ArticleClinical neuroradiology2026
Uncovering Individual Language Vulnerability in Epilepsy Through Functional Connectivity Laterality.
Article in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLanguage processing is organized in brain networks, generally lateralized to the left hemisphere. In clinical routine, task-based functional MRI (fMRI) is the gold standard for non-invasive evaluation of language lateralization. However, standard fMRI does not account for the individual heterogeneity of language networks. fMRI-based functional connectivity analysis (FCA) has addressed this shortcoming by identifying correlates of dysfunctional language networks in epilepsy patients. In order to individualize FCA, translation of group-based network analysis to individual epilepsy patients is necessary. Here, we introduce the functional connectivity laterality index (LI
methodsThis retrospective study included adults with unilateral temporal lobe epilepsy (TLE) who underwent task-based fMRI and a control group. To account for individual variations, fMRI was performed at a 3T scanner and processed entirely in native space. Laterality indices were computed from both activation maps and seed-based functional connectivity across frontal, temporal, and combined language regions. Group comparisons and associations with neuropsychological language performance were analysed.
resultsForty patients with unilateral TLE and 25 healthy controls were included. Groups were comparable in terms of sex, handedness, imaging findings, and epilepsy duration, although the controls were younger. Classical LI showed predominantly left-lateralization, while LI
conclusionOur findings suggest an individual vulnerability of language networks to seizure burden, although this uncorrected, exploratory finding requires replication in larger, independent samples. Incorporating functional connectivity measures into presurgical clinical fMRI analysis may enhance our ability to predict and protect language function in patients with TLE by prioritizing further therapies or surgical interventions for those at higher risk of language decline.
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