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Related Concept Videos

Epilepsy and Seizures: Overview01:24

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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
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Related Experiment Video

Updated: Jan 15, 2026

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
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Structural and effective brain connectivity in focal epilepsy.

S B Jelsma1,2,3, M Zijlmans1,2, I B Heijink1,2

  • 1Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, P.O. box 85500, 3508, GA, Utrecht, the Netherlands.

Neuroimage. Reports
|October 6, 2025
PubMed
Summary

Epilepsy surgery can be improved by understanding brain networks. This study shows moderate overlap between structural and effective brain connectivity, supporting network-based approaches for epilepsy treatment.

Keywords:
Diffusion-weighted imaging tractographyEffective connectivityIntracranial EEGNetwork topologySingle pulse electrical stimulationStructural connectivity

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Area of Science:

  • Neuroscience
  • Medical Imaging
  • Computational Biology

Background:

  • Epilepsy surgery traditionally targets localized epileptogenic zones.
  • Viewing epilepsy as a network disease necessitates patient-specific network analysis.
  • Developing network-based surgical strategies requires detailed insight into individual epileptic brain networks.

Purpose of the Study:

  • To investigate the relationship between structural and effective brain connectivity in epilepsy surgery candidates.
  • To assess the overlap between non-invasively measured structural connectivity and invasively measured effective connectivity.
  • To evaluate the potential of combining these connectivity measures for improved understanding and surgical planning in epilepsy.

Main Methods:

  • Diffusion-weighted imaging (DWI) and intracranial EEG with single pulse electrical stimulation (SPES) were used in 13 epilepsy surgery candidates.
  • Structural connectivity was reconstructed using fiber tractography.
  • Effective connectivity was derived from SPES cortico-cortical evoked responses.
  • Inter-modal similarity was quantified using the Jaccard index, and network topologies were compared using centrality measures.

Main Results:

  • A moderate overlap (median Jaccard index of 0.25) was found between structural and effective connectivity, significantly higher than chance.
  • Structural connectivity degree positively correlated with effective connectivity degree in 9/13 patients and at the group level.
  • Seizure onset zone and electrode contact area volume did not significantly predict the structural-effective connectivity correlation.

Conclusions:

  • There is a moderate overlap between non-invasive structural and invasive effective connectivity in epileptic brain networks.
  • These findings support the use of non-invasively acquired connectivity data alongside intracranial EEG for understanding the epileptic brain.
  • Further research is needed to translate these network insights into effective, network-based surgical strategies for epilepsy.