{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:00:29Z","timestamp":1790420429003,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Temporal lobe epilepsy (TLE) frequently affects clinically\u2010classified ictal consciousness, which the 2025 International League Against Epilepsy (ILAE) classification operationalizes through clinical assessment of awareness and responsiveness. It remains uncertain whether the spatial lateralization between the seizure\u2010onset zone and the language\u2010dominant hemisphere is associated with this classification.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed 40 adults with TLE who underwent video\u2013electroencephalography (EEG) evaluation and language\u2010task functional magnetic resonance imaging (fMRI). Seizures were classified as focal with preserved consciousness (FPC) or focal with impaired consciousness (FIC). Patients were grouped as ipsilateral (seizure onset ipsilateral to language dominance) or contralateral. The primary analysis utilized Bayesian beta\u2010binomial estimation, alongside secondary whole\u2010brain functional network connectivity (FNC) comparisons.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 40 patients, 27 (67.5%) experienced FIC and 13 (32.5%) experienced FPC. FIC occurred in 86.7% of ipsilateral (13\/15) patients compared to 56.0% of contralateral (14\/25) patients. Bayesian estimation yielded a 97.4% posterior probability of a directional association between ipsilateral onset and a higher rate of FIC, although the magnitude carries considerable uncertainty (posterior median odds ratio [OR]\u2009=\u20094.10, 95% credible interval [CI]: .98\u201321.20). Absolute laterality index did not differ between FIC and FPC groups (Mann\u2013Whitney\n U<\/jats:italic>\n \u2009=\u2009230,\n p<\/jats:italic>\n \u2009=\u2009.115). Compared with healthy controls, FPC patients showed widespread FNC differences, whereas no significant control differences were detected in FIC patients. However, direct FIC\u2013FPC comparisons did not reveal significant global task\u2010evoked FNC differences.\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n Bayesian estimation supported an association between ipsilateral seizure onset relative to the language\u2010dominant hemisphere and a higher probability of FIC classification. The absence of detectable task\u2010evoked FNC differences between FIC and FPC patients did not provide evidence for clearly separable interictal language\u2010network architectures.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/epi.70512","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:22:32Z","timestamp":1790418152000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Re\u2010evaluating impaired consciousness in temporal lobe epilepsy: The role of language dominance and network reorganization"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9395-252X","authenticated-orcid":false,"given":"Radheshyam","family":"Stepponat","sequence":"first","affiliation":[{"name":"Developmental and Interventional Neuroimaging Lab (DINLAB), Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna Vienna Austria"},{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Berger","sequence":"additional","affiliation":[{"name":"Developmental and Interventional Neuroimaging Lab (DINLAB), Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna Vienna Austria"},{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"},{"name":"Department of Neurology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurin","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"},{"name":"Department of Neurology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Flamm","sequence":"additional","affiliation":[{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"},{"name":"Department of Neurology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5983-5307","authenticated-orcid":false,"given":"Kathrin","family":"Kollndorfer","sequence":"additional","affiliation":[{"name":"Developmental and Interventional Neuroimaging Lab (DINLAB), Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna Vienna Austria"},{"name":"Department of Neurology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6346-8474","authenticated-orcid":false,"given":"Silvia","family":"Bonelli","sequence":"additional","affiliation":[{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"},{"name":"Department of Neurology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3858-3347","authenticated-orcid":false,"given":"Gregor","family":"Kasprian","sequence":"additional","affiliation":[{"name":"Developmental and Interventional Neuroimaging Lab (DINLAB), Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna Vienna Austria"},{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1454-7600","authenticated-orcid":false,"given":"Ekaterina","family":"Pataraia","sequence":"additional","affiliation":[{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"},{"name":"Department of Neurology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4573-7666","authenticated-orcid":false,"given":"Florian Ph. S.","family":"Fischmeister","sequence":"additional","affiliation":[{"name":"Developmental and Interventional Neuroimaging Lab (DINLAB), Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna Vienna Austria"},{"name":"Comprehensive Center of Clinical Neurosciences and Mental Health (C3NMH) Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"147","volume-title":"Progress in brain research","author":"Englot DJ","year":"2009"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.2307\/2183914","article-title":"What is it like to Be a bat?","volume":"83","author":"Nagel T","year":"1974","journal-title":"Philos 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