Hard-wired or Soft-wired ? Evidence for the Structural Plasticity of White Matter Networks Following Anterior Temporal Lobectomy

Introduction Temporal lobe epilepsy (TLE) is the most common cause of medically intractable partial epilepsy, and in approximately 80% of patients with TLE, seizures are refractory to drug treatment. For this group of patients, anterior temporal lobe resection (ATLR) is now a well-established and effective means of treatment. Though up to 80% of these patients may be rendered seizure free by surgery, up to 40% are also at risk of postoperative decline in language functioning. We used diffusion tensor imaging in a longitudinal study in order to investigate the reorganisation of white matter that occurs after epilepsy surgery and how this relates to neuropsychological outcome.