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Here, we mapped multimodal neocortical markers of epilepsy\u2010related structural compromise in a pediatric cohort of temporal lobe epilepsy and explored how they relate to clinical factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We measured cortical thickness, gray\u2013white matter intensity contrast and intracortical FLAIR intensity in 22 patients with hippocampal sclerosis (HS) and 30 controls. Surface\u2010based linear models assessed between\u2010group differences in morphological and MR signal intensity markers. Structural integrity of the hippocampus was measured by quantifying atrophy and FLAIR patterns. Linear models were used to evaluate the relationships between hippocampal and neocortical MRI markers and clinical factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the hippocampus, patients demonstrated ipsilateral atrophy and bilateral FLAIR hyperintensity. In the neocortex, patients showed FLAIR signal hyperintensities and gray\u2013white matter boundary blurring in the ipsilesional mesial and lateral temporal neocortex. In contrast, cortical thinning was minimal and restricted to a small area of the ipsilesional temporal pole. Furthermore, patients with a history of febrile convulsions demonstrated more pronounced FLAIR hyperintensity in the ipsilesional temporal neocortex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Pediatric HS patients do not yet demonstrate the widespread cortical thinning present in adult cohorts, which may reflect consequences of a protracted disease process. However, pronounced temporal neocortical FLAIR hyperintensity and blurring of the gray\u2013white matter boundary are already detectable, suggesting that alterations in MR signal intensities may reflect a different underlying pathophysiology that is detectable earlier in the disease and more pervasive in patients with a history of febrile convulsions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.634","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T06:50:17Z","timestamp":1538117417000},"page":"1200-1210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Multimodal computational neocortical anatomy in pediatric hippocampal sclerosis"],"prefix":"10.1002","volume":"5","author":[{"given":"Sophie","family":"Adler","sequence":"first","affiliation":[{"name":"Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London  London United Kingdom"},{"name":"Great Ormond Street Hospital for Children  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallory","family":"Blackwood","sequence":"additional","affiliation":[{"name":"Institute of Neurology University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma B.","family":"Northam","sequence":"additional","affiliation":[{"name":"Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Gunny","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok\u2010Jun","family":"Hong","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris C.","family":"Bernhardt","sequence":"additional","affiliation":[{"name":"Multimodal Imaging and Connectome Analysis Lab McConnell Brain Imaging Centre Montreal Neurological Institute McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Neuroimaging of Epilepsy Laboratory McConnell Brain Imaging Centre Montreal Neurological Institute and Hospital McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Jacques","sequence":"additional","affiliation":[{"name":"Developmental Biology and Cancer Programme UCL Great Ormond Street Institute of Child Health University College London  London United Kingdom"},{"name":"Department of Histopathology Great Ormond Street Hospital for Children NHS Foundation Trust  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Tisdall","sequence":"additional","affiliation":[{"name":"Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London  London United Kingdom"},{"name":"Great Ormond Street Hospital for Children  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London  London United Kingdom"},{"name":"Great Ormond Street Hospital for Children  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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