{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:43:42Z","timestamp":1793040222043,"version":"4.5.0"},"reference-count":66,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["G0802012"],"award-info":[{"award-number":["G0802012"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/M00841X\/1"],"award-info":[{"award-number":["MR\/M00841X\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Anterior temporal lobe resection (ATLR) is an effective treatment for drug\u2010resistant temporal lobe epilepsy (TLE), although language deficits may occur after both left and right ATLR. Functional reorganization of the language network has been observed in the ipsilateral and contralateral hemispheres within 12\u2009months after ATLR, but little is known of longer\u2010term plasticity effects. Our aim was to examine the plasticity of language functions up to a decade after ATLR, in relation to cognitive profiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined 24 TLE patients (12 left [LTLE]) and 10 controls across four time points: pre\u2010surgery, 4\u2009months, 12\u2009months, and ~9\u2009years post\u2010ATLR. Participants underwent standard neuropsychological assessments (naming, phonemic, and categorical fluency tests) and a verbal fluency functional magnetic resonance imaging (fMRI) task. Using a flexible factorial design, we analyzed longitudinal fMRI activations from 12\u2009months to ~9\u2009years post\u2010ATLR, relative to controls, with separate analyses for people with hippocampal sclerosis (HS). Change in cognitive profiles was correlated with the long\u2010term change in fMRI activations to determine the \u201cefficiency\u201d of reorganized networks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LTLE patients had increased long\u2010term engagement of the left extra\u2010temporal and contralateral temporal regions, with better language performance linked to bilateral activation. Those with HS exhibited more widespread bilateral activations. RTLE patients showed plasticity in the left extra\u2010temporal regions, with better language outcomes associated with these areas. Both groups of patients achieved cognitive stability over 9\u2009years, with more than 50% of LTLE patients improving. Older age, longer epilepsy duration, and lower pre\u2010operative cognitive reserve negatively affected long\u2010term language performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Neuroplasticity continues for up to ~9\u2009years post\u2010epilepsy surgery in LTLE and RTLE, with effective language recovery linked to bilateral engagement of temporal and extra\u2010temporal regions. This adaptive reorganization is associated with improved cognitive outcomes, challenging the traditional view of localized surgery effects. These findings emphasize the need for early intervention, tailored pre\u2010operative counseling, and the potential for continued cognitive gains with extended post\u2010ATLR rehabilitation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18147","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T15:20:37Z","timestamp":1730906437000},"page":"207-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Long\u2010term neuroplasticity in language networks after anterior temporal lobe resection"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7113-0660","authenticated-orcid":false,"given":"Maria","family":"Sablik","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"MRI Unit Chalfont Centre for Epilepsy  Chalfont St. Peter UK"},{"name":"College of Medicine and Health, Cognitive Neuroscience Institute Bangor University  Bangor UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9947-0322","authenticated-orcid":false,"given":"Marine N.","family":"Fleury","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"MRI Unit Chalfont Centre for Epilepsy  Chalfont St. Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence P.","family":"Binding","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"MRI Unit Chalfont Centre for Epilepsy  Chalfont St. Peter UK"},{"name":"Department of Computer Science UCL Centre for Medical Image Computing  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Computer Science UCL Centre for Medical Image Computing  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"d'Avossa","sequence":"additional","affiliation":[{"name":"Department of Computer Science UCL Centre for Medical Image Computing  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9930-6469","authenticated-orcid":false,"given":"Sallie","family":"Baxendale","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"MRI Unit Chalfont Centre for Epilepsy  Chalfont St. Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9395-1478","authenticated-orcid":false,"given":"Gavin P.","family":"Winston","sequence":"additional","affiliation":[{"name":"Department 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