The present resting-state fMRI study performed structural equation modeling to evaluate intrinsic effective connectivity (iEC) within the Papez circuit in patients with unilateral temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS). Left TLE-MTS is characterized by decreased iEC on the left frontotemporal path, which might be associated with deficits in executive functions and working memory. Right TLE-MTS is characterized by decreased iEC on the paths in the right posterior limbic regions, which might be associated with deficits in autobiographical memory processing. Our findings might facilitate identifying potential epileptic network pathways and developing novel targeted therapies for unilateral TLE-MTS.
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