BackgroundTemporal lobe epilepsy (TLE) manifests with diverse seizure symptoms, including focal to bilateral tonic—clonic seizures (FBTCS), linked to widespread brain network disruptions. The role of cortical morphometric similarity (MS) network gradients and their relationship with gene expression in TLE remains unclear.MethodsWe studied MS network gradient abnormalities through group comparisons among 87 left TLE patients (48 FBTCS−, 39 FBTCS+) and 63 healthy controls (HC). In addition, partial least squares (PLS) regression analysis was performed to investigate the association between gradient changes and whole-brain gene expression in left FBTCS+ TLE patients.ResultsFBTCS+ patients showed significant reductions in the principal MS network gradient within default mode network (DMN) regions compared to healthy controls, while FBTCS− patients exhibited no such abnormalities. Gradient alterations in FBTCS+ were linked to whole-brain expression of genes involved in neurobiological pathways, cell types, and cortical layers.ConclusionFBTCS+ TLE is associated with distinct MS network gradient alterations, which may reflect underlying molecular mechanisms contributing to structural changes linked to severe seizure symptoms.
Radically different