{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:58:34Z","timestamp":1791471514581,"version":"4.3.4"},"reference-count":71,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Social disadvantage is an important determinant of health in focal epilepsy, but its neurobiological basis remains unclear. We examined whether brain morphometric alterations represent a structural signature of deprivation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study of 340 adults with pharmacoresistant focal epilepsy evaluated at the Cleveland Clinic (2010\u20132022). Age\u2010 and sex\u2010adjusted volumetric percentiles were derived from 3\u2010T brain magnetic resonance imaging. To account for hemispheric network differences, analyses were stratified by epilepsy laterality (right vs. left), adjusting for seizure localization, seizure burden, and lesional status. Neighborhood disadvantage was quantified using the Area Deprivation Index (ADI) and categorized into low, moderate, and high deprivation using the R sociome package. To identify coordinated structural patterns, least absolute shrinkage and selection operator regression with 10\u2010fold cross\u2010validation was applied to high\u2010dimensional volumetric data, followed by latent Dirichlet allocation (LDA) to derive latent volumetric networks. Associations between network expression and ADI were assessed using Spearman correlation and Kruskal\u2013Wallis with false discovery rate (FDR) correction. Regional patterns were visualized using ggseg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In right\u2010sided epilepsy, LDA\u2010derived networks were significantly associated with ADI (FDR\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.01). Occipitoparietal and frontal opercular networks showed declining membership with increasing deprivation (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u2009\u2212.23, FDR\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.01). All top\u2010loading regions demonstrated negative volume\u2013ADI correlations, with pericalcarine cortex and cuneus volumes decreasing by 27.1 and 24.4 percentile points, respectively, from lowest to highest deprivation. Associations were weaker but directionally consistent in left\u2010sided epilepsy (FDR\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.053). The visual and ventral attention networks emerged as most heavily ADI\u2010sensitive. No individual regional volumes showed significant associations with ADI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Neighborhood disadvantage was linked to network\u2010level, but not focal, brain alterations in adults with focal epilepsy, with laterality\u2010specific vulnerability patterns supporting incorporation of neighborhood metrics into epilepsy research and care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70537","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:31:41Z","timestamp":1791469901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Brain volumetric signatures of neighborhood disadvantage in focal 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Life Sciences Cleveland Clinic Research, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5190-2411","authenticated-orcid":false,"given":"Jingdi","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Computational Life Sciences Cleveland Clinic Research, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0643-7110","authenticated-orcid":false,"given":"Raphael F.","family":"Casseb","sequence":"additional","affiliation":[{"name":"Neuroimaging Laboratory Department of Neurology, Epilepsy  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0553-3220","authenticated-orcid":false,"given":"Daniel M.","family":"Rotroff","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Quantitative Health Sciences Cleveland Clinic Research, Cleveland Clinic  Cleveland Ohio USA"},{"name":"Center for Quantitative Metabolic Research Cleveland Clinic Research, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9336-9568","authenticated-orcid":false,"given":"Fernando","family":"Cendes","sequence":"additional","affiliation":[{"name":"Neuroimaging Laboratory Department of Neurology, Epilepsy  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8041-6377","authenticated-orcid":false,"given":"Lara","family":"Jehi","sequence":"additional","affiliation":[{"name":"Department of Computational Life Sciences Cleveland Clinic Research, Cleveland Clinic  Cleveland Ohio USA"},{"name":"Cleveland Clinic Lerner College of Medicine of Case Western 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