Epilepsy and brain network hubs

Epilepsy is a disorder of brain networks. A better understanding of structural and dynamic network properties may improve epilepsy diagnosis, treatment, and prognostics. Hubs are brain regions with high connectivity to other parts of the brain and are typically situated along the brain's most efficient communication pathways, supporting large-scale brain wiring and many higher order neural functions. The visualization and analysis of hubs offers a perspective on regional and global network organization and can provide novel insights into brain disorders and epilepsy. By notably supporting the interaction between various brain networks, hubs may be implicated in seizure spread and in epilepsy-related phenotypes. In this review, we will discuss the growing literature on atypical hub organization in common epilepsy syndromes, both related to neuroimaging of brain structure and function, and related to neurophysiological data from magneto- and electroencephalographic measures of neural dynamics. With studies increasingly exploring the clinical utility of network neuroscience approaches, we highlight the potential of hub mapping as a candidate biomarker of cognitive dysfunction and postsurgical seizure outcome. We will conclude the review with a discussion of current limitations and outlook for future research.