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Dynamic brain configuration analyses were performed with resting\u2010state functional magnetic resonance imaging (MRI) data to quantify the functional stability over time and the dynamic interactions between brain regions. Relationships between seizure frequency and ipsilateral hippocampal module allegiance were evaluated using a machine learning predictive model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to the healthy controls, patients with mTLE displayed an overall higher dynamic network, switching mainly in the epileptogenic regions (false discovery rate [FDR] corrected\u00a0<jats:italic>p<\/jats:italic>\u2010FDR\u2009&lt;\u2009.05). Moreover, the dynamic network configuration in mTLE was characterized by decreased recruitment (intra\u2010network communication), and increased integration (inter\u2010network communication) among hippocampal systems and large\u2010scale higher\u2010order brain networks (<jats:italic>p<\/jats:italic>\u2010FDR\u2009&lt;\u2009.05). We further found that the dynamic interactions between the hippocampal system and the default\u2010mode network (DMN) or control networks exhibited an opposite distribution pattern (<jats:italic>p<\/jats:italic>\u2010FDR\u2009&lt;\u2009.05). Strikingly, we showed that there was a robust association between predicted seizure frequency based on the ipsilateral hippocampal\u2010DMN dynamics model and actual seizure frequency (<jats:italic>p<\/jats:italic>\u2010perm\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>These findings suggest that the interictal brain of mTLE is characterized by dynamical shifts toward unstable state. Our study provides novel insights into the brain dynamic network alterations and supports the potential use of DMN dynamic parameters as candidate neuroimaging markers in monitoring the seizure frequency clinically during interictal periods.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17325","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T12:20:03Z","timestamp":1655209203000},"page":"2242-2255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Interictal dynamic network transitions in mesial temporal lobe epilepsy"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7266-0241","authenticated-orcid":false,"given":"Rong","family":"Li","sequence":"first","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High\u2010Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chijun","family":"Deng","sequence":"additional","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High\u2010Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuyang","family":"Wang","sequence":"additional","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High\u2010Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danni","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangya Hospital Central South University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5204-1902","authenticated-orcid":false,"given":"Bo","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangya Hospital Central South University  Changsha China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaonan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Magnetic Resonance The First Affiliated Hospital of Zhengzhou University  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing Liang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Magnetic Resonance The First Affiliated Hospital of Zhengzhou University  Zhengzhou 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