Drug‐resistant epilepsy (DRE) considerably affects patient health, cognition, and well‐being, and disproportionally contributes to the overall burden of epilepsy. The most common DRE syndromes are temporal lobe epilepsy related to mesiotemporal sclerosis and extratemporal epilepsy related to cortical malformations. Both syndromes have been traditionally considered as "focal," and most patients benefit from brain surgery for long‐term seizure control. However, increasing evidence indicates that many DRE patients also present with widespread structural and functional network disruptions. These anomalies have been suggested to relate to cognitive impairment and prognosis, highlighting their importance for patient management. The advent of multimodal neuroimaging and formal methods to quantify complex systems has offered unprecedented ability to profile structural and functional brain networks in DRE patients. Here, we performed a systematic review on existing DRE network biomarker candidates and their contribution to three key application areas: (1) modeling of cognitive impairments, (2) localization of the surgical target, and (3) prediction of clinical and cognitive outcomes after surgery. Although network biomarkers hold promise for a range of clinical applications, translation of neuroimaging biomarkers to the patient's bedside has been challenged by a lack of clinical and prospective studies. We therefore close by highlighting conceptual and methodological strategies to improve the evaluation and accessibility of network biomarkers, and ultimately guide clinically actionable decisions.

中文翻译：

---

耐药性癫痫的连接组生物标志物

耐药性癫痫 (DRE) 显着影响患者的健康、认知和幸福感，并且不成比例地增加了癫痫的整体负担。最常见的 DRE 综合征是与颞叶中硬化相关的颞叶癫痫和与皮质畸形相关的颞外癫痫。这两种综合征传统上都被认为是“局灶性”，大多数患者受益于脑部手术以长期控制癫痫发作。然而，越来越多的证据表明，许多 DRE 患者也存在广泛的结构和功能网络中断。这些异常被认为与认知障碍和预后有关，突出了它们对患者管理的重要性。多模态神经影像学和量化复杂系统的正式方法的出现提供了前所未有的能力来描述 DRE 患者的结构和功能大脑网络。在这里，我们对现有的 DRE 网络生物标志物候选物及其对三个关键应用领域的贡献进行了系统评价：(1) 认知障碍建模，(2) 手术目标的定位，以及 (3) 术后临床和认知结果的预测。手术。尽管网络生物标志物有望用于一系列临床应用，但由于缺乏临床和前瞻性研究，神经影像生物标志物向患者床边的转化一直受到挑战。因此，我们通过强调概念和方法策略来结束网络生物标志物的评估和可及性，