{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T09:28:11Z","timestamp":1787131691254,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"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":["F31NS131056"],"award-info":[{"award-number":["F31NS131056"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS108445"],"award-info":[{"award-number":["R01NS108445"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS112252"],"award-info":[{"award-number":["R01NS112252"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS134625"],"award-info":[{"award-number":["R01NS134625"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Resective surgery achieves seizure freedom in approximately 60%\u201380% of patients with drug\u2010resistant temporal lobe epilepsy (TLE), yet the extent to which seizure cessation permits recovery of disrupted functional brain networks remains unclear. Increasing evidence suggests that recurrent seizures alter subcortical\u2013cortical communication involved in arousal and cognition, contributing to chronic interictal deficits, such as in executive function. Prior work demonstrates that the nucleus basalis of Meynert (NBM), the primary source of cortical cholinergic input to the cortex, exhibits aberrant functional connectivity in patients with TLE. We examined NBM connectivity in patients with TLE before and after surgery using patient\u2010specific NBM segmentations. We sought to investigate whether seizure freedom is associated with recovery of NBM functional connectivity, consistent with previous observations of interictal network dysfunction reversal in other subcortical arousal structures.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Resting\u2010state functional magnetic resonance imaging was analyzed in 75 patients with TLE, including 34 patients postoperatively, and 106 controls. Patient\u2010specific NBM segmentations were used to compute functional connectivity between the NBM and frontoparietal association cortex (FPAC) and across the whole brain. Subcortical arousal network community structure was assessed using community detection. Postoperative network changes were evaluated relative to seizure outcome.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Prior to surgery, patients exhibited reduced bilateral NBM connectivity to the FPAC and whole brain compared to controls, indicating widespread cholinergic network disruption beyond the ipsilateral hemisphere. Following surgery, NBM connectivity increased and no longer differed from controls. Seizure\u2010free patients demonstrated greater postoperative increases in ipsilateral NBM\u2010FPAC connectivity than non\u2010seizure\u2010free patients, which was not explained by time to postoperative scan or volumetric change. Subcortical arousal community structure remained altered postoperatively.<\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n Successful TLE surgery is associated with partial restoration of cholinergic arousal network connectivity, supporting the idea that seizure cessation enables recovery of brain networks disrupted by recurrent seizures. These findings position the NBM as a potential biomarker of network recovery following epilepsy surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/epi.70451","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T09:09:26Z","timestamp":1787130566000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nucleus basalis functional connectivity aberrations in temporal lobe epilepsy and improvements after successful epilepsy surgery"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0153-8979","authenticated-orcid":false,"given":"Addison C.","family":"Cavender","sequence":"first","affiliation":[{"name":"Vanderbilt Brain Institute Vanderbilt University Nashville Tennessee USA"},{"name":"Vanderbilt University Institute of Imaging Science Vanderbilt University Nashville Tennessee USA"},{"name":"Vanderbilt Institute for Surgery and Engineering Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2685-0762","authenticated-orcid":false,"given":"Derek J.","family":"Doss","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science Vanderbilt University Nashville Tennessee USA"},{"name":"Vanderbilt Institute for Surgery and Engineering Vanderbilt University Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghassan S.","family":"Makhoul","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science Vanderbilt University Nashville Tennessee USA"},{"name":"Vanderbilt Institute for Surgery and Engineering Vanderbilt University Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7307-4762","authenticated-orcid":false,"given":"Bruno Hidalgo Monroy","family":"Lerma","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science Vanderbilt University Nashville Tennessee USA"},{"name":"Vanderbilt Institute for Surgery and Engineering Vanderbilt University Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9782-2505","authenticated-orcid":false,"given":"Anas","family":"Reda","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science Vanderbilt University Nashville Tennessee USA"},{"name":"Vanderbilt Institute for Surgery and Engineering Vanderbilt University Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Price","family":"Withers","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science Vanderbilt University Nashville Tennessee USA"},{"name":"Vanderbilt Institute for Surgery and Engineering Vanderbilt University Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2913-5708","authenticated-orcid":false,"given":"Kate","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hern\u00e1n F. J.","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California, San Diego La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Goodale","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science Vanderbilt University Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie E.","family":"Cutting","sequence":"additional","affiliation":[{"name":"Vanderbilt Brain Institute Vanderbilt University Nashville Tennessee USA"},{"name":"Department of Special Education Vanderbilt University 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