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The DTI\u2010ALPS index was calculated based on 3.0T diffusion tensor image sequences, and the memory performance was assessed using the Wechsler Memory Scale\u2010Revised. The DTI\u2010ALPS index was compared among the three groups, and its relationships with clinical characteristics and memory performance were explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TLE\u2010HS group showed a significantly lower DTI\u2010ALPS index compared with healthy controls in both hemispheres (ipsilateral:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; contralateral:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). By contrast, TLE\u2010NL group exhibited a reduced DTI\u2010ALPS index solely in the ipsilateral hemisphere (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Within TLE\u2010NL cohort, those with a history of focal to bilateral tonic\u2013clonic seizures showed reduced DTI\u2010ALPS indices in both hemispheres (ipsilateral:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037; contralateral:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). In the TLE\u2010HS group, DTI\u2010ALPS index positively correlated with memory performance (\n                      <jats:italic>p<\/jats:italic>\n                      s\u2009&lt;\u20090.05). A multiple regression analysis indicated that the average DTI\u2010ALPS index was significantly associated with memory quotient (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.309,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001;\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.226), independent of the ipsilateral hippocampal volume.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The patterns of reduced DTI\u2010ALPS index differed between TLE\u2010HS and TLE\u2010NL patients. The extent of GS impairment in TLE\u2010HS patients correlated with memory decline, suggesting its potential as a therapeutic target for memory enhancement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>This study employed the DTI\u2010ALPS index, a neuroimaging marker, to assess glymphatic system function in distinct subtypes of temporal lobe epilepsy (TLE). Glymphatic impairment was observed in both TLE with hippocampal sclerosis (TLE\u2010HS) and nonlesional TLE (TLE\u2010NL), exhibiting distinct patterns. Notably, this dysfunction was associated with memory deficits, suggesting that targeting glymphatic clearance may represent a novel therapeutic strategy for memory improvement in epilepsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70167","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T13:46:51Z","timestamp":1761313611000},"page":"1953-1965","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Differential glymphatic dysfunction and memory correlation in temporal lobe epilepsy subtypes"],"prefix":"10.1002","volume":"10","author":[{"given":"Ruotong","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Neurology, Epilepsy Center Second Affiliated Hospital, School of Medicine, Zhejiang University  Hangzhou 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