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Epileptic Disorders - Editor's Choice

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August, 2014

Comments by Associate Editor Sara Wilson

Cortical network dysfunction in musicogenic epilepsy reflecting the role of snowballing emotional processes in seizure generation: an fMRI-EEG study.

Epileptic Disorders March 2014

Volker Diekmann & Anselm C. Hoppner
Epileptic Disorders. Volume 16, Number 1, 31-44, March 2014

Within the field of epilepsy research, musicogenic epilepsy has received scant attention, with little known about its underlying mechanisms despite being described over 75 years ago. By contrast, the field of music neuroscience is burgeoning with studies investigating the music networks of the brain, including the potent ability of music to activate reward and emotion processing systems. Musicogenic seizures provide an obvious opportunity to investigate these networks and their dysfunction in people with epilepsy. In the current study this was done in a patient using the gold-standard technique of EEG-fMRI.

An intriguing aspect of musicogenic epilepsy is triggering by highly selective music stimuli, which in this case was a specific type of Russian music as opposed to similar music of different origin. In addition to pink noise, the latter provided an ideal control stimulus, allowing the specificity of network dysfunction to be explored. This revealed activation of the affective network, particularly regions involved in positive emotional processing, at the onset of the Russian music. A clear strength of the study was subsequent exploration of the way this activation changed over time, prior to the emergence of a seizure. This analysis identified maladaptive interactions between components of the cognitive control, autobiographic memory and affective networks, with reduced cognitive down regulation thought to allow ‘snowballing’ activity in emotion-related areas, ultimately triggering the seizure.

By drawing on the broader cognitive neuroscience literature investigating network function in healthy individuals combined with careful examination of this instructive case, this study presents a compelling argument that musicogenic epilepsy may not just arise from musicological features of the stimulus per se. Moreover, the researchers propose that similar mechanisms of cognitive dysregulation of emotion processing networks may apply in other cases of reflexive epilepsy, such as reading epilepsy. This interesting hypothesis provides an exciting direction for future research into this poorly understood form of epilepsy.

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