Cortical wiring measures associated with seizure recurrence after epilepsy surgery

Researchers compared preoperative MRI-derived cortical wiring-cost measures in 47 patients with unilateral mesial temporal lobe epilepsy and pathologically confirmed hippocampal sclerosis and 48 matched healthy controls. The surgical patients were classified as seizure-free (27) or non-seizure-free (20) after at least two years of follow-up. The analysis assessed global and local surface-based geodesic metrics and tested their ability to classify postoperative seizure outcomes.

Global wiring costs were lower in the ipsilateral temporal cortex in patients, with more extensive reductions in those who experienced seizure recurrence. Local abnormalities in sensorimotor and default mode networks were also more pronounced in the non-seizure-free group. A support vector machine classifier distinguished non-seizure-free from seizure-free patients with an area under the receiver operating characteristic curve of 0.86. The findings suggest a possible imaging-based prognostic marker, but the study was small and the abstract does not report external validation. The measures should not be treated as established tools for surgical selection or individual outcome prediction.