Operculo-insular epilepsy (OIE) is a rare and under-diagnosed pathology due to its heterogeneous presentation. Interestingly, no studies have looked at the structural connectome in OIE. In this study, we used a cutting-edge diffusion MRI processing pipeline to evaluate the connectivity pattern of OIE. The filtering-based COMMIT weight obtained from surface-enhanced tractography was used as a marker of ‘connectivity strength’. We found an increase in ‘connectivity strength’ within the epileptic network of OIE. Moreover, the pattern of connectivity was distinct from the one of TLE, potentially constituting a tool to help differentiate OIE from the closely related and challengingly distinguishable TLE.
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