Higher-order interdependencies of the epileptogenic network in presurgical resting-state fMRI

Drug-resistant focal epilepsy (DRFE) is understood as a complex brain network disorder. As a result, conventional pairwise functional connectivity may fail to capture the higher-order interactions between groups of epileptogenic regions. We applied multivariate information theory to stereotactic electroencephalography-defined networks in retrospective resting-state fMRI analysis to determine whether the overall strength and dominant type of interdependencies between three or more regions, represented by the S-information and O-information respectively, could offer clinically relevant insights prior to surgical intervention in DRFE. We found networks involving the epileptogenic zone to be mostly dominated by redundant information-sharing, which was predicted by stronger structural and functional connections between regions. Non-temporal lobe epilepsy patients demonstrated greater redundancy and stronger comparative interdependencies than temporal lobe epilepsy patients, in line with a more complex network architecture. Among non-temporal lobe cases with postoperative follow-up, not seizure-free patients displayed more positive O-information deviation scores than seizure-free patients, suggesting elevated redundancy in networks associated with poorer surgical outcomes. Our findings potentiate the S-information and O-information as complementary higher-order descriptors of the epileptogenic network within personalised presurgical assessments.