To seek neural correlates of seizure recurrence, the structural equation modeling (SEM) and resting-state functional MRI were performed to evaluate intrinsic effective connectivity (iEC) within the Papez circuit, hippocampal–diencephalic–cingulate (HDC) model, and simplified HDC model in patients with left and right temporal lobe epilepsy. We verified that the simplified HDC model was the best model to estimate iEC and found associations between seizure frequency and aberrant iEC on the paths connecting to the mammillary body. Our findings could facilitate the discovery of potential epilepsy pathways and the development of novel targeted therapies for unilateral temporal lobe epilepsy.
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