Actual paradigm postulates that the brain functioning is emerging from a
complex interplay of different brain areas and relies on the integrity of structural
and functional networks. The application of network analysis in modern epilepsy
research has provided valuable information on seizure onset, propagation and
termination, on the interictal state of functional networks and on alterations
in structural networks. Ictal studies have repeatedly identified a more regular
network topology and changes in modularity when the epileptic brain goes into
a seizure. Resulting disruptions in structural and functional connectivity may be
associated with cognitive and behavioral impairments, often seen in patients with
pharmacoresistant epilepsy.
Development of functional network biomarkers is a possible clinical application
of network analysis to predict the risk of seizure recurrence (outcome) after epilepsy
surgery. Resection of hub nodes that were active during a seizure is associated with
seizure freedom in patients with neocortical epilepsy. Studies indicate the potential
use of network analysis to improve the outcome of epilepsy surgery.
Characterization of epileptogenic networks in the dynamic process of seizure
generation and in the interictal state will advance our understanding of epilepsy
as a network disease. Early identification of network alterations may lead to an
improved intervention in pharmacoresistant epilepsy to reduce future burdens
associated with the disease.