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The objective of this study was to investigate network\u2010wide alterations in brain dynamics of patients with TLE before and after surgical resection of the seizure focus using average regional controllability (ARC), a measure of the ability of a node to influence network dynamics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Diffusion\u2010weighted imaging (DWI) data were acquired in 27 patients with drug\u2010resistant unilateral mesial TLE who underwent selective amygdalohippocampectomy. Imaging data were acquired before and after surgery and a presurgical and postsurgical structural connectome was generated from whole\u2010brain tractography. Edge\u2010wise strength, node strength, and node ARC were compared before and after surgery. Direct and indirect edge\u2010wise strength changes were identified using patient\u2010specific simulated resections. Direct edges were defined as primary edges disconnected by the resection zone itself. Indirect edges were secondary measured edge strength changes. Changes in node strength and ARC were then related to both direct and indirect edge changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found nodes with significant postsurgical changes in both node strength and ARC surrounding the resection zone (paired <jats:italic>t<\/jats:italic> tests, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05, Bonferroni corrected). ARC identified additional postsurgical changes in nodes outside of the resection zone within the ipsilateral occipital lobe, which were associated with indirect edge\u2010wise strength changes of the postsurgical network (Fisher's exact test, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). These indirect edge\u2010wise changes were facilitated through the \u201chub\u201d nodes including the thalamus, putamen, insula, and precuneus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Discrete network disconnection from TLE resection results in widespread structural and functional changes not predicted by disconnection alone. These can be well characterized by dynamic controllability measures such as ARC and may be useful for investigating changes in brain function that may contribute to seizure recurrence and behavioral or cognitive changes after surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17889","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T15:19:56Z","timestamp":1705677596000},"page":"675-686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Indirect structural changes and reduced controllability after temporal lobe epilepsy resection"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-4011","authenticated-orcid":false,"given":"Andrew","family":"Janson","sequence":"first","affiliation":[{"name":"Department of Radiology and Radiological Sciences, Institute of Imaging Science Vanderbilt University Medical Center  Nashville Tennessee 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Radiology and Radiological Sciences, Institute of Imaging Science Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5666-2797","authenticated-orcid":false,"given":"Baxter P.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences, Institute of Imaging Science Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Biomedical Engineering Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catie","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences, Institute of Imaging Science Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Biomedical 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