Virus-induced electrotonic coupling: hypothesis on the mechanism of periodic EEG discharges in Creutzfeldt-Jakob disease.

Experimental evidence and computer modeling indicate that periodic synchronous cellular depolarizing bursts (interictal spikes) arise when the balance recurrent inhibition and local excitatory coupling is altered. Such a mechanism may explain the generalized periodic sharp waves that characterize the electroencephalogram of many patients with Creutzfeldt-Jakob disease. In Creutzfeldt-Jakob disease, fusions of neuronal processes, particularly dendrites, may lead to abnormal electrotonic coupling between cells, providing the basis for powerful excitatory interaction whereby large neuronal aggregates burst in near synchrony. Cortical synchronous discharges would give rise to sharp waves in the electroencephalogram, whereas similar discharges in brainstem, spinal cord, or elsewhere could lead to myoclonic jerks.