Związek między rozłącznymi sieciami mózgu a wynikami chirurgicznego leczenia opornej na leki epilepsji skroniowej

PURPOSE: To characterize alterations in structural network connection strength (SNCS), functional network connection strength (FNCS), and structural-functional correlation (SFC) of preoperative disconnected networks in temporal lobe epilepsy (TLE) and the association of these measures with postoperative seizure outcomes. METHODS: This retrospective cohort study enrolled 39 TLE patients with 29 healthy controls (HCs). Patients were divided into seizure-free (SF) (Engel Ia) and non-seizure-free (NSF) (Engel Ib-IV) groups. Each network was partitioned into predefined resection-anchored tiers, including three disconnected-network tiers and an unaffected network. SNCS and FNCS of each subnet were calculated, and SFC was analyzed. RESULTS: Compared with HCs, both SF and NSF groups showed lower FNCS in the 1st-, 2nd-, and 3rd-level disconnected networks, and these patient-control differences remained significant after FDR correction. SNCS abnormalities were more localized, with a significant corrected pairwise difference observed only between SF and HCs in the 1st-level disconnected network. The SF-NSF differences in 3rd-level FNCS and 1st-level SNCS were observed only in uncorrected post-hoc analyses and did not survive FDR correction. SFC was significant in HCs at the 1st-, 2nd-, and 3rd-level disconnected networks after FDR correction, whereas no significant SFC was detected in either patient group. In exploratory linear regression analyses, the SF group showed a positive SFC at the 2nd-level disconnected network. CONCLUSION: The SFC of disconnected networks showed widespread reductions in TLE. Exploratory analyses suggested that second-tier SFC may be related to postoperative seizure outcome, highlighting the potential relevance of resection-anchored network organization in TLE surgery.