{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:27:54Z","timestamp":1787120874115,"version":"build-2736575974"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study investigated neurovascular\u2013cerebrospinal fluid dynamic interactions using blood-oxygen-level-dependent\u2013cerebrospinal fluid (BOLD-CSF) coupling metrics and examined their associations with cognitive impairment in patients with MRI-negative unilateral temporal lobe epilepsy (TLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, 36 patients with MRI-negative unilateral TLE and 26 healthy controls (HCs) recruited during the same study period were enrolled. Resting-state functional MRI (rs-fMRI) was used to quantify global BOLD-CSF (gBOLD-CSF) and temporal BOLD-CSF (tBOLD-CSF) coupling. Comprehensive neuropsychological assessments included the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Digit Span Test (DST), Block Design, Phonological Fluency Test (PFT), and semantic verbal fluency (SVF). Partial correlations and multivariable linear regression were performed to evaluate associations between imaging metrics and cognitive performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with HCs, TLE patients showed significantly poorer performance on MoCA (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.007), DSST, DST, Block Design, PFT, and SVF (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Both gBOLD-CSF and tBOLD-CSF coupling strengths were markedly reduced in TLE patients (FDR-\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001 for both). After adjustment for age, sex, education level, and sleep duration, both coupling metrics were positively associated with SVF performance. False discovery rate (FDR) correction was applied to the three prespecified primary imaging\u2013SVF associations\u2013gBOLD\u2013CSF coupling, tBOLD\u2013CSF coupling, and CPV\u2013using the Benjamini-Hochberg procedure. The associations between the BOLD\u2013CSF coupling metrics and SVF performance remained significant after FDR correction (gBOLD-CSF coupling: partial\n                      <jats:italic>r<\/jats:italic>\n                      = 0.723, unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001, FDR-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001; tBOLD-CSF coupling: partial\n                      <jats:italic>r<\/jats:italic>\n                      = 0.396, unadjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.025, FDR-adjusted\n                      <jats:italic>p<\/jats:italic>\n                      = 0.038).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Reduced tBOLD\u2013CSF and gBOLD\u2013CSF coupling may serve as functional imaging correlates of semantic network vulnerability in patients with MRI-negative TLE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1879851","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:47:40Z","timestamp":1787118460000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduced BOLD-CSF coupling as a potential functional imaging correlate of semantic fluency decline in MRI-negative temporal lobe epilepsy"],"prefix":"10.3389","volume":"18","author":[{"given":"Ying","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Radiology, Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaona","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University","place":["Qingdao, China"]},{"name":"Medical Imaging and Engineering Intersection Key Laboratory of Qingdao","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Xue","sequence":"additional","affiliation":[{"name":"MR Research Collaboration, Shanghai United Imaging Healthcare Co., Ltd.","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd.","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangshui","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University","place":["Qingdao, China"]},{"name":"Medical Imaging and Engineering Intersection Key Laboratory of Qingdao","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1016\/j.nicl.2015.03.002","article-title":"Co-localization between the BOLD response and epileptiform discharges recorded by simultaneous intracranial EEG-fMRI at 3 T.","volume":"7","author":"Aghakhani","year":"2015","journal-title":"NeuroImage Clin."},{"key":"B2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.15274\/nrj-2014-10005","article-title":"EEG-fMRI evaluation of patients with mesial temporal lobe sclerosis.","volume":"27","author":"Avesani","year":"2014","journal-title":"Neuroradiol. 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