{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:01:32Z","timestamp":1789239692968,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP\u201057840"],"award-info":[{"award-number":["MOP\u201057840"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP\u2010123520"],"award-info":[{"award-number":["MOP\u2010123520"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Drug\u2010resistant temporal lobe epilepsy (TLE) is typically associated with hippocampal pathology. However, widespread network alterations are increasingly recognized and suggested to perturb cognitive function in multiple domains. Here we tested (1) whether TLE shows atypical cortical hierarchical organization, differentiating sensory and higher order systems; and (2) whether atypical hierarchy predicts cognitive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 72 well\u2010characterized drug\u2010resistant TLE patients and 41\u00a0healthy controls, statistically matched for age and sex, using multimodal magnetic resonance imaging analysis and cognitive testing. To model cortical hierarchical organization in vivo, we used a bidirectional stepwise functional connectivity analysis tapping into the differentiation between sensory\/unimodal and paralimbic\/transmodal cortices. Linear models compared patients to controls. Finally, we assessed associations of functional anomalies to cortical atrophy and microstructural anomalies, as well as clinical and cognitive parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to controls, TLE presented with bidirectional disruptions of sensory\u2013paralimbic functional organization. Stepwise connectivity remained segregated within paralimbic and salience networks at the top of the hierarchy, and sensorimotor and dorsal attention at the bottom. Whereas paralimbic segregation was associated with atypical cortical myeloarchitecture and hippocampal atrophy, dysconnectivity of sensorimotor cortices reflected diffuse cortical thinning. The degree of abnormal hierarchical organization in sensory\u2010petal streams covaried, with broad cognitive impairments spanning sensorimotor, attention, fluency, and visuoconstructional ability and memory, and was more marked in patients with longer disease duration and Engel I outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Our findings show atypical functional integration between paralimbic\/transmodal and sensory\/unimodal systems in TLE. Differential associations with paralimbic microstructure and sensorimotor atrophy suggest that system\u2010level imbalance likely reflects complementary structural processes, but ultimately accounts for a broad spectrum of cognitive impairments. Hierarchical contextualization of cognitive deficits promises to open new avenues for personalized counseling in TLE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.17032","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T05:29:35Z","timestamp":1630992575000},"page":"2589-2603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Atypical functional connectome hierarchy impacts cognition in temporal lobe epilepsy"],"prefix":"10.1111","volume":"62","author":[{"given":"Fatemeh","family":"Fadaie","sequence":"first","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Caldairou","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravnoor S.","family":"Gill","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane","family":"Sziklas","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Crane","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9256-6041","authenticated-orcid":false,"given":"Boris C.","family":"Bernhardt","sequence":"additional","affiliation":[{"name":"Medical Imaging and Connectome Analysis Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok\u2010Jun","family":"Hong","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9358-5703","authenticated-orcid":false,"given":"Andrea","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8947-9518","authenticated-orcid":false,"given":"Neda","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16067"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70018-8"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2011.3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.116706"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007370"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107686"},{"key":"e_1_2_8_8_1","first-page":"175","article-title":"The role of cognitive fMRI in mesial temporal lobe epilepsy","volume":"9","author":"Labudda K","year":"2011","journal-title":"Progress Epileptic Disord"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0759-12.2012"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.12.033"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2015.11.005"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","unstructured":"Jones\u2010GotmanM DjordjevicJ.Neuropsychological testing in presurgical evaluation. 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