{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:22:32Z","timestamp":1790220152903,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011852","name":"Paracelsus Medizinische Privatuniversit\u00e4t","doi-asserted-by":"publisher","award":["2021\u2010UP\u2010003\u2010Kuchukhidze"],"award-info":[{"award-number":["2021\u2010UP\u2010003\u2010Kuchukhidze"]}],"id":[{"id":"10.13039\/501100011852","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002428","name":"Austrian Science Fund","doi-asserted-by":"publisher","award":["KLI 969\u2010B"],"award-info":[{"award-number":["KLI 969\u2010B"]}],"id":[{"id":"10.13039\/501100002428","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Status epilepticus (SE) is the most severe expression of seizures, encompassing both SE with prominent motor symptoms and nonconvulsive SE (NCSE). Ictal\u2013interictal continuum (IIC), an electroencephalographic phenomenon, is characterized by periodic discharges (PD), spike\u2010and\u2010waves or sharp\u2010and\u2010waves (SW), or lateralized rhythmic delta activity (LRDA). Peri\u2010ictal magnetic resonance imaging (MRI) abnormalities (PMA) may offer a potential surrogate marker for ictal activity, yet their association with IIC remains unclear. We aimed to investigate the occurrence of PMA in patients with SE and IIC, and to determine the relationship between IIC patterns and PMA through a latent cluster analysis (LCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective cohort study, 223 adult patients diagnosed with SE or IIC underwent electroencephalography (EEG) and MRI within 48\u2009h of diagnosis. Patients were stratified into two groups: the IIC group and SE group. PMA were assessed using the following MRI sequences: diffusion\u2010weighted imaging, fluid\u2010attenuated inversion recovery, and arterial spin labeling. LCA was performed to identify classes based on etiology, EEG patterns, and their localization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PMA were as frequent in patients of the IIC group (23\/49, 47%) as in patients of the SE group (64\/149, 43%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.37). In the IIC group, peri\u2010ictal hyperperfusion was more frequently associated with lower frequency PD\/SW (.5\u20131\u2009Hz; 12\/19, 63%), followed by LRDA (4\/13, 31%) and higher frequency PD\/SW (&gt;1\u20132.5\u2009Hz; 4\/17, 24%). LCA revealed two classes; Class 1, characterized by nonunilateral high\u2010frequency PD\/SW and triggering factors in epilepsy, had fewer PMA (18%) as compared to Class 2, characterized by predominantly unilateral low\u2010frequency PD\/SW and diverse etiologies (50%; odds ratio\u2009=\u20095.79,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>PMA occurrence in IIC aligned closely with that in SE, suggesting an overlap between IIC and SE and raising the critical question of whether patients with IIC may have NCSE. We propose an etiology\u2010driven approach for EEG interpretation in IIC, which may enhance diagnostic accuracy and treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70131","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:34:23Z","timestamp":1770042863000},"page":"2377-2388","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Ictal\u2013interictal continuum and status epilepticus: Two sides of the same coin? A prospective magnetic resonance imaging study"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0488-7863","authenticated-orcid":false,"given":"Pilar","family":"Bosque\u2010Varela","sequence":"first","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"},{"name":"Neuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7437-8992","authenticated-orcid":false,"given":"Lukas","family":"Machegger","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Christian Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5774-0846","authenticated-orcid":false,"given":"Wanda","family":"Lauth","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"},{"name":"Department of Mathematics Paris\u2010Lodron University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2344-6323","authenticated-orcid":false,"given":"Panagiota Eleni","family":"Tsalouchidou","sequence":"additional","affiliation":[{"name":"Epilepsy Center Hessen, Department of Neurology Philipps University  Marburg Germany"},{"name":"Second Department of Neurology Attikon University Hospital, National and Kapodistrian University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6298-0513","authenticated-orcid":false,"given":"Susanne","family":"Knake","sequence":"additional","affiliation":[{"name":"Epilepsy Center Hessen, Department of Neurology Philipps University  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8282-1034","authenticated-orcid":false,"given":"Georg","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"},{"name":"Department of Mathematics Paris\u2010Lodron University  Salzburg Austria"},{"name":"Team Biostatistics and Big Medical Data, IDA Lab Salzburg, Paracelsus Medical University  Salzburg Austria"},{"name":"Research and Innovation Management, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9925-2248","authenticated-orcid":false,"given":"Nicolas","family":"Jannone\u2010Pedro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"},{"name":"Department of Clinical Neurophysiology University and Polytechnic La Fe Hospital, member of European Reference Network EpiCARE  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3585-5872","authenticated-orcid":false,"given":"Giada","family":"Giovannini","sequence":"additional","affiliation":[{"name":"Unit of Clinical Neurophysiology OCB Hospital  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-539X","authenticated-orcid":false,"given":"Stefano","family":"Meletti","sequence":"additional","affiliation":[{"name":"Unit of Clinical Neurophysiology OCB Hospital  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6257-1580","authenticated-orcid":false,"given":"Adrian Ridski","family":"Harsono","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"},{"name":"Neurophysiology and Epilepsy Division, Department of Neurology, Faculty of Medicine University of Indonesia  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7300-7877","authenticated-orcid":false,"given":"Fabio","family":"Rossini","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-6762","authenticated-orcid":false,"given":"Markus","family":"Leitinger","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0672-5718","authenticated-orcid":false,"given":"Johannes","family":"Pfaff","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Christian Doppler University Hospital, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6035-6581","authenticated-orcid":false,"given":"S\u00e1ndor","family":"Beniczky","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Clinical Neurophysiology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"},{"name":"Danish Epilepsy Center  Dianalund Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5950-2692","authenticated-orcid":false,"given":"Eugen","family":"Trinka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University Hospital, member of European Reference Network EpiCARE, and Center for Cognitive Neuroscience, Paracelsus Medical University  Salzburg Austria"},{"name":"Neuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience  Salzburg Austria"},{"name":"Karl Landsteiner Institute for Clinical Neurosciences  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6899-8506","authenticated-orcid":false,"given":"Giorgi","family":"Kuchukhidze","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care, and Neurorehabilitation Christian Doppler University 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