{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:14:15Z","timestamp":1789978455458,"version":"4.0.1"},"reference-count":75,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","award":["FO996\/1-1"],"award-info":[{"award-number":["FO996\/1-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"International League against Epilepsy (NAF)","award":["FO996\/1-1"],"award-info":[{"award-number":["FO996\/1-1"]}]},{"name":"Open Access Publication Fund of the University of Freiburg","award":["FO996\/1-1"],"award-info":[{"award-number":["FO996\/1-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Objective: Temporal lobe epilepsy (TLE) constitutes the most common drug-refractory epilepsy syndrome. Tailored approaches are required, as TLE originates from extrahippocampal lesions in about one-quarter of surgical candidates. Despite high success rates in seizure control, concern persists regarding postoperative memory decline after lesionectomy. We investigated the associations between structural connectivity and postoperative memory performance in extrahippocampal TLE surgery. Methods: In total, 55 patients (25 females, 30 males; mean age 29.8 \u00b1 14.5 years; epilepsy duration 7.9 \u00b1 10.5 years, 31 left, 24 right TLE) with extrahippocampal TLE undergoing hippocampal-sparing surgery were evaluated with standardized pre- and postoperative neuropsychological testing. Lesion volumes intersected with Human Connectome Project-derived tractography data were employed to assess the structural connectivity integrity via voxel-based and connectome-informed lesion\u2013symptom mapping to identify cortical and white matter structures associated with cognitive outcomes. Results: Post-surgery, the widespread structural disconnection of several major white matter pathways was found, correlating with verbal memory and delayed recall. Additionally, the structural disconnection of the ipsilateral temporal lobe white matter was further associated with hippocampal atrophy. Conclusions: Our study highlights the role of structural connectivity alterations in postoperative memory decline in extrahippocampal TLE surgery. These findings expand the traditional understanding of hippocampal integrity in memory function towards the importance of broader structural networks. Individualized, connectome-informed surgical approaches might protect neurocognitive function.<\/jats:p>","DOI":"10.3390\/neurolint17040052","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T08:48:00Z","timestamp":1743410880000},"page":"52","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Linking Memory Impairment to Structural Connectivity in Extrahippocampal Temporal Lobe Epilepsy Surgery"],"prefix":"10.3390","volume":"17","author":[{"given":"Niels Alexander","family":"Foit","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany"},{"name":"Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Gau","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-6043","authenticated-orcid":false,"given":"Alexander","family":"Rau","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Faculty of Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7264-4807","authenticated-orcid":false,"given":"Horst","family":"Urbach","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Faculty of Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schulze-Bonhage","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1111\/epi.12220","article-title":"International Consensus Classification of Hippocampal Sclerosis in Temporal Lobe Epilepsy: A Task Force Report from the ILAE Commission on Diagnostic Methods","volume":"54","author":"Thom","year":"2013","journal-title":"Epilepsia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1111\/j.1750-3639.2012.00582.x","article-title":"Long-Term Epilepsy-Associated Tumors","volume":"22","author":"Thom","year":"2012","journal-title":"Brain Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.1111\/epi.12402","article-title":"Cavernoma-Related Epilepsy: Review and Recommendations for Management\u2014Report of the Surgical Task Force of the ILAE Commission on Therapeutic Strategies","volume":"54","author":"Rosenow","year":"2013","journal-title":"Epilepsia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1056\/NEJMoa1703784","article-title":"Histopathological Findings in Brain Tissue Obtained during Epilepsy Surgery","volume":"377","author":"Blumcke","year":"2017","journal-title":"N. 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