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In epilepsy, we assume that patients use this cognitive ability when deciding between various treatment options, but this assumption has not been robustly tested. The temporal lobes are key contributors to this \u2018future thinking\u2019 and its building blocks include cognitive functions commonly impaired in temporal lobe epilepsy such as memory and language, giving rise to a hypothesis that \u2018future thinking\u2019 is impaired in this patient cohort. Participants were 68 adults: 37 with neurosurgically-na\u00efve, unilateral temporal lobe epilepsy (51% right lateralized) and 31 healthy controls of similar age, sex and intellectual ability to the participants with epilepsy. Future thinking was measured using an imagined experiences task validated in other neurological populations. Tools well-established in temporal lobe epilepsy were used to measure potential cognitive correlates of future thinking. Analysis of variance revealed significantly impoverished future thinking in both left and right temporal lobe epilepsy relative to controls (P\u2009=\u20090.001, \u03b7p2=0.206), with no difference between temporal lobe epilepsy groups (P\u2009&amp;gt;\u20090.05). Future thinking deficits in left temporal lobe epilepsy were paralleled by deficits in scene construction, whereas impoverished future thinking in right temporal lobe epilepsy occurred in the setting of intact scene construction. Deficits in future thinking were associated with reductions in lexical access and episodic autobiographic memory in both epilepsy groups. In sum, future thinking is compromised in both left and right temporal lobe epilepsy. The deficit in left temporal lobe epilepsy is largely explainable by dysfunction in verbal cognitive processes including scene construction. While the basis of the deficits observed with right temporal foci shares features with that of left temporal lobe epilepsy, their intact scene construction raises questions about the role of the left and right temporal lobes in future thinking and scene construction and the relationship between these two constructs, including whether right temporal lobe might play a specific role in future thinking in terms of creative processing. Clinicians should take impaired future thinking into account when counselling temporal lobe epilepsy patients about various treatment options, as they may struggle to vividly imagine what different outcomes might mean for their future selves.<\/jats:p>","DOI":"10.1093\/braincomms\/fcac062","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T12:32:29Z","timestamp":1647433949000},"source":"Crossref","is-referenced-by-count":10,"title":["Compromised future thinking: another cognitive cost of temporal lobe epilepsy"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-3877","authenticated-orcid":false,"given":"Genevieve","family":"Rayner","sequence":"first","affiliation":[{"name":"Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia"},{"name":"Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia"},{"name":"Department of Clinical Neuropsychology, 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