Disruption, emergence and lateralization of brain network hubs in mesial temporal lobe epilepsy

Hubs of brain networks are brain regions exhibiting denser connections than others, promoting long-range communication. Studies suggested the reorganization of hubs in epilepsy. The patterns of connector hub abnormalities specific to mesial temporal lobe epilepsy (mTLE) are unclear. We wish to quantify connector hub abnormalities in mTLE and identify epilepsy-related resting state networks involving abnormal connector hubs. A recently developed sparsity-based analysis of reliable k-hubness (SPARK) allowed us to address this question by using resting state functional MRI in 20 mTLE patients and 17 healthy controls. Handling the multicollinearity of functional networks, SPARK measures a new metric of hubness by counting the number (k) of networks involved in each voxel, and identifies which networks are actually associated to each connector hub. This measure provides new information about the network architecture involving connector hubs and a realistic range of k-hubness. We quantified the disruption and emergence of connector hubs in individual epileptic subjects and assessed the lateralization of networks involving connector hubs. In mTLE, we found pathological disruptions of normal connector hubs in the mTL and within the default mode network. Right mTLE had remarkably higher emergence of new connector hubs in the mTL than left mTLE. Different patterns of lateralization of the salience network involving the abnormal hippocampus were found in right versus left mTLE. The temporal, cerebellar, default mode, subcortical and motor networks also contributed to the lateralization of hippocampal networks. We finally observed an asymmetrical connector hub reorganization and overall regularization of epilepsy-related resting state networks in mTLE, characterized by the disruption of distant connections and the emergence of local connections.