Unilateral temporal lobe epilepsy (TLE) is the most common type of focal epilepsy characterized by foci in the unilateral temporal lobe grey matters of regions such as the hippocampus. However, it remains unclear how the functional features of white matter are altered in TLE. In the current study, resting-state functional magnetic resonance imaging (fMRI) was performed on 71 left TLE (LTLE) patients, 79 right TLE (RTLE) patients and 47 healthy controls (HC). Clustering analysis was used to identify fourteen white matter networks (WMN). The functional connectivity (FC) was calculated among WMNs and between WMNs and grey matter. Furthermore, the FC laterality of hemispheric WMNs was assessed. First, both patient groups showed decreased FCs among WMNs. Specifically, cerebellar white matter illustrated decreased FCs with the cerebral superficial WMNs, implying a dysfunctional interaction between the cerebellum and the cerebral cortex in TLE. Second, the FCs between WMNs and the ipsilateral hippocampus (grey matter foci) were also reduced in patient groups, which may suggest insufficient functional integration in unilateral TLE. Interestingly, RTLE showed more severe abnormalities of white matter FCs, including links to the bilateral hippocampi and temporal white matter, than LTLE. Taken together, these findings provide functional evidence of white matter abnormalities, extending the understanding of the pathological mechanism of white matter impairments in unilateral TLE.

单侧颞叶癫痫（TLE）是最常见的局灶性癫痫类型，其特征是病灶位于海马等区域的单侧颞叶灰质。然而，目前尚不清楚 TLE 中白质的功能特征是如何改变的。在目前的研究中，对 71 名左侧 TLE (LTLE) 患者、79 名右侧 TLE (RTLE) 患者和 47 名健康对照 (HC) 进行了静息状态功能磁共振成像 (fMRI)。聚类分析用于识别十四个白质网络（WMN）。计算 WMN 之间以及 WMN 与灰质之间的功能连接性 (FC)。此外，评估了半球 WMN 的 FC 偏侧性。首先，两个患者组均显示 WMN 中的 FC 减少。具体来说，小脑白质表明脑浅表 WMN 的 FCs 减少，这意味着 TLE 中小脑和大脑皮层之间存在功能失调的相互作用。其次，患者组中 WMN 和同侧海马（灰质病灶）之间的 FCs 也减少，这可能表明单侧 TLE 的功能整合不足。有趣的是，与 LTLE 相比，RTLE 显示出更严重的白质 FC 异常，包括与双侧海马和颞叶白质的联系。总之，这些发现提供了白质异常的功能证据，扩展了对单侧 TLE 中白质损伤病理机制的理解。这可能表明单侧 TLE 中的功能整合不足。有趣的是，与 LTLE 相比，RTLE 显示出更严重的白质 FC 异常，包括与双侧海马和颞叶白质的联系。总之，这些发现提供了白质异常的功能证据，扩展了对单侧 TLE 中白质损伤病理机制的理解。这可能表明单侧 TLE 中的功能整合不足。有趣的是，与 LTLE 相比，RTLE 显示出更严重的白质 FC 异常，包括与双侧海马和颞叶白质的联系。总之，这些发现提供了白质异常的功能证据，扩展了对单侧 TLE 中白质损伤病理机制的理解。