The aims of this study were to investigate whether the cortical atrophy caused by temporal lobe epilepsy (TLE) was reversible after successful anterior temporal lobectomy (ATL) and to further observe whether possible changes are related to age at surgery and cognitive changes. Twelve patients with unilateral mesial TLE who received ATL and remained seizure free in one year follow-up were included. They underwent two MRI scans few days before and oneyear after surgery. Thirty age- and sex-matched healthy participants were recruited as controls. Group comparisons were used to test the differences in cortical thickness (CTh) between the pre-/postsurgical patients and controls. Longitudinal test was used to directly show postsurgical changes of the patients. Besides, the correlations between regional cortical volume (CVo) changes and age at surgery or cognitive changes were also tested. Compared with controls, the patients with TLE showed dispersed cortical thinning especially in the bilateral frontal lobes before surgery and no significant cortical thinning except for cortices near the resected areas after surgery. The longitudinal analysis showed CTh increment in the ipsilateral precentral and postcentral gyrus, cuneus and widespread in the contralateral cortex. In the volumetric analysis, the CVo changes in the contralateral hemisphere were negatively correlated with age at surgery and positively correlated with MoCA score changes. This study suggests that the cortical atrophy caused by TLE could recover after successful ATL. The recovery ability is greater in younger subjects and is positively related to cognitive recovery. These findings could serve as new clues that patients with TLE can benefit from timely and successful ATL.

本研究的目的是探讨前颞叶切除术（ATL）成功后颞叶癫痫（TLE）引起的皮质萎缩是否可逆，并进一步观察可能的变化是否与手术年龄和认知改变有关。纳入了 12 名接受 ATL 且在一年随访中无癫痫发作的单侧内侧 TLE 患者。他们在手术前几天和一年后接受了两次 MRI 扫描。招募了 30 名年龄和性别匹配的健康参与者作为对照。组比较用于测试术前/术后患者与对照组之间皮质厚度 (CTh) 的差异。纵向试验用于直接显示患者的术后变化。除了，还测试了区域皮质体积 (CVo) 变化与手术年龄或认知变化之间的相关性。与对照组相比，TLE 患者术前表现为分散的皮质变薄，尤其是双侧额叶，术后除切除区域附近的皮质外，无明显皮质变薄。纵向分析显示同侧中央前回和中央后回、楔叶和对侧皮层广泛的CTh增量。在体积分析中，对侧半球的 CVo 变化与手术年龄呈负相关，与 MoCA 评分变化呈正相关。这项研究表明，TLE 引起的皮质萎缩在 ATL 成功后可以恢复。年轻受试者的恢复能力更强，并且与认知恢复呈正相关。这些发现可以作为 TLE 患者可以从及时和成功的 ATL 中受益的新线索。