Different patterns of white matter changes after successful surgery of mesial temporal lobe epilepsy.

•Widespread white matter abnormalities existed in mesial temporal lobe epilepsy.•We explored longitudinal DTI changes at five serial time points before and after anterior temporal lobectomy.•We found four distinct patterns of diffusion changes, reflecting different structural adaptions following epilepsy surgery.•Structural reorganization did occur after surgery, especially in contralateral hemisphere.