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

The pathophysiology of functional/dissociative seizures (FDS), also known as psychogenic nonepileptic seizures, remains incompletely understood. Current theories suggest that ictal changes in self-awareness and behavioural control are likely related to arousal-mediated disruptions of brain network d...

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Main Authors: Domantė Kučikienė, Johannes Jungilligens, Stefan Wolking, Yvonne Weber, Jörg Wellmer, Stoyan Popkirov
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Epilepsy & Behavior Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589986425000693
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author Domantė Kučikienė
Johannes Jungilligens
Stefan Wolking
Yvonne Weber
Jörg Wellmer
Stoyan Popkirov
author_facet Domantė Kučikienė
Johannes Jungilligens
Stefan Wolking
Yvonne Weber
Jörg Wellmer
Stoyan Popkirov
author_sort Domantė Kučikienė
collection DOAJ
description The pathophysiology of functional/dissociative seizures (FDS), also known as psychogenic nonepileptic seizures, remains incompletely understood. Current theories suggest that ictal changes in self-awareness and behavioural control are likely related to arousal-mediated disruptions of brain network dynamics, but direct electrophysiological evidence is scarce. In a proof-of-concept, the second of its kind pilot study, we explored ictal changes in EEG microstates – quasi-stable patterns of electrical activity of 50–70 ms duration that represent fundamental building blocks of large-scale brain network dynamics. Across a sample of 13 FDS patients, four microstates yielded a high mean global explained variance of 76.2 % and qualitatively resembled the well-established “canonical” microstate map topographies A-D. Repeated measure analysis of variance did not reveal any significant differences in contribution, occurrence or global field power of microstates between baseline and ictal recordings. Microstate duration, however, was significantly different between baseline and seizure recordings with shorter durations of microstates in FDS (p = 0.007). This was most pronounced for microstate D (Cohen’s d = 0.75) with the change being significant in an exploratory post hoc paired t-test (p = 0.044). Since microstate D is thought to reflect frontoparietal network activity, the findings of this pilot study can be interpreted as supportive of current theories of arousal-mediated disruptions of network activity that reduce cognitive and behavioural control during FDS.
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spelling doaj-art-f824e1029a4a40b3af39f93a0a151a362025-08-20T03:35:44ZengElsevierEpilepsy & Behavior Reports2589-98642025-09-013110080910.1016/j.ebr.2025.100809Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstatesDomantė Kučikienė0Johannes Jungilligens1Stefan Wolking2Yvonne Weber3Jörg Wellmer4Stoyan Popkirov5Department of Epileptology and Neurology, RWTH Aachen University, Aachen, GermanyDepartment of Neurology, University Hospital Knappschaft Kliniken Bochum, Bochum, Germany; Ruhr-Epileptology, Department of Neurology, Knappschaft Kliniken University Hospital Bochum, Bochum, GermanyDepartment of Epileptology and Neurology, RWTH Aachen University, Aachen, GermanyDepartment of Epileptology and Neurology, RWTH Aachen University, Aachen, GermanyRuhr-Epileptology, Department of Neurology, Knappschaft Kliniken University Hospital Bochum, Bochum, GermanyDepartment of Neurology and Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Hospital Essen, Essen, GermanyThe pathophysiology of functional/dissociative seizures (FDS), also known as psychogenic nonepileptic seizures, remains incompletely understood. Current theories suggest that ictal changes in self-awareness and behavioural control are likely related to arousal-mediated disruptions of brain network dynamics, but direct electrophysiological evidence is scarce. In a proof-of-concept, the second of its kind pilot study, we explored ictal changes in EEG microstates – quasi-stable patterns of electrical activity of 50–70 ms duration that represent fundamental building blocks of large-scale brain network dynamics. Across a sample of 13 FDS patients, four microstates yielded a high mean global explained variance of 76.2 % and qualitatively resembled the well-established “canonical” microstate map topographies A-D. Repeated measure analysis of variance did not reveal any significant differences in contribution, occurrence or global field power of microstates between baseline and ictal recordings. Microstate duration, however, was significantly different between baseline and seizure recordings with shorter durations of microstates in FDS (p = 0.007). This was most pronounced for microstate D (Cohen’s d = 0.75) with the change being significant in an exploratory post hoc paired t-test (p = 0.044). Since microstate D is thought to reflect frontoparietal network activity, the findings of this pilot study can be interpreted as supportive of current theories of arousal-mediated disruptions of network activity that reduce cognitive and behavioural control during FDS.http://www.sciencedirect.com/science/article/pii/S2589986425000693Functional/dissociative seizuresPsychogenic nonepileptic seizuresFunctional neurological disorderEEG microstates
spellingShingle Domantė Kučikienė
Johannes Jungilligens
Stefan Wolking
Yvonne Weber
Jörg Wellmer
Stoyan Popkirov
Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates
Epilepsy & Behavior Reports
Functional/dissociative seizures
Psychogenic nonepileptic seizures
Functional neurological disorder
EEG microstates
title Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates
title_full Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates
title_fullStr Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates
title_full_unstemmed Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates
title_short Changes in brain network dynamics during functional/dissociative seizures: An exploratory pilot study on EEG microstates
title_sort changes in brain network dynamics during functional dissociative seizures an exploratory pilot study on eeg microstates
topic Functional/dissociative seizures
Psychogenic nonepileptic seizures
Functional neurological disorder
EEG microstates
url http://www.sciencedirect.com/science/article/pii/S2589986425000693
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