Primary Stenting of the Superficial Femoral Artery in Intermittent Claudication Improves Health Related Quality of Life, ABI and Walking Distance: 12 Month Results of a Controlled Randomised Multicentre Trial.

BACKGROUND: Invasive treatment of intermittent claudication (IC) because of severe atherosclerotic stenosis or occlusion in the superficial femoral artery (SFA) is controversial. This prospective randomised trial was performed to assess the impact on health related quality of life (HRQoL) of primary stenting with nitinol self expanding stents compared with best medical treatment alone in patients suffering from stable IC due to SFA disease. METHODS: One hundred patients with stable IC caused by SFA disease from seven Swedish hospitals treated with best medical treatment (BMT) were randomised to either the stent (n = 48) or the control (n = 52) group. Change in HRQoL assessed by the Short Form 36 Health Survey (SF-36) and EuroQoL 5 dimensions (EQ5D) 12 months after treatment was the primary outcome measure. Improvement in the Walking Impairment Questionnaire (WIQ), ankle brachial index (ABI), and walking distance were secondary outcomes. RESULTS: HRQoL improved significantly. In the stent group the following SF-36 domains improved: Physical Function, 19 points (p < .001); Bodily Pain, 14 points (p = .001); General Health, 6 points (p = .019); Vitality, 10 points (p = .004); Physical Component Summary, 6.5 points (p < .001); EQ5D, 0.14 points (p = .008); and WIQ 22 points (p < .001). They were unchanged in the control group. Both ABI (from 0.58 ± 0.11 to 0.86 ± 0.19, p < .001, in the stent group and from 0.63 ± 0.17 to 0.70 ± 0.20, p = .005, in the control group) and walking distance (WD) (from 171 ± 90 meters to 613 ± 381 meters, p < .001, in the stent group and from 209 ± 106 m to 335 ± 321 meters, p = .012, in the control group) improved, and at 12 months both the ABI (p < .001) and the WD (p = .001) were higher in the stent group. CONCLUSIONS: In patients with IC caused by lesions in the SFA, the addition of primary stenting to BMT was associated with significant improvement in HRQoL, ABI, and walking distance after 12 months follow-up compared with BMT alone.

The applicability of chimney grafts in the aortic arch.

AIM: Proximal fixation is often limiting for thoracic endovascular aortic repair (TEVAR) and the stent graft may need to cover the origin of the arch branch vessels. Chimney grafts have been proposed to preserve flow into over stented branches during urgent TEVAR. The aim of this report is to share our initial experience of this technique. METHOD: Eleven patients underwent urgent TEVAR combined with a chimney graft between January 2004 and April 2009. The indications included acute complicated type B dissection (N. = 2), ruptured aneurysms of the aortic arch (1) and descending aorta (2), traumatic aortic transaction (1), aortoesophageal fistula (1) and accidental over stenting of the left carotid artery during TEVAR (4). Chimney grafts were implanted into the innominate (N. = 3), left carotid (7) and left subclavian (1) arteries. Mean length of follow up was 20 months. RESULTS: All chimney grafts were successfully implanted. Two patients developed a primary proximal type I endoleak: one leak was successfully coil embolized, the other awaits treatment. One paraplegia was reversed by spinal drainage but two months later, this patient presented with a contained rupture and underwent successful conversion to open repair. No other postoperative aneurysm expansion has occurred and the chimney grafts remain patent. The only aneurysm related death occurred in a patient with an unrecognized chronic occlusion of his right carotid artery who received a left carotid chimney graft and suffered from a lethal stroke. CONCLUSION: Chimney grafts in the supra-aortic branches seem feasible and may facilitate urgent TEVAR in patients with an inadequate proximal neck.

Heritability of resting metabolic rate in a wild population of blue tits.

We report the first study with the aim to estimate heritability in a wild population, a nest box breeding population of blue tits. We estimated heritability as well as genetic and phenotypic correlations of resting metabolic rate (RMR), body mass and tarsus length with an animal model based on data from a split cross-fostering experiment with brood size manipulations. RMR and body mass, but not tarsus length, showed significant levels of explained variation but for different underlying reasons. In body mass, the contribution to the explained variation is mainly because of a strong brood effect, while in RMR it is mainly because of a high heritability. The additive variance in RMR was significant and the heritability was estimated to 0.59. The estimates of heritability of body mass (0.08) and tarsus length (0.00) were both low and based on nonsignificant additive variances. Thus, given the low heritability (and additive variances) in body mass and tarsus length the potential for direct selection on RMR independent of the two traits is high in this population. However, the strong phenotypic correlation between RMR and mass (0.643 +/- 0.079) was partly accounted for by a potentially strong, although highly uncertain, genetic correlation (1.178 +/- 0.456) between the two traits. This indicates that the additive variance of body mass, although low, might still somewhat constrain the independent evolvability of RMR.

