excitability distribution. High variance, i.e., localized seizure activity, is observed in networks highly heterogeneous with regard to the distribution of connections or excitabilities. However, networks that are both heterogeneous in their structure and excitability can underlie the emergence of generalized seizures, depending on the interplay between structure and excitability. Thus, our results imply that the emergence of focal and generalized seizures is underpinned by an interplay between network structure and excitability distribution.

The Role of Excitability and Network Structure in the Emergence of Focal and Generalized Seizures