Temporal lobe epilepsy is the most common form of focal epilepsy and related cognitive dysfunction impacts significantly on quality of life in patients. Identifying the mechanisms of such impairment would assist in the management and treatment of patients. The study of perturbations in resting-state networks could shed light on this subject. The aim of this systematic review was to synthesize findings on the relationship between aberrant resting-state functional connectivity and cognitive performance in patients with TLE. Literature searches were conducted on Scopus and PubMed electronic databases and 17 relevant articles were extracted, all of which studied the association between resting-state functional connectivity (RSFC) and cognition in adults with TLE. Study findings were synthesized according to methods used to analyze resting-state data, cognitive domains tested, and neuropsychology tasks administered. Results show that increased RSFC in the primary epileptogenic hippocampus, and reduced intra-hemispheric RSFC, are associated with weaker memory performance. In left TLE, memory impairment may be compensated for by bilateral hippocampal connectivity, which is also predictive of better postoperative memory outcomes. In right TLE, memory loss may be compensated for by increased connectivity between the contralateral hippocampus and inferior frontal gyrus. There is also tentative evidence that working memory dysfunction is related to reduced RSFC between the medial frontal-insular parietal network and the medial temporal network, executive dysfunction is related to reduced RSFC between frontal and parietal lobes, and between the frontal lobe and subcortical regions and that language dysfunction is related to reduced RSFC within the left fronto-temporal language network. Multicenter studies could refute or support these findings by enrolling large samples of patients and employing multivariate regression analysis to control for the effects of anatomical disruption, interictal discharges, seizure frequency, medication, and mood. Systematic review registration: PROSPERO: 191323.

中文翻译：

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颞叶癫痫认知障碍的机制：静息状态功能连接研究的系统评价

颞叶癫痫是局灶性癫痫最常见的形式，相关的认知功能障碍对患者的生活质量有显着影响。确定这种损伤的机制将有助于患者的管理和治疗。对静止状态网络中的扰动的研究可以阐明这个主题。本系统评价的目的是综合有关 TLE 患者异常静息状态功能连接与认知能力之间关系的发现。在 Scopus 和 PubMed 电子数据库上进行文献检索，提取了 17 篇相关文章，所有文章均研究了静息状态功能连接 (RSFC) 与成人 TLE 认知之间的关联。根据用于分析静息状态数据的方法综合研究结果，测试认知领域，并管理神经心理学任务。结果表明，原发性癫痫海马区 RSFC 增加和半球内 RSFC 减少与较弱的记忆能力有关。在左侧 TLE 中，双侧海马连接可以补偿记忆障碍，这也预示着更好的术后记忆结果。在右侧 TLE 中，记忆丧失可以通过对侧海马体和额下回之间增加的连接来补偿。也有初步证据表明，工作记忆功能障碍与内侧额叶-岛顶叶网络和内侧颞叶网络之间的 RSFC 减少有关，执行功能障碍与额叶和顶叶之间的 RSFC 减少有关，在额叶和皮层下区域之间，语言功能障碍与左额颞语言网络内的 RSFC 减少有关。多中心研究可以通过招募大量患者样本并采用多元回归分析来控制解剖破坏、发作间期放电、癫痫发作频率、药物治疗和情绪的影响来反驳或支持这些发现。系统评价注册：PROSPERO：191323。