{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T04:15:46Z","timestamp":1761192946788,"version":"build-2065373602"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"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. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Automatisms with preserved responsiveness (APR) represent a distinctive clinical feature in right mesial temporal lobe epilepsy (MTLE). This study aimed to investigate whether interictal FDG-PET hypometabolism correlates with impaired responsiveness during seizures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 49 patients with right MTLE who underwent presurgical evaluation. Patients were stratified into APR+ (\n                      <jats:italic>n<\/jats:italic>\n                      = 16) and APR- (\n                      <jats:italic>n<\/jats:italic>\n                      = 33) groups based on a standardized four-domain assessment (orientation, memory, verbal command, motor execution). Interictal FDG-PET hypometabolism was visually scored on a three-point scale (0 = absent, 1 = moderate, 2 = severe) across 31 predefined brain regions by three blinded epileptologists. Group comparisons were performed using independent-sample\n                      <jats:italic>t<\/jats:italic>\n                      tests or Mann\u2013Whitney U tests, with Bonferroni correction (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.0016) and effect size estimation (Cohen\u2019s d).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      APR- patients exhibited significantly greater hypometabolism in the posterior lateral temporal cortex (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.00061, Cohen\u2019s d = 1.20) compared to APR+ patients. Although hypometabolic trends were also observed in posterior mesial (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.00203) and posterior basal temporal regions (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.00328), these did not survive multiple-comparison correction. No significant group differences were found in anterior temporal, frontal, insular, parietal, occipital, or subcortical regions. Contralateral hemispheric metabolism was preserved across all regions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Consciousness impairment in right MTLE is specifically associated with posterior lateral temporal dysfunction, with broader posterior temporal vulnerability suggested by subthreshold trends. These findings identify posterior lateral temporal hypometabolism as a potential biomarker of impaired responsiveness in right MTLE and highlight the value of FDG-PET for characterizing consciousness-related network dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1690510","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T04:13:18Z","timestamp":1761192798000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preserved ictal responsiveness in right mesial temporal lobe epilepsy: metabolic correlates in posterior temporal networks with FDG-PET"],"prefix":"10.3389","volume":"16","author":[{"given":"Yi-Seul","family":"Choo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young-Min","family":"Shon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Hwan","family":"Moon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeongsik","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hea Ree","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Yeon","family":"Joo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae 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