Effects of seizure burden on structural global brain networks in patients with unilateral hippocampal sclerosis

Abstract Background and purpose Temporal lobe epilepsy secondary to hippocampal sclerosis is related to epileptogenic networks rather than a focal epileptogenic source. Graph‐theoretical gray and white matter networks may help to identify alterations within these epileptogenic networks. Methods Twenty‐seven patients with hippocampal sclerosis and 14 controls underwent magnetic resonance imaging, including 3D‐T1, fluid‐attenuated inversion recovery, and diffusion tensor imaging. Subject‐specific structural gray and white matter network properties (normalized path length, clustering, and small‐worldness) were reconstructed. Group differences and differences between those with higher and lower seizure burden ( .05). Patients with lower seizure burden had significantly lower gray matter small‐worldness and normalized clustering compared to controls and those with higher seizure burden (all p