ReviewInternational journal of molecular sciences2026
Advancing the Paradigm of Temporal Lobe Epilepsy as a Network Disease: The Promise of Biomarkers and Targeted Disease Modification.
Review in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
10 authors.
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Abstract
Temporal lobe epilepsy (TLE) is increasingly conceptualized not as an isolated hippocampal lesion, but as a complex, multiscale limbic network connectomic disorder. Despite advances in pharmacological management, over 30% of patients experience drug-resistant epilepsy, underscoring the urgent need to shift from symptomatic seizure control to mechanism-directed disease modification. This review comprehensively synthesizes the pathophysiological architecture of epileptogenesis in TLE, spanning mitochondrial bioenergetic alterations, chronic neuroinflammation, synaptic reorganization, and ionic plasticity resulting from ion-channel dysregulation. We evaluate diagnostic advancements, highlighting how invasive stereo-EEG disambiguates pathological high-frequency oscillations from physiological ripples, how structural HARNESS-MRI maps anatomical substrates, and how AI-driven algorithms analyze ultra-long-term EEG streams for continuous seizure forecasting. Additionally, peripheral biofluid proteins and microRNAs provide noninvasive windows into active neuroinflammation and network remodeling, serving as valuable tools for longitudinal disease monitoring rather than primary screening. Therapeutically, the field is evolving beyond empirical antiseizure medications toward mechanism-based rational drug design and precision interventions. Dual-mechanism agents enhance seizure freedom, while antisense oligonucleotides, microRNA antagomirs, and cation-chloride cotransporter modulators target underlying genetic and biophysical drivers. Minimally invasive ablation, AI-guided closed-loop neuromodulation, targeted anti-inflammatory biologics, and patient-derived 3D cerebral organoid platforms further expand the translational frontier. Ultimately, bridging these experimental modalities through prospective clinical validation may provide a viable path toward interrupting epileptogenesis and realizing true disease modification in human TLE.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.