Aberrant executive control networks and default mode network in patients with right-sided temporal lobe epilepsy: a functional and effective connectivity study

Objective: We aimed to explore functional connectivity (FC) and effective connectivity (EC) of the executive control networks (ECNs) and the default mode network (DMN) in patients with right-sided TLE (rTLE) by applying independent component analysis (ICA) and Granger causal analysis (GCA). Methods: Twenty-seven patients with rTLE and 20 healthy controls (HCs) matched for age, gender underwent resting-state functional magnetic resonance imaging and Attention Network Test (ANT). Results: The FC analysis showed compared to HCs, patients with rTLE demonstrated reduced FC strength in the right inferior parietal gyrus (IPG) and the right middle temporal gyrus (MTG). The left superior temporal gyrus (STG) displayed reduced FC values whereas the left thalamus revealed increased FC values in rTLE. ROI-wise GCA revealed that patients with rTLE displayed increased EC from the left thalamus to the left STG, and as well as enhanced EC from the right IPG to the right MTG compared to HCs. Voxel-wise GCA showed positive EC from the left thalamus to the left insula while the right middle occipital gyrus (MOG) exhibited increased EC to the right MTG in patients. The ANT results demonstrated executive dysfunction in patients compared to HCs. The increased FC in the left thalamus showed a negative association with ECF in patients. Conclusion: We speculated that recurrent seizures take effect on disruption among the brain networks, and self-modulation occurs simultaneously to compensate for cognitive decline. Our findings revealed new insights on the neuropathophysiological mechanisms of rTLE.