The neuroanatomical basis of psychosis of epilepsy (POE) is not well understood. As POE is more prevalent in temporal lobe epilepsy1, most structural neuroimaging studies have examined structural changes in the temporal lobe, particularly the hippocampus, with conflicting results.2–7 Given that epilepsy is now understood as a disease of brain networks8,9, pathology in network hubs beyond the hippocampus in POE is likely.10 Indirect support for this idea comes from evidence of structural changes in patients with schizophrenia, the paradigmatic psychotic illness, in key hubs of two brain networks – the cognitive control network and the default mode network.
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