Effect and mechanism of lateralization of cerebellar-cerebral network abnormalities on language in patients with unilateral temporal lobe epilepsy

OBJECTIVE: Since epilepsy is associated with cerebral dysfunction, there may be a recombination of language circuits in the course of epilepsy. We explored the differences in speech impairment patterns in patients with temporal lobe epilepsy (TLE) and different hemiencephalic attacks from the perspective of the cerebellum. METHODS: Fifty-eight patients with TLE and 30 healthy controls (HCs) were recruited. including 28 patients with left temporal lobe epilepsy (LTLE) and 30 patients with right temporal lobe epilepsy (RTLE). The resting state functional connection method was used to investigate the effects of lateralization and cerebellar laterality on language function in patients with TLE. The differences in functional connectivity (FC) in the whole cerebellar cortex were compared between the three groups. RESULTS: FC analysis revealed significant differences among the LTLE, RTLE, and HCs. Post-hoc comparisons indicated that both LTLE and RTLE patients exhibited significantly reduced FC relative to HCs. Moreover, the RTLE group demonstrated significantly lower FC compared to the LTLE group. CONCLUSION: In the brain regions related to language, patients with RTLE had stronger left hemispheric activation than patients with LTLE. The RTLE group had greater language central connection disorder than the HCs. Cerebellar-cerebral functional connectivity has different connectivity patterns between LTLE and RTLE groups. Cerebellar network alterations in TLE may be associated with functional reorganization and a potential shift of language-related network activity toward homologous regions in the contralateral hemisphere.