Microsatellite diversity predicts recruitment of sibling great reed warblers.

Inbreeding increases the level of homozygosity, which in turn might depress fitness. In addition, individuals having the same inbreeding coefficient (e.g. siblings) vary in homozygosity. The potential fitness effects of variation in homozygosity that is unrelated to the inbreeding coefficient have seldom been examined. Here, we present evidence from wild birds that genetic variation at five microsatellite loci predicts the recruitment success of siblings. Dyads of full-sibling great reed warblers (Acrocephalus arundinaceus), one individual of which became a recruit to the natal population while the other did not return, were selected for the analysis. Each dyad was matched for sex and size. Local recruitment is strongly tied to fitness in great reed warblers as the majority of offspring die before adulthood, philopatry predominates among surviving individuals and emigrants have lower lifetime fitness. Paired tests showed that recruited individuals had higher individual heterozygosity and higher genetic diversity, which was measured as the mean squared distance between microsatellite alleles (mean d(2)), than their non-recruited siblings. These relationships suggest that the microsatellite markers, which are generally assumed to be neutral, cosegregated with genes exhibiting genetic variation for fitness.

Avoiding acetate accumulation in Escherichia coli cultures using feedback control of glucose feeding.

An automated glucose feeding strategy that avoids acetate accumulation in cultivations of Escherichia coli is discussed. We have previously described how a probing technique makes it possible to detect and avoid overflow metabolism using a dissolved oxygen sensor. In this article these ideas are extended with a safety net that guarantees that aerobic conditions are maintained. The method is generally applicable, as no strain-specific information is needed and the only sensor required is a standard dissolved oxygen probe. It also gives the highest feed rate possible with respect to limitations from overflow metabolism and oxygen transfer, thus maximizing bioreactor productivity. The strategy was implemented on three different laboratory-scale platforms and fed-batch cultivations under different operating conditions were performed with three recombinant strains, E. coli K-12 UL635, E. coli BL21(DE3), and E. coli K-12 UL634. In spite of disturbances from antifoam and induction of recombinant protein production, the method reproducibly gave low concentrations of acetate and glucose. The ability to obtain favorable cultivation conditions independently of strain and operating conditions makes the presented strategy a useful tool, especially in situations where it is important to get good results on the first attempt.

On-line detection of acetate formation in Escherichia coli cultures using dissolved oxygen responses to feed transients.

Recombinant protein production in Escherichia coli can be significantly reduced by acetate accumulation. It is demonstrated that acetate production can be detected on-line with a standard dissolved oxygen sensor by superimposing short pulses to the substrate feed rate. Assuming that acetate formation is linked to a respiratory limitation, a model for dissolved oxygen responses to transients in substrate feed rate is derived. The model predicts a clear change in the character of the transient response when acetate formation starts. The predicted effect was verified in fed-batch cultivations of E. coli TOPP1 and E. coli BL21(DE3), both before and after induction of recombinant protein production. It was also observed that the critical specific glucose uptake rate, at which acetate formation starts, was significantly decreased after induction. On-line detection of acetate formation with a standard sensor opens up new possibilities for feedback control of substrate feeding.

Orthosis as prognostic instrument in lumbar fusion: no predictive value in 50 cases followed prospectively.

To evaluate pain relief in a lumbar orthosis as a predictor for good clinical results after solid fusion, all patients scheduled for such a surgical procedure were preoperatively encouraged to use an orthosis, soft or rigid, for 3 weeks. Grade of back pain relief as a percent using the orthosis was assessed by the patients and was registered before surgery. After surgery, at 1-year follow-up, patients with nonunion demonstrated radiographically were excluded from the series. Thus, 50 patients with solid fusion could be identified and followed for at least 2 years prospectively. At follow-up these 50 patients graded the pain relief induced by the fusion. In the preoperative corset test, 31 patients experienced significant back pain relief, meaning a reduction of at least 50%. No applicable correlation was found, however, between outcome in this corset test and the eventual clinical result expressed as improvement/no improvement after solid fusion. The two types of orthoses did not differ in this aspect. We conclude that the orthosis, rigid or soft, is not a useful instrument when selecting patients for lumbar fusion.

