{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:06:36Z","timestamp":1788941196318,"version":"build-2803163510"},"reference-count":68,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["NET\u20102013\u201002355313"],"award-info":[{"award-number":["NET\u20102013\u201002355313"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Although hippocampal sclerosis (TLE\u2010HS) represents the most frequent cause of temporal lobe epilepsy (TLE), up to 30% of patients show no lesion on visual MRI inspection (TLE\u2010MRIneg). These cases pose diagnostic and therapeutic challenges and are underrepresented in surgical series. We investigated whether TLE\u2010MRIneg constitutes a distinct clinical and neuroanatomical entity compared to TLE\u2010HS and aimed to identify subtypes within the TLE\u2010MRIneg group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed MRI and clinical data from 209 patients with TLE and 102 healthy controls from the multicenter \u201c3TLE project\u201d. Based on expert radiological review, 96 patients were classified as TLE\u2010MRIneg and 76 as TLE\u2010HS; the remaining 37 were excluded due to other focal lesions. We compared clinical characteristics and brain morphometry between TLE\u2010MRIneg and TLE\u2010HS and applied clustering techniques to detect TLE\u2010MRIneg subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with TLE\u2010HS, TLE\u2010MRIneg was associated with later onset, shorter disease duration, and milder clinical presentation. TLE\u2010HS patients exhibited widespread cortical and subcortical atrophy, while TLE\u2010MRIneg showed only subtle cortical thinning. Cluster analysis revealed two subtypes of TLE\u2010MRIneg: one characterized by ipsilateral amygdala enlargement (AE) and the other by diffuse cortical atrophy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>These findings demonstrate that TLE\u2010MRIneg represents a distinct clinical\u2010imaging entity from TLE\u2010HS. The identification of morphologically defined subtypes, particularly AE, highlights the heterogeneity of TLE\u2010MRIneg and its potential clinical relevance. This work supports the use of advanced imaging and data\u2010driven methods to improve diagnosis and guide individualized management in non\u2010lesional epilepsies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70349","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T10:06:51Z","timestamp":1774346811000},"page":"1878-1892","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional Profiling of\n                    <scp>MRI<\/scp>\n                    \u2010Negative Temporal Lobe Epilepsy Uncovers Distinct Phenotypes"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0544-1599","authenticated-orcid":false,"given":"Alice","family":"Ballerini","sequence":"first","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia  Modena 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