OBJECTIVE: Previous studies have associated network hubs and epileptiform activity, such as spikes and high frequency oscillations (HFOs), with the epileptogenic zone. The epileptogenic zone is approximated by the area that generates interictal epileptiform activity: the irritative zone. Our aim was to determine the relation between network hubs and the irritative zone.
METHODS: Interictal resting-state MEG recordings of 12 patients with refractory epilepsy were analysed. Beamformer-based virtual electrodes were calculated at 70 locations around the epileptic spikes (irritative zone) and in the contralateral hemisphere. Spikes and HFOs were marked in all virtual electrodes. A minimum spanning tree network was generated based on functional connectivity (phase lag index; PLI) between all virtual electrodes to calculate the betweenness centrality, an indicator of hub status of network nodes.
RESULTS: Betweenness centrality was low, and PLI was high, in virtual electrodes close to the centre of the irritative zone, and in virtual electrodes with many spikes and HFOs.
CONCLUSION: Node centrality increases with distance from brain areas with spikes and HFOs, consistent with the idea that the irritative zone is a functionally isolated part of the epileptic network during the interictal state.
SIGNIFICANCE: A new hypothesis about a pathological hub located remotely from the irritative zone and seizure onset zone opens new ways for surgery when epileptogenic areas and eloquent cortex coincide.