Therefore, our results suggest that severe and long-term epilepsy, particularly temporal lobe epilepsy, may perturb BDNF and IGF-1 signaling in central autonomic system and disrupt limbic circuitry and HPA axis regulation, which contribute to the dysfunction of the ANS and the impaired cerebral autoregulation in patients with epilepsy. Here, IGF1 is linked to temporal lobe epilepsy.