BackgroundTemporal lobe epilepsy (TLE) manifests with diverse seizure symptoms, including focal to bilateral tonic—clonic seizures (FBTCS), linked to widespread brain network disruptions. The role of cortical morphometric similarity (MS) network gradients and their relationship with gene expression in TLE remains unclear.MethodsWe studied MS network gradient abnormalities through group comparisons among 87 left TLE patients (48 FBTCS−, 39 FBTCS+) and 63 healthy controls (HC). In addition, partia