In this study, researchers aimed to identify the brain regions and networks associated with epilepsy by mapping lesion locations. The study included patients with post-stroke epilepsy and control patients with stroke. The findings showed that lesion locations associated with epilepsy occurred in multiple locations spanning different lobes and vascular territories. However, these same lesion locations were part of a specific brain network defined by functional connectivity to the basal ganglia and cerebellum. This association was validated in four independent cohorts. The study also found that lesion connectivity to this brain network was associated with an increased risk of epilepsy after stroke, as well as across different lesion types. Additionally, deep brain stimulation site connectivity to this network was associated with improved seizure control in patients with drug-resistant epilepsy. Overall, the study suggests that lesion-related epilepsy can be mapped to a human brain network, which could help identify patients at risk of epilepsy after a brain lesion and guide brain stimulation therapies. The findings have implications for refining models to predict epilepsy risk, gaining mechanistic insight into the development of epilepsy, and identifying therapeutic targets for seizure control.

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