Dissecting Epileptic and Cognitive Network Dysfunction in Epilepsy

Abstract

Abstract Cognitive and behavioral impairment can drastically affect the quality of life of patients with epilepsy, particularly when seizures appear in early childhood. Treating such deficits is therefore critical, and understanding the mechanisms involved is an important step toward this goal. Although seizures are believed to play a critical role in these deficits, the underlying etiology of the epilepsy may also directly affect brain function. Unfortunately, dissociating the impact of seizure activity from the impact of etiology is complex. Experimental strategies developed to make this dissociation consist of three levels of investigation: behavioral performance analysis, neural coding properties of epileptic networks, and organization of neuronal dynamics through brain rhythms and oscillations. From this strategy, evidence suggests that both seizures and cognitive deficits take their origin in a discoordination of epileptic networks, caused by GABAergic dysfunction and/or the abnormal presence of excitatory loops. Such network discoordination manifests itself in the form of abnormal rhythmical activity or of epileptiform activity. Restoring such rhythmopathies might be the focus of future therapeutic perspectives.