Acoustic cues and postural control.

The effect of auditory input on postural control was evaluated in separate experiments performed in three groups of healthy volunteers. Auditory input took the form either of feedback signals generated by a force platform in response to the subject's postural control movements, or of field orientation (frame of reference) input provided by repeated clicks emitted by loudspeakers in a normally reverberative environment. The effect of these acoustic cues was measured in terms of body sway recorded on a force platform during stance perturbations induced by vibratory stimuli applied to the calf muscles either at low (120mW) or high (850 mW) intensity, the subject standing with eyes closed or open, as instructed. In the presence of feedback auditory input, body sway in response to low intensity vibratory stimulation was significantly reduced, but not that in response to high intensity stimulation. This may be due to the fact that the head and body movements induced by high intensity vibratory stimulation are so rapid and powerful that they override the information available or to the subject using other strategies for postural control in which auditory feedback, at least in the form used here, does not contribute useful information. The availability of field orientation input did not reduce body sway in response to vibratory stimulation at low intensity. This was probably due to the cognitive lag which precluded use being made of the input before the fast proprioceptive responses to vibratory stimulation had already occurred.

Carboplatin in combination with epirubicin and cyclophosphamide in patients with advanced ovarian cancer. A phase II study.

Seventy-one patients with epithelial ovarian cancer stage III (n = 56) or IV (n = 15) were treated with carboplatin 300 mg/m2, epirubicin 50 mg/m2 and cyclophosphamide 400 mg/m2 every fourth week. Patients clinically free of tumour after six courses (n = 58) underwent a second-look laparotomy. Seventeen patients were microscopically tumour-free (24% of all) and an additional 10 (14%) had only microscopic cancer. Median time to progression was 19 months. The median survival was 33 months and the estimated 5-year survival 27%. The toxicity was mainly haematological, with leukopenia WHO grade 3-4 seen in 88% and thrombocytopenia grade 3-4 in 42% of the patients. The gastrointestinal toxicity was mild and no renal toxicity was seen. This chemotherapy regimen was effective with acceptable toxicity and could be given on an out-patient basis. The possibility of increasing the efficacy and decreasing the toxicity was discussed.

Reduced voluntary non-visual suppression of the vestibulo-ocular reflex gain during nitrous oxide narcosis.

The effect of subanesthetic nitrous oxide (N2O) narcosis (21%) on the vestibulo-ocular reflex (VOR) and on voluntary non-visual suppression of the VOR was studied in 12 subjects, using a velocity step rotational test. Gain and time constant of the VOR were calculated by computer. During tests, the subjects were required either to perform mental arithmetic or to attempt to follow an imaginary target rotating with them in the dark. Voluntary non-visual suppression of gain was significantly reduced during exposure to N2O, though there was no statistically significant effect of N2O on gain per se. The time constant was unaffected either by voluntary suppression or by N2O. The reducing effect of N2O on voluntary non-visual suppression of VOR gain is assumed to be due to reduced alertness. Reduced voluntary non-visual suppression of VOR may imply reduced visual-vestibular interaction, which might be one explanation of the complaints of dizziness associated with fatigue or with ingestion of certain sedatives.

Low risk for vertebral slipping after decompression with facet joint preserving technique for lumbar spinal stenosis.

The incidence and magnitude of vertebral slipping after decompression for central lumbar spinal stenosis were determined in a prospective study of 60 consecutive patients. Mean patient age was 64 (35-83) years, and 35 patients were men. In all cases, laminectomy was performed using a facet joint preserving undercutting technique. Plain radiographs were obtained before and 1 year after surgery. Vertebral slipping and disc degeneration were measured. Preoperative degenerative olisthesis was seen in 19 of the 60 patients. Further slipping had occurred in 6 of these patients by 1 year postoperatively. Of the remaining 41 patients, only 1 showed a postoperative slipping. Improvement concerning leg pain was reported by 45 patients, and there was no difference in patients with or without postoperative slipping. It is concluded that decompression with a facet joint preserving technique yielded a low risk for postoperative vertebral slipping. The risk for slip was higher in patients with preoperative degenerative olisthesis but was still less than 1/3. Vertebral slipping did not influence the outcome of the operation at 1 year. Our results do not support the routine use of spinal fusion in connection with decompression for lumbar spinal stenosis.

