{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:42:27Z","timestamp":1792226547038,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 NS112816\u201001"],"award-info":[{"award-number":["R01 NS112816\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Focal\u2010to\u2010bilateral tonic\u2013clonic seizures (FBTCS) in temporal lobe epilepsy (TLE) involve thalamocortical networks, yet the functional integrity and role of specific thalamic subregions in seizure generalization remain unclear. In this cross\u2010sectional study, we investigated whether thalamic subregion functional connectivity patterns distinguish TLE patients with and without FBTCS and tested for laterality\u2010specific differences between right TLE (RTLE) and left TLE (LTLE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed resting\u2010state functional magnetic resonance imaging (fMRI) data from 166 patients with TLE (71 RTLE, 95 LTLE; 120 FBTCS+, and 46 FBTCS\u2212) and 119 healthy participants. Thalamic parcellation identified eight bilateral regions of interest. We computed graph theory measures of regional segregation, connection density, and integration, as well as intrinsic connectivity contrast to characterize thalamic subregion network topology. Sensitivity analyses controlled for pathology subgroup and anti\u2010seizure medication burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TLE patients exhibited reduced cross\u2010hemispheric functional connectivity between bilateral ventral anterior (VA) thalamic regions compared with controls. Compared with patients with LTLE, patients with RTLE showed more pronounced ipsilateral VA hypoconnectivity and more disrupted nodal topology (clustering coefficient, degree centrality, local efficiency) in the ipsilateral VAia. Within RTLE, FBTCS+ patients (vs FBTCS\u2212) showed ipsilateral connectivity reductions and cross\u2010hemispheric VA reductions that increased with illness duration. Within LTLE, FBTCS+ patients (vs FBTCS\u2212) showed bilateral connectivity increases in the ventral posterior medial subregion. Sensitivity analyses confirmed that these findings were robust across pathology subtypes and independent of anti\u2010seizure medication burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>These findings provide initial evidence that intra\u2010thalamic functional connectivity, particularly within the bilateral VA complex, is associated with FBTCS history in TLE and varies with lateralization of seizureonset. The observations may represent a biomarker for FBTCS, but whether this is causal or an epiphenomenon of this seizure type remains to be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70390","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T17:42:27Z","timestamp":1784396547000},"page":"5412-5424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ventral anterior thalamic dysfunction distinguishes seizure generalization in temporal lobe epilepsy"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8832-467X","authenticated-orcid":false,"given":"Stacy N.","family":"Hudgins","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering, Science, and Health Systems Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0708-6006","authenticated-orcid":false,"given":"Michael R.","family":"Sperling","sequence":"additional","affiliation":[{"name":"Jefferson Comprehensive Epilepsy Center Thomas Jefferson University  Philadelphia Pennsylvania USA"},{"name":"Department of Neurology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5514-2741","authenticated-orcid":false,"given":"Hasan","family":"Ayaz","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Science, and Health Systems Drexel University  Philadelphia Pennsylvania USA"},{"name":"Department of Psychological and Brain Sciences, College of Arts and Sciences Drexel University  Philadelphia Pennsylvania USA"},{"name":"A.J. Drexel Autism Institute Drexel University  Philadelphia Pennsylvania USA"},{"name":"Drexel Solutions Institute Drexel University  Philadelphia Pennsylvania USA"},{"name":"Center for Injury Research and Prevention Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5260-3290","authenticated-orcid":false,"given":"Joseph I.","family":"Tracy","sequence":"additional","affiliation":[{"name":"Jefferson Comprehensive Epilepsy Center Thomas Jefferson University  Philadelphia Pennsylvania USA"},{"name":"Department of Neurology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2015.11.003"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2019.107790"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3949"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010645"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16819"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.52135"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2021.102564"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14688"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awz361"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004035"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13085"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0085843"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17908"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awad121"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.25444"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2014.09.023"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2023.106045"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1202631"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17535"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-64922-w"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00783.2009"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy042"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2023.103387"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41592-018-0235-4"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41593-020-00711-6"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.11.001"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.56441\/hilbertpress.2207.6598"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.06.075"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-96418-4"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000206887"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-60183-9"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1480819"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0014-4886(72)90174-4"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)30158-2"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000345969.57574.f5"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx341"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2007.01485.x"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi.70390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:26:58Z","timestamp":1792225618000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi.70390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":37,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/epi.70390"],"URL":"https:\/\/doi.org\/10.1002\/epi.70390","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,18]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}