Can brain network analyses guide epilepsy surgery?
Ghassan S Makhoul1,2,3, Derek J Doss1,2,3, Dario J Englot1,2,4,5,6,3,7
1Department of Biomedical Engineering at Vanderbilt University.
Current Opinion in Neurology
|January 31, 2025
Summary
Epilepsy surgery is evolving, with network models now guiding interventions for medically refractory epilepsy. These models enhance surgical planning by identifying critical brain network features and informing neuromodulation targets like the thalamus.
Area of Science:
- Neuroscience
- Neurosurgery
- Epileptology
Background:
- Epilepsy is increasingly understood as a complex network disorder.
- Medically refractory epilepsy presents significant challenges, necessitating advanced treatment strategies.
- Surgical intervention offers a potentially curative option for select patients.
Purpose of the Study:
- To review the influence of epilepsy as a network disorder on surgical interventions.
- To explore how network models are currently impacting epilepsy surgery planning and execution.
- To identify barriers to the widespread adoption of network models in surgical decision-making.
Main Methods:
- Review of current literature on epilepsy network models and surgical applications.
- Analysis of studies linking network features to surgical outcomes.
- Examination of neuromodulation techniques informed by network properties.
Main Results:
- Surgical outcomes are increasingly correlated with network characteristics, such as node hubness.
- Network metrics can potentially enhance the identification of the seizure onset zone for surgical planning.
- The thalamus is emerging as a viable target for neuromodulation due to its role in seizure propagation networks.
Conclusions:
- Network models are beginning to influence current epilepsy surgery practices.
- Further research and validation are needed to overcome barriers to widespread adoption.
- Integrating network approaches promises to refine surgical strategies for epilepsy treatment.