Inhibition in synchronously firing human hippocampal neurons.

In order to study the extent of inhibition in human epileptic hippocampus, we recorded extracellular unit activities of human hippocampal neurons and their responses to single pulse stimulation in temporal lobe epilepsy patients during interictal periods. The criteria for diagnosing the hippocampus as epileptic were: (1) all seizures originated in that one hippocampus, (2) surgical removal of that hippocampus resulted in seizure relief, and (3) the surgically excised hippocampus was sclerotic. Analysis of firing pattern by cross-correlation showed that synchronized firing between neurons occurred only in the epileptic hippocampus. However, synchronized firing was not limited to only bursting neurons, as previously reported in some animal models of epilepsy, but was also observed among non-bursting neurons in the epileptic hippocampus. Furthermore, no significant difference in distribution of burst-discharge neurons was found between epileptic and non-epileptic hippocampi. In response to single pulse stimulation, neurons in both 'normal' (contralateral hippocampus) and epileptic hippocampus showed a rapid increase of firing (excitation), cessation of firing (inhibition), or a sequence of both (initial excitation followed by inhibition). However, a significant difference was found in the duration of the inhibition between synchronously firing neurons and non-synchronously firing neurons: the inhibition evoked by a single stimulation in synchronously firing epileptic neurons was significantly longer (373.8 msec +/- 35.9 S.E.M., P less than 0.005) than that of non-synchronously firing neurons (83.9 msec +/- 8.9 S.E.M.). Moreover, prolonged inhibition in synchronously firing epileptic neurons could occur with little or no prior excitation, suggesting that this inhibition does not necessarily depend on an intrinsic Ca2+-dependent K+-mediated after-burst hyperpolarization but is rather likely to be synaptic. As this inhibition was longer when epileptic neurons fired in synchrony, it could be interpreted that principal neurons recruited more recurrent inhibitory circuits by firing synchronously. By taking into account the previously reported neurophysiological evidence in human in vitro epileptic tissue showing GABA-mediated inhibition and the neuroanatomical evidence in excised human epileptic hippocampus showing GAD-positive neurons and synapses, our data suggest that, in human chronic epileptic hippocampus, recurrent inhibition remains functional, and alterations in GABA-mediated inhibition may not represent the critical change responsible for seizure generation.

Neurophysiological characterization of commissurally projecting dentate neurons in the rat.

Commissural neurons in the dentate hilus and in the deep dentate granule cell layer were recorded intracellularly in vivo, in conjunction with combined injection of the anterograde tracer Phaseolus vulgaris leucoagglutinin (PHA-L) at sites of electrical stimulation. Two hilar neurons responded with short latency antidromic spikes to stimulation of the contralateral dentate infrapyramidal molecular layer, but did not show any synaptic potentials, suggesting that these neurons do not receive commissural hilar input, either directly or indirectly, from the stimulating sites. On the other hand, 3 dentate-hilar border neurons responded to the contralateral hilar stimulation with antidromic spikes, excitatory postsynaptic potentials (EPSPs), orthodromic spikes, and inhibitory PSPs (IPSPs), suggesting a rich synaptic interaction both commissurally and locally in this region. No direct commissural inhibition was observed in any of the cells. PHA-L injection at the stimulation site indicated that commissural hilar axon terminals project to a limited region of the contralateral molecular layer in a lamellar fashion, and have only a sparse distribution in the contralateral hilus. The results indicate that rapidly conducting commissural neurons in the dentate gyrus are themselves inhibited in an indirect manner by commissural fibers.

Feedforward inhibition of the rat entorhinal cortex and subicular complex.

