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The interaction between cerebellum and cerebrum participates widely in function from motor processing to high‐level cognitive and affective processing. Because of the motor symptom, idiopathic generalized epilepsy (IGE) patients with generalized tonic–clonic seizure have been recognized to associate with motor abnormalities, but the functional interaction in the cerebello–cerebral circuit is still poorly understood. Resting‐state functional magnetic resonance imaging data were collected for 101 IGE patients and 106 healthy controls. The voxel‐based functional connectivity (FC) between cerebral cortex and the cerebellum was contacted. The functional gradient and independent components analysis were applied to evaluate cerebello–cerebral functional integration on the voxel‐based FC. Cerebellar motor components were further linked to cerebellar gradient. Results revealed cerebellar motor functional modules were closely related to cerebral motor components. The altered mapping of cerebral motor components to cerebellum was observed in motor module in patients with IGE. In addition, patients also showed compression in cerebello–cerebral functional gradient between motor and cognition modules. Interestingly, the contribution of the motor components to the gradient was unbalanced between bilateral primary sensorimotor components in patients: the increase was observed in cerebellar cognitive module for the dominant hemisphere primary sensorimotor, but the decrease was found in the cerebellar cognitive module for the nondominant hemisphere primary sensorimotor. The present findings suggest that the cerebral primary motor system affects the hierarchical architecture of cerebellum, and substantially contributes to the functional integration evidence to understand the motor functional abnormality in IGE patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate potential functional and structural large‐scale network disturbances in untreated patients with generalized tonic–clonic seizures (GTCS) and the effects of antiseizure drugs. Methods: In this study, 41 patients with GTCS, comprising 21 untreated patients and 20 patients who received antiseizure medications (ASMs), and 29 healthy controls were recruited to construct large‐scale brain networks based on resting‐state functional magnetic resonance imaging and diffusion tensor imaging. Structural and functional connectivity and network‐level weighted correlation probability (NWCP) were further investigated to identify network features that corresponded to response to ASMs. Results: Untreated patients showed more extensive enhancement of functional and structural connections than controls. Specifically, we observed abnormally enhanced connections between the default mode network (DMN) and the frontal–parietal network. In addition, treated patients showed similar functional connection strength to that of the control group. However, all patients exhibited similar structural network alterations. Moreover, the NWCP value was lower for connections within the DMN and between the DMN and other networks in the untreated patients; receiving ASMs could reverse this pattern. Significance: Our study identified alterations in structural and functional connectivity in patients with GTCS. The influence of ASMs may be more noticeable within the functional network; moreover, abnormalities in both the functional and structural coupling state may be improved by ASM treatment. Therefore, the coupling state of structural and functional connectivity may be used as an indicator of the efficacy of ASMs. [ABSTRACT FROM AUTHOR]