Neuronal complexity loss in temporal lobe epilepsy: effects of carbamazepine on the dynamics of the epileptogenic focus.

Analysis methods derived from the theory of non-linear dynamics have been shown to provide new information about the complex spatio-temporal behaviour of neuronal networks involved in temporal lobe epilepsy. To test whether day to day alterations in neuronal complexity are influenced by changes in serum level of carbamazepine (CBZ), a moving-window correlation dimension analysis was applied to electrocorticographic and stereoelectroencephalographic recordings of 10 patients with unilateral temporal lobe epilepsy. Data sets (n = 78) were obtained from interictal states at subsequent days during the presurgical evaluation with strongly variant CBZ serum levels. The so-called neuronal complexity loss L* was used to quantify the change of dimensionality in brain electrical activity recorded under different levels of medication. We found a significant inverse relationship between L* and CBZ serum level spatially restricted to the primary epileptogenic area. This finding can be assumed to reflect the mechanism of action of CBZ attributed to an inhibition of sustained high-frequency firing of bursting neurons.