We used in vivo intracellular recording techniques in order to provide evidence about the source of postsynaptic inhibition in the rat entorhinal cortex and subicular complex. Several different structures in the basal forebrain and hippocampus were electrically stimulated in order to activate inhibition by different pathways. This allowed a test of 2 different neuronal circuit models: feedback inhibition, in which recurrent collaterals from principal cell axons excite a local population of inhibitory neurons, and feedforward inhibition, in which excitatory afferents activate the inhibitory neurons. In both models, inhibitory cell axons branch and contribute to the inhibition of a population of principal cells. In the feedback model, a good correlation between antidromic and inhibitory response latencies is predicted. The feedforward model predicts independent antidromic and inhibitory response latencies. In one particular model of feedforward inhibition, afferents excite both local inhibitory cells and principal cells. This model predicts a high correlation between principal cell EPSP and IPSP latencies. The results showed no consistent relationship between the presence of antidromic action potentials and the presence of inhibition in response to stimulation of different sites. In addition, there was no correlation between antidromic and inhibitory response latencies. These results provide no clear support for the feedback model of inhibition. By contrast, there was a highly significant correlation between the latency of principal cell EPSPs and IPSPs, in support of a feedforward model of inhibition. Response latencies of candidate inhibitory neurons were also consistent with the feedforward model. The results provide evidence that an excitatory relay function of the entorhinal cortex and subicular complex is modified temporally by local, extrinsically activated inhibitory circuits.

Diversity in periodic pattern of firing in human hippocampal neurons.

Firing periodicity was examined in human hippocampal neurons using autocorrelation analysis. Extracellular single-unit activities were recorded from the anterior hippocampus through fine platinum microelectrodes, and the typical firing pattern in an entire recording period was reconstructed statistically in autocorrelograms (average number of firings analyzed: 5639.0 +/- 968.1 SE, range: 1158 to 31,203; number of single-unit trains was 57). Three types of periodic firing were identified as highly consistent. The first pattern consisted of a random recurrence of high-frequency action potentials (100 to 300 Hz) and was observed as an intermittent burst. In this burst, the first 10 to 30 ms after the onset of the burst was the patterned firing of several action potentials, suggesting that the generation of this stereotyped portion of the burst is primarily due to intrinsic membrane characteristics. The second pattern was the continuous rhythmical firing with a lower frequency ranging from 1 to 30 Hz. The third pattern was a clustered rhythmical firing in which a series of short rhythmical firings recurred with regular intervals; the frequency of short rhythmical firing varied from 6.7 to 17 Hz between neurons, and the interval of the regular recurrence of these rhythmical firings ranged from 0.5 to 10 s among neurons. These firing periodicities not only cover a cellular rhythm in the theta frequency reported in the lower mammalian hippocampus but also appear to be more diverse than those previously reported for hippocampal neurons in the animal literature.

Firing patterns of human limbic neurons during stereoencephalography (SEEG) and clinical temporal lobe seizures.

Comparisons of the patterns of neuronal firing and stereoencephalography (SEEG) recorded from the same microelectrodes chronically implanted in the human limbic system were made in order to study neuronal electrogenesis at onset and during propagation of focal partial complex seizures. Alert or sleeping patients were monitored during spontaneous subclinical seizures (no alterations in consciousness detectable), during auras reported by the patients as typical, and during clinical seizures with loss of consciousness, movements and post-ictal confusion. During subclinical SEEG seizures (ipsilateral, normal consciousness), few neurons increased firing (estimated at only 7%) either at the focus or at propagated sites. During auras, with altered consciousness, there were relatively few neurons that increased firing, with the estimate about 14% or twice as many as during a subclinical seizure. During the onset of a clinical seizure that involved loss of consciousness, movements and post-ictal confusion, many neurons were recruited into increased firing, with an estimate of approximately 36%. During this increased electrogenesis, neurons fired briefly in association with high-frequency local SEEG; however, the bursts were shorter than the SEEG seizure pattern. Apparently, other local neurons were recruited to fire in bursts to sustain sufficient axonal driving for widespread propagation of the seizure. When the focal SEEG slowed, the units stopped firing, which suggested that the 'focal' seizure need not be sustained for more than several seconds because propagated seizure activity was self-sustaining at distant structures. The data lead to the conclusion that SEEG seizures can be generated focally by synchronous firing of fewer than 10% of neurons in the 'epileptic pool.' However, when greater percentages of neurons are recruited in the 'epileptic focus' there is greater propagation to widespread sites, especially contralaterally, which will produce clinical partial complex seizures.

Difference in projections to the lateral and medial facial nucleus: anatomically separate pathways for rhythmical vibrissa movement in rats.

