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. 2023 Jan 7;13:367. doi: 10.1038/s41598-022-27248-x

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Failure to resect nodes with high FR rates and low local efficiency (i.e., FR desynchrony) correlates with poor surgical outcome. (A) Comparison of local efficiency (LE) with FR rate. K-means clustering identified three distinct clusters of nodes. (B1) Percentage of resected (top) and unresected (bottom) nodes, within patients, with FR but zero LE (i.e., disconnected and not shown in panel A) for all the patients in the study cohort stratified by outcome. The percentage of zero LE nodes resected or unresected did not correlate with outcome (spearman, p > 0.05). (B3) Histogram of FR rate in the nodes with zero local efficiency stratified by seizure freedom showing no marked differences. (C1-3) The percentage of nodes, within patients, in the resection cavity belonging to each cluster shown in panel A: cluster 1 members (blue, C1); or cluster 2 members (red, C2); or cluster 3 members (green, C3) stratified by outcome. (C4-C6) as in C1-C3 but for unresected nodes. Only cluster 1 unresected nodal percentage was statistically correlated with outcome (C4, asterisk, Spearman, p < 0.05). Notably, some of the E1-3 patients also showed relatively higher cluster 1 values in resected nodes (C1).