{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:10:28Z","timestamp":1778238628561,"version":"3.51.4"},"reference-count":14,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Medically refractory, magnetic resonance imaging (MRI)-negative mesial temporal lobe epilepsy presents a diagnostic challenge, often leading to difficulties in localizing the epileptogenic zone and planning effective surgical strategies.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n We present a case in which complementary preoperative and intraoperative electrophysiological analyses identified an occult epileptogenic focus. Preoperative high-density scalp electroencephalogram evaluated with gamma oscillation regularity (GOR) analysis localized a putative epileptogenic region adjacent to the hippocampus. Guided by this localization, intraoperative electrocorticography was analyzed using GOR-based transfer entropy (TE). This mapping revealed a compact hub of consistent outgoing directed information flow localized to the parahippocampal gyrus. The surgical strategy targeted the GOR-based TE-defined parahippocampal focus and its immediate efferent connections while preserving the hippocampus. The patient remains seizure-free with preserved neurocognitive function at follow-up.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This case demonstrates that preoperative GOR analysis can noninvasively direct focused intraoperative network interrogation and that GOR-based TE-derived directed connectivity mapping can unmask mesial temporal epileptogenicity in MRI-negative cases, thereby guiding effective, tissue-sparing resections.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_56_2026","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T10:33:36Z","timestamp":1778236416000},"page":"276","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Network-guided resection of magnetic resonance imaging-negative mesial temporal epilepsy using gamma oscillation regularity-based transfer entropy analysis"],"prefix":"10.25259","volume":"17","author":[{"given":"Yosuke","family":"Sato","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"10.25259\/SNI_56_2026\/ref-1","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.1016\/j.clinph.2020.05.029","article-title":"The \u201cconnectivity epileptogenicity index\u201d (cEI), a method for mapping the different seizure onset patterns in StereoElectroEncephalography recorded seizures","volume":"131","author":"Balatskaya","year":"2020","journal-title":"Clin Neurophysiol"},{"key":"10.25259\/SNI_56_2026\/ref-2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/pcn.12604","article-title":"Neural basis of major depressive disorder: Beyond monoamine hypothesis","volume":"72","author":"Boku","year":"2018","journal-title":"Psychiatry Clin Neurosci"},{"key":"10.25259\/SNI_56_2026\/ref-3","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1001\/jamaneurol.2014.585","article-title":"Interictal scalp electroencephalography and intraoperative electrocorticography in magnetic resonance imaging-negative temporal lobe epilepsy surgery","volume":"71","author":"Burkholder","year":"2014","journal-title":"JAMA Neurol"},{"key":"10.25259\/SNI_56_2026\/ref-4","doi-asserted-by":"crossref","first-page":"10904","DOI":"10.1038\/s41598-021-89774-4","article-title":"Epileptogenic zone detection in MRI negative epilepsy using adaptive thresholding of arterial spin labeling data","volume":"11","author":"Gajdo","year":"2021","journal-title":"Sci Rep"},{"key":"10.25259\/SNI_56_2026\/ref-5","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/epi.17472","article-title":"Clinical utility of intraoperative electrocorticography for epilepsy surgery: A systematic review and metaanalysis","volume":"64","author":"Goel","year":"2023","journal-title":"Epilepsia"},{"key":"10.25259\/SNI_56_2026\/ref-6","doi-asserted-by":"crossref","first-page":"254","DOI":"10.25259\/SNI_298_2021","article-title":"Intraoperative epileptogenic network visualization using gamma oscillation regularity correlation analysis in epilepsy surgery","volume":"12","author":"Kobayashi","year":"2021","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_56_2026\/ref-7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1177\/15357597241253413","article-title":"Out of sight, not yet out of reach: Surgical outcomes in MRInegative and pathologynegative epilepsy patients","volume":"24","author":"Li","year":"2024","journal-title":"Epilepsy Curr"},{"key":"10.25259\/SNI_56_2026\/ref-8","doi-asserted-by":"crossref","first-page":"3678","DOI":"10.1038\/s44319-024-00205-7","article-title":"The Derlin-1-Stat5b axis maintains homeostasis of adult hippocampal neurogenesis","volume":"25","author":"Murao","year":"2024","journal-title":"EMBO Rep"},{"key":"10.25259\/SNI_56_2026\/ref-9","doi-asserted-by":"crossref","first-page":"106950","DOI":"10.1016\/j.eplepsyres.2022.106950","article-title":"Validity of intraoperative ECoG in the parahippocampal gyrus as an indicator of hippocampal epileptogenicity","volume":"184","author":"Orihara","year":"2022","journal-title":"Epilepsy Res"},{"key":"10.25259\/SNI_56_2026\/ref-10","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1214\/25-AOAS2050","article-title":"Measuring information transfer between nodes in a brain network through spectral transfer entropy","volume":"19","author":"Redondo","year":"2025","journal-title":"Ann Appl Stat"},{"key":"10.25259\/SNI_56_2026\/ref-11","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1227\/ons.0000000000000245","article-title":"Interictal high gamma oscillation regularity as a marker for presurgical epileptogenic zone localization","volume":"23","author":"Sato","year":"2022","journal-title":"Oper Neurosurg (Hagerstown)"},{"key":"10.25259\/SNI_56_2026\/ref-12","doi-asserted-by":"crossref","first-page":"9362","DOI":"10.1038\/s41598-017-09931-6","article-title":"Spatiotemporal changes in regularity of gamma oscillations contribute to focal ictogenesis","volume":"7","author":"Sato","year":"2017","journal-title":"Sci Rep"},{"key":"10.25259\/SNI_56_2026\/ref-13","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1103\/PhysRevLett.85.461","article-title":"Measuring information transfer","volume":"85","author":"Schreiber","year":"2000","journal-title":"Phys Rev Lett"},{"key":"10.25259\/SNI_56_2026\/ref-14","doi-asserted-by":"crossref","DOI":"10.1109\/EMBC46164.2021.9629793","article-title":"Transfer Entropy between Intracranial EEG Nodes Highlights Network Dynamics That Cause and Stop Epileptic Seizures","volume-title":"2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC)","author":"Wing","year":"2021"}],"container-title":["Surgical Neurology 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