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Updated: Apr 6, 2026
Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Lateralized neural and oculomotor alterations in temporal lobe epilepsy: A combined eye-tracking and event-related
Ziwei Tian1, Sha Huang2, Bingliang Hu3
1Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an, 710119, China; University of Chinese Academy of Sciences, Beijing, 101408, China; Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an, 710119, China.
Objective:
Temporal lobe epilepsy (TLE) is associated with lateralized memory dysfunction, but the dynamic cognitive processes underlying these deficits remain poorly characterized by standard clinical scales. This study investigated whether combining eye-tracking and electroencephalography (EEG) could uncover specific, lateralized patterns of visual exploration and brain activity in LTLE and RTLE patients during a memory task.
Methods:
We enrolled 12 LTLE patients, 18 RTLE patients, and 20 healthy controls (HC), administering Wechsler Memory Scale and a high-load change detection task with synchronized eye-tracking and scalp EEG. We analyzed key eye-tracking metrics (fixation counts, average fixation duration) and event-related potentials reflecting early spatial attention (occipital N1b) and later memory-related activity (temporal late positive component [LPC]).
Results:
While both TLE groups showed impaired task performance compared to HC, they exhibited distinct neuro-ocular signatures. LTLE patients exhibited longer fixation durations, alongside reduced left-temporal LPC and rightward LPC shift. This pattern suggests a disruption of memory processes dependent on the left temporal lobe, accompanied by functional reorganization to the right hemisphere, which necessitates prolonged processing of local visual information. RTLE patients exhibited more frequent and shorter fixations, alongside reduced right-temporal LPC and increased occipital N1b effect. This profile indicates an impairment in right lobe-mediated memory, leading to a reliance on rapid visual sampling and greater attention demands.
Conclusions:
These findings demonstrate that LTLE and RTLE are associated with dissociable oculomotor-ERP patterns. This study establishes that eye-tracking and ERP techniques can objectively reveal latent cognitive deficits in TLE, offering a valuable complement to standard neuropsychological tests.
