Leveraging Functional and Structural Connectomics to Guide Neuromodulation in Epilepsy.

Epilepsy is not solely a disorder of abnormal brain structure; it is fundamentally a disorder of disrupted brain networks and impaired communication across brain regions. Thalamic neuromodulation, once conceptualized as a fixed, anatomically guided intervention, is now undergoing a paradigm shift toward dynamic, network-informed modulation. Using tools such as stereo-EEG, diffusion MRI, and advanced connectomic analyses, we are entering a new era where neurostimulation strategies can be individualized, responsive, and aligned with the real-time neurophysiology and structural networks of each patient. By integrating anatomic and functional connectivity data, we are moving toward precision neuromodulation tailored to patient-specific seizure networks. In this review, we highlight the emerging role of functional and structural connectivity in refining our understanding of seizure dynamics and guiding neuromodulation interventions.

Duke Scholars

Author Shruti Agashe Neurology, Epilepsy and Sleep