Language typically utilizes left lateralized brain structures, but its specific localization is heterogeneous, which can complicate surgical approaches to pediatric epilepsy. This study used diffusion weighted connectome to explore the structural network properties of patients clinically characterized as “left language dominant” or “bilateral language dominant.” Nodal efficiency values in canonical language regions were found to be more left lateralized in left language dominant patients, improving prediction of group membership beyond clinical variables and identifying pairwise connections that further distinguished lateralization groups. Our findings support the utility of diffusion connectome in predicting language-dominant hemisphere for presurgical evaluation of pediatric epilepsy surgery.
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