Network hubs supporting memory encoding: Implications for cognitive preservation in epilepsy surgery

Memory impairments are common in neurological disorders, especially drug-resistant epilepsy, where cognitive deficits such as accelerated long-term forgetting may occur before surgery due to interictal/ictal discharges, antiseizure medications, and disease progression. Postsurgical memory decline affects 40%-60% of patients. Understanding the neural mechanisms of memory encoding is essential for identifying critical network hubs and guiding surgical interventions that preserve cognitive function.

We analyzed intracranial electroencephalographic recordings from epilepsy patients (n = 15) performing a verbal memory encoding task to identify key structures involved in successful memory formation. Functional connectivity was computed using multiple features across several frequency bands. Temporal dynamics of connectivity were examined to characterize pre-encoding and encoding phases.

The middle temporal gyrus (MTG) consistently emerged as a verbal memory hub across features and frequency bands. The inferior frontal gyrus (IFG) was identified as a beta-band-specific hub via phase synchrony. Temporal analyses revealed that MTG exhibited stable and widespread connectivity differences across all encoding phases, suggesting a role in pre-encoding network priming. In contrast, IFG displayed a transient decrease in connectivity and spatial extent during early encoding, indicating a more focal and dynamic contribution.

These findings suggest that successful memory encoding relies on widespread, frequency-specific connectivity patterns centered on MTG, complemented by transient, localized IFG activity. Identifying such hubs may inform surgical planning by highlighting regions critical for cognitive outcomes, ultimately supporting strategies to preserve memory in epilepsy surgery.