Respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case report

Abstract Background Brain activity in focal epilepsy is marked by a pronounced excitation-inhibition (E:I) imbalance and interictal epileptiform discharges (IEDs) observed in periods between recurrent seizures. As a marker of E:I balance, aperiodic neural activity and its underlying 1/f characterist...

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Main Authors: Daniel S. Kluger, Tim Erdbrügger, Christina Stier, Malte B. Höltershinken, Omid Abbasi, Martina Saltafossi, Kanjana Unnwongse, Tim Wehner, Jörg Wellmer, Joachim Gross, Carsten H. Wolters
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00811-z
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author Daniel S. Kluger
Tim Erdbrügger
Christina Stier
Malte B. Höltershinken
Omid Abbasi
Martina Saltafossi
Kanjana Unnwongse
Tim Wehner
Jörg Wellmer
Joachim Gross
Carsten H. Wolters
author_facet Daniel S. Kluger
Tim Erdbrügger
Christina Stier
Malte B. Höltershinken
Omid Abbasi
Martina Saltafossi
Kanjana Unnwongse
Tim Wehner
Jörg Wellmer
Joachim Gross
Carsten H. Wolters
author_sort Daniel S. Kluger
collection DOAJ
description Abstract Background Brain activity in focal epilepsy is marked by a pronounced excitation-inhibition (E:I) imbalance and interictal epileptiform discharges (IEDs) observed in periods between recurrent seizures. As a marker of E:I balance, aperiodic neural activity and its underlying 1/f characteristic reflect the dynamic interplay of excitatory and inhibitory currents. Recent studies have independently assessed 1/f changes both in epilepsy and in the context of body-brain interactions in neurotypical individuals where the respiratory rhythm has emerged as a potential modulator of excitability states in the brain. Methods Here, we investigate respiration phase-locked modulations of E:I balance and their involvement in the timing of spike discharges in a case report of a 25 year-old focal epilepsy patient using magnetoencephalography (MEG). Results We show that i) respiration differentially modulates E:I balance in focal epilepsy compared to N = 40 neurotypical controls and ii) IED timing depends on both excitability and respiratory states. Conclusions These findings overall suggest an intricate interplay of respiration phase-locked changes in excitation and the consequential susceptibility for IED generation and we hope they will spark interest in subsequent work on body-brain coupling and E:I balance in epilepsy.
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spelling doaj-art-133dce511b7e409bbc19ed25ff965ca52025-08-20T03:10:08ZengNature PortfolioCommunications Medicine2730-664X2025-04-01511710.1038/s43856-025-00811-zRespiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case reportDaniel S. Kluger0Tim Erdbrügger1Christina Stier2Malte B. Höltershinken3Omid Abbasi4Martina Saltafossi5Kanjana Unnwongse6Tim Wehner7Jörg Wellmer8Joachim Gross9Carsten H. Wolters10Institute for Biomagnetism and Biosignal Analysis, University of MünsterInstitute for Biomagnetism and Biosignal Analysis, University of MünsterInstitute for Biomagnetism and Biosignal Analysis, University of MünsterInstitute for Biomagnetism and Biosignal Analysis, University of MünsterInstitute for Biomagnetism and Biosignal Analysis, University of MünsterInstitute for Biomagnetism and Biosignal Analysis, University of MünsterRuhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr-University BochumRuhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr-University BochumRuhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr-University BochumInstitute for Biomagnetism and Biosignal Analysis, University of MünsterInstitute for Biomagnetism and Biosignal Analysis, University of MünsterAbstract Background Brain activity in focal epilepsy is marked by a pronounced excitation-inhibition (E:I) imbalance and interictal epileptiform discharges (IEDs) observed in periods between recurrent seizures. As a marker of E:I balance, aperiodic neural activity and its underlying 1/f characteristic reflect the dynamic interplay of excitatory and inhibitory currents. Recent studies have independently assessed 1/f changes both in epilepsy and in the context of body-brain interactions in neurotypical individuals where the respiratory rhythm has emerged as a potential modulator of excitability states in the brain. Methods Here, we investigate respiration phase-locked modulations of E:I balance and their involvement in the timing of spike discharges in a case report of a 25 year-old focal epilepsy patient using magnetoencephalography (MEG). Results We show that i) respiration differentially modulates E:I balance in focal epilepsy compared to N = 40 neurotypical controls and ii) IED timing depends on both excitability and respiratory states. Conclusions These findings overall suggest an intricate interplay of respiration phase-locked changes in excitation and the consequential susceptibility for IED generation and we hope they will spark interest in subsequent work on body-brain coupling and E:I balance in epilepsy.https://doi.org/10.1038/s43856-025-00811-z
spellingShingle Daniel S. Kluger
Tim Erdbrügger
Christina Stier
Malte B. Höltershinken
Omid Abbasi
Martina Saltafossi
Kanjana Unnwongse
Tim Wehner
Jörg Wellmer
Joachim Gross
Carsten H. Wolters
Respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case report
Communications Medicine
title Respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case report
title_full Respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case report
title_fullStr Respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case report
title_full_unstemmed Respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case report
title_short Respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy: a case report
title_sort respiratory modulations of cortical excitability and interictal spike timing in focal epilepsy a case report
url https://doi.org/10.1038/s43856-025-00811-z
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