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Additionally, we investigated the variables contributing to memory impairment in TLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study included 88 unilateral people with TLE (45 left\/43 right), and 42 healthy controls. Graph theory analysis was employed to compare the FBTCS (+) group (<jats:italic>n<\/jats:italic>\u2009=\u200951) with the FBTCS (\u2212) group (<jats:italic>n<\/jats:italic>\u2009=\u200937). The FBTCS (+) group was subcategorized into current\u2010FBTCS (<jats:italic>n<\/jats:italic>\u2009=\u200931) and remote\u2010FBTCS (<jats:italic>n<\/jats:italic>\u2009=\u200920), based on the history of FBTCS within 1\u2009year or longer than 1\u2009year before scanning, respectively. We evaluated the discriminatory power of topological network properties by receiver operating characteristic (ROC) analysis. Generalized linear models (GLMs) were employed to investigate variables associated with memory impairment in TLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Global efficiency (Eg) was significantly reduced in the FBTCS (+) group, especially in the current\u2010FBTCS subgroup. Greater disruption of regional properties in the ipsilateral occipital and temporal association cortices was observed in the FBTCS (+) group. ROC analysis revealed that Eg, normalized characteristic shortest path length, and nodal efficiency of the ipsilateral middle temporal gyrus could distinguish between FBTCS (+) and FBTCS (\u2212) groups. Additionally, GLMs linked the occurrence of current FBTCS with poorer verbal memory outcomes in TLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Our study suggests that abnormal networks could be the structural basis of seizure propagation in FBTCS. Strategies aimed at reducing the occurrence of FBTCS could potentially improve the memory outcomes in people with TLE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.52135","type":"journal-article","created":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T05:23:50Z","timestamp":1723872230000},"page":"2277-2288","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Altered structural network in temporal lobe epilepsy with focal to bilateral tonic\u2013clonic seizures"],"prefix":"10.1002","volume":"11","author":[{"given":"Yi","family":"Ge","sequence":"first","affiliation":[{"name":"Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of 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