Connectomes in Temporal Lobe and Idiopathic Generalized Epilepsies

Epilepsy is widely known as a network disease. Ictal and interictal activities are generated and spread within the existing networks involving different regions of the brain. Network alterations affect both grey and white matter, deep brain nuclei, including those of the ascending reticular formation. These structures may be involved in a disorganized connectome associated with epilepsy. A growing body of neuroimaging and neuropsychological findings suggests that global and focal network aberrations are closely linked to cognitive deficits in epilepsy patients. This evidence relates equally to focal epilepsies, such as temporal lobe epilepsy or extra-temporal lobe epilepsy, as well as generalized epilepsies, such as juvenile myoclonic epilepsy. Network abnormalities have been associated with a broad range of cognitive impairments, including language, memory, and executive functions, as well as sensory and motor functions. Whole-brain structural connectome models help in the understanding of seizure generation and spread. Identifying key nodes of seizure propagation may help in planning surgical procedures in individual patients by simulating epilepsy surgery on virtual models. Functional connectomic profiles may predict seizure outcomes in patients who undergo deep brain stimulation due to intractable seizures. Therefore, individualized interventional strategies could be developed based on connectome characteristics.