{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:53:08Z","timestamp":1785505988358,"version":"3.56.0"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171443"],"award-info":[{"award-number":["82171443"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82471482"],"award-info":[{"award-number":["82471482"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","award":["2022NSFSC1483"],"award-info":[{"award-number":["2022NSFSC1483"]}],"id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Dystonic posturing (DP) is a common semiology in temporal lobe epilepsy (TLE). We aimed to explore cerebellar gradient alterations in functional connectivity in TLE patients with and without DP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Resting\u2010state functional MRI data were obtained in 60 TLE patients and 32 matched healthy controls. Patients were further divided into two groups: TLE with DP (TLE\u2009+\u2009DP, 31 patients) and TLE without DP (TLP\u2010DP, 29 patients). We explored functional gradient alterations in the cerebellum based on cerebellar\u2013cerebral functional connectivity and combined with independent component analysis to evaluate cerebellar\u2013cerebral functional integration and reveal the contribution of the motor components to the gradient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no obvious differences in clinical features and postoperative seizure outcomes between TLE\u2009+\u2009DP and TLE\u2010DP patients. Patients and controls all showed a clear unimodal\u2010to\u2010transmodal gradient transition in the cerebellum, while TLE patients demonstrated an extended principal gradient in functional connectivity compared to healthy controls, which was more limited in TLE\u2009+\u2009DP patients. Gradient alterations were more widespread in TLE\u2010DP patients, involving bilateral cerebellum, while gradient alterations in TLE\u2009+\u2009DP patients were limited in the cerebellum ipsilateral to the seizure focus. In addition, more cerebellar motor components contributed to the gradient alterations in TLE\u2009+\u2009DP patients, mainly in ipsilateral cerebellum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Extended cerebellar principal gradients in functional connectivity revealed excessive functional segregation between unimodal and transmodal systems in TLE. The functional connectivity gradients were more limited in TLE\u2009+\u2009DP patients. Functional connectivity in TLE patients with dystonic posturing involved more contribution of cerebellar motor function to ipsilateral cerebellar gradient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Dystonic posturing contralateral to epileptic focus is a common symptom in temporal lobe epilepsy, and the cerebellum may be involved in its generation. In this study, we found cerebellar gradients alterations in functional connectivity in temporal lobe epilepsy patients with and without contralateral dystonic posturing. In particular, we found that TLE patients with dystonic posturing may have more limited cerebellar gradient in functional connectivity, involving more contribution of cerebellar motor function to ipsilateral cerebellar gradient. Our study suggests a close relationship between ipsilateral cerebellum and contralateral dystonic posturing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.13056","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T15:55:02Z","timestamp":1727366102000},"page":"2251-2262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Limited cerebellar gradient extension in temporal lobe epilepsy with dystonic posturing"],"prefix":"10.1002","volume":"9","author":[{"given":"Wei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology West China Hospital, Sichuan University  Chengdu Sichuan China"},{"name":"Department of Geriatrics West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junxia","family":"Chen","sequence":"additional","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science 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