Personalized biomarkers of multiscale functional alterations in temporal lobe epilepsy

作者：Ke Xie, Ella Sahlas, Alexander Ngo, Judy Chen, Thaera Arafat, Jessica Royer, Yigu Zhou, Raúl Rodríguez‐Cruces, Arielle Dascal, Benoît Caldairou, Fatemeh Fadaie, Alexander J. Barnett, Sam Audrain, Sara Larivière, Lorenzo Caciagli, Raluca Pana, Alexander Gregory Weil, Christophe Grova, Birgit Frauscher, Dewi Victoria Schrader, Zhiqiang Zhang, Luis Concha, Andrea Bernasconi, Neda Bernasconi, Boris C. Bernhardt · 发表于：Nature Communications · 年份：2025 · DOI：10.1038/s41467-025-65042-1 · 被引用次数：13 · 研究领域：Functional Brain Connectivity Studies、Epilepsy research and treatment、Advanced Neuroimaging Techniques and Applications

Temporal lobe epilepsy (TLE) is the most common pharmacoresistant epilepsy in adults, yet few patients receive curative surgery due to diagnostic and prognostic uncertainty. In a multicenter cohort, we analyzed multimodal MRI and clinical data from 282 TLE patients, 298 healthy controls, and 45 disease controls. Patient-specific deviations from typical lifespan trajectories of intrinsic brain function were mapped using normative modeling. Regional functional alterations were heterogeneous but overlapped most in the mesiotemporal cortex. Connectome-based simulations revealed abnormality spread followed structural network architecture, highlighting the hippocampus as well as paralimbic and medial default-mode regions as epicenters. Multimodal integration implicated superficial white-matter microstructural alterations as a key contributor. Supervised models achieved AUCs of 0.77 for distinguishing TLE from disease controls, 0.74 for lateralizing seizure focus, and 0.64 for predicting postsurgical seizure freedom; greater contralateral temporal deviations predicted poorer outcomes. These findings support individualized functional biomarkers for precision presurgical care in focal epilepsy.