Abstract
Temporal lobe epilepsy (TLE) is a progressive brain network disorder. Elucidating network reorganization and identifying disease progression-associated biomarkers are crucial for understanding pathological mechanisms, quantifying disease burden, and optimizing clinical strategies. This study aimed to investigate progressive changes in TLE by constructing a novel individualized morphological brain network based on T1-weighted structural magnetic resonance imaging (MRI). MRI data were collected from 34 postoperative seizure-free TLE patients and 28 age- and sex-matched healthy controls (HC), with patients divided into LONG-TERM and SHORT-TERM groups. Individualized morphological networks were constructed using the Morphometric INverse Divergence (MIND) framework by integrating cortical thickness and volume features (CTV-MIND). Network properties were then calculated and compared across groups to identify features potentially associated with disease progression. Results revealed progressive hub-node reorganization in CTV-MIND networks, with the LONG-TERM group showing increased connectivity in the lesion-side temporal lobe compared to SHORT-TERM and HC groups. The altered network node properties showed a significant correlation with local cortical atrophy. Incorporating identified network features into a machine learning-based brain age prediction model further revealed significantly elevated brain age in TLE. Notably, duration-related brain regions exerted a more significant and specific impact on premature brain aging in TLE than other regional combinations. Thus, prolonged duration may serve as an important contributor to the pathological aging observed in TLE. Our findings could help clinicians better identify abnormal brain trajectories in TLE and have the potential to facilitate the optimization of personalized treatment strategies.