Cavender, Addison C.; Doss, Derek J.; Makhoul, Ghassan S.; Lerma, Bruno Hidalgo Monroy; Reda, Anas; Withers, C. Price; Liao, Emily; Wang, Kate; Gonz谩lez, Hern谩n F. J.; Goodale, Sarah E.; Johnson, Graham W.; Cutting, Laurie E.; Bick, Sarah K.; Chang, Catie; Morgan, Victoria L.; Englot, Dario J. (2026).听.听Epilepsia.听
Temporal lobe epilepsy (TLE) can disrupt brain networks involved in attention, alertness, and thinking. This study examined whether these networks recover after epilepsy surgery, particularly in patients who become seizure-free. Brain scans from 75 patients with TLE and 106 healthy controls showed reduced connectivity involving the nucleus basalis of Meynert (NBM), a brain region important for attention and cognitive function. After surgery, this connectivity improved and became similar to that of healthy controls, with greater recovery seen in patients who were seizure-free. These findings suggest that stopping seizures may allow some disrupted brain networks to recover and that NBM connectivity could help track recovery after epilepsy surgery.
FIGURE 1
Nucleus basalis of Meynert (NBM) exhibits reduced connectivity in patients with temporal lobe epilepsy compared to controls. Violin plots show Fisher听z-transformed Pearson correlations between ipsilateral NBM node time series (A, B) and the contralateral node time series (C, D) with the frontoparietal association cortex (FPAC) as well as all other nodes in the brain (whole-brain). Data include 75 patients with temporal lobe epilepsy and 106 healthy controls. Voxelwise connectivity maps show threshold-free cluster enhancement (TFCE)-corrected听t-statistics, illustrating reductions in ipsilateral (E) and contralateral (F) NBM connectivity in preoperative patients compared to controls. Negative contrasts (patients < controls) are shown, and no positive differences (patients > controls) survived correction. One patient in panel A had functional connectivity (FC)鈥�=鈥夆垝7.60, which falls outside the plotted axis range and thus was not shown for visualization purposes. Group differences were assessed using independent samples听t-tests with false discovery rate correction. *p鈥�<鈥�.05, **p鈥�<鈥�.01, ***p鈥�<鈥�.001. C, contralateral; I, ipsilateral.