The present paper demonstrates that the lateral and medial subdivisions of the rat facial motor nucleus (NVII) receive differing mesencephalic and metencephalic projections. In order to study brain projections to facial nucleus, horseradish peroxidase (HRP) was injected iontophoretically into the entire facial nucleus or the following subdivisions: lateral, dorsolateral, medial, intermediate, and ventral. In the mesencephalic region, the retrorubral nucleus was found to project to the contralateral medial subdivision of NVII, while the red nucleus was found to project to the contralateral lateral subdivision of NVII. Other mesencephalic projections to the facial nucleus arose from the deep mesencephalic nucleus, oculomotor nucleus, central gray including interstitial nucleus of Cajal and nucleus Darkschewitsch, superior colliculus and substantia nigra (reticular). In the mesencephalic region, the Kölliker-Fuse nucleus, parabrachial nucleus, and the ventral nucleus of the lateral lemniscus projected mainly to the ipsilateral lateral subdivision of NVII. In addition, the trapezoid, pontine reticular, vestibular, and motor trigeminal nuclei were observed to have predominantly ipsilateral connections to the facial nucleus. In contrast, projections from the myelencephalic region were to both the lateral and medial subdivision of NVII. The medullary reticular nucleus, ambiguus nucleus, spinal trigeminal nucleus and parvocellular reticular nucleus projected to both lateral and medial subdivisions of NVII with an ipsilateral predominance. The gigantocellular and paragigantocellular reticular nuclei, raphe magnus, external cuneate nucleus and the nucleus of the solitary tract also projected to the facial motor nucleus. Surprisingly, no direct projections to the NVII were observed from diencephalic and telencephalic regions. Our findings that the lateral subdivision of NVII which innervates vibrissa-pad-muscles (Dom et al. 1973; Martin and Lodge 1977; Watson et al. 1982) receives different metencephalic and mesencephalic projections than medial subdivision which controls pinna movement (Henkel and Edwards 1978), suggest that the functional difference between these subdivisions is mediated by the anatomically separate pathways. We confirmed our anatomical findings by eliciting exclusively vibrissa responses by electrical stimulation of the nuclei which project to the lateral subdivision of NVII.

Structurally stable burst and synchronized firing in human amygdala neurons: auto- and cross-correlation analyses in temporal lobe epilepsy.

Burst structure and synchronized firing of bursts were studied, in the interictal period, using auto- and cross-correlation analyses in human amygdala neurons in temporal lobe epilepsy patients diagnosed as having a unilateral limbic seizure focus in anterior hippocampus and/or amygdala. Satisfactory single unit recordings were obtained from chronically implanted microelectrodes in 51 amygdala neurons, and auto-correlation analysis identified 27 of 51 neurons where burst firings recurred with regular interspike interval structures (structurally stable burst: S-burst). This structural stability was characteristic only for a short burst, or at the beginning of a series of repetitive firings, involving 2-5 action potentials. In 'non-epileptic' amygdala neurons located contralateral to the seizure focus, the average duration of S-burst was 15 msec and the number of action potentials (spikes) in the S-burst was inversely related to the interspike intervals in the S-burst, suggesting that endogenous membrane characteristics of non-epileptic amygdala neurons determine the patterns of S-burst. In contrast, in the seizure focus amygdala ('epileptic'), the duration of the S-burst was prolonged among epileptic neurons, not because of the occurrence of more action potentials within the S-burst, but because of a prolonged interspike interval within the S-burst. Furthermore, there was no relationship between the interspike interval and the number of action potentials in the S-burst, suggesting that synaptic inputs and/or extracellular environmental factors may affect an intrinsic mechanism for generating stable S-burst in epileptic neurons. Cross-correlation analysis identified synchronized firings in epileptic neurons: when two epileptic neurons both exhibited S-bursts, when either epileptic neuron exhibited S-burst, but never when neither exhibited S-bursts. Conversely, non-epileptic neurons rarely fired synchronously; even though they showed S-bursts. The difference in the pattern of S-bursts between epileptic and non-epileptic amygdala neurons seems to be the degree of firing synchrony. Our results provide, for the first time, direct evidence that human epileptogenic amygdala neurons recorded in vivo have unique burst firing patterns and significant synchronous excitatory interactions, different from a burst pattern found in non-epileptogenic amygdala neurons during the interictal period.