{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:16:15Z","timestamp":1780481775617,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["221934\/Z\/20\/Z"],"award-info":[{"award-number":["221934\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["218380"],"award-info":[{"award-number":["218380"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Magnetic resonance imaging (MRI) abnormalities have been reported in individuals who later die from sudden unexpected death in epilepsy (SUDEP), but their specificity and predictive value remain uncertain. Postmortem MRI (PM\u2010MRI) offers a unique opportunity to distinguish structural features associated with SUDEP from changes related to epilepsy, comorbid illness, or the postmortem interval. We performed PM\u2010MRI in nine individuals: five with suspected SUDEP, two with epilepsy who died from non\u2010seizure\u2010related causes, and two without epilepsy who died from sudden cardiac death. Hippocampal, amygdala, and subcortical volumes were quantified using validated segmentation methods and compared with 70 healthy in\u00a0vivo controls. Compared with non\u2010SUDEP cases, SUDEP cases showed significantly larger hippocampal (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) and amygdala (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) volumes, with most exceeding the healthy control mean, whereas non\u2010SUDEP cases consistently demonstrated volume reductions. These findings parallel in\u00a0vivo MRI observations in individuals at high risk of SUDEP and are consistent with transient peri\u2010 or postictal structural changes. In the context of recent large\u2010scale studies showing few validated clinical SUDEP biomarkers beyond frequent generalized tonic\u2013clonic seizures and sleeping alone, PM\u2010MRI may provide an objective approach to positively identifying individuals who died from SUDEP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>We used magnetic resonance imaging (MRI) scans taken after death to study brain changes in people who died from sudden unexpected death in epilepsy (SUDEP). We found that certain brain areas involved in seizure control and automatic body functions, such as breathing and heart rate, were larger in people who died from SUDEP than in people who died from other causes. These changes were similar to those previously seen on brain scans of people with epilepsy who are known to be at higher risk of SUDEP while they were still alive. Our findings suggest that postmortem MRI may help identify brain changes linked to SUDEP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70276","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T13:07:18Z","timestamp":1778245638000},"page":"1054-1060","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postmortem\n                    <scp>MRI<\/scp>\n                    reveals distinct structural features in sudden unexpected death in epilepsy"],"prefix":"10.1002","volume":"11","author":[{"given":"Andrea","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1308-6539","authenticated-orcid":false,"given":"Fenglai","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7712-2629","authenticated-orcid":false,"given":"Maria","family":"Thom","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Maudgil","sequence":"additional","affiliation":[{"name":"NIHR Great Ormond Street Biomedical Research Centre  London UK"},{"name":"Department of Radiology Wexham Park Hospital  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen J.","family":"Arthurs","sequence":"additional","affiliation":[{"name":"NIHR Great Ormond Street Biomedical Research Centre  London UK"},{"name":"Radiology Department Great Ormond Street Hospital  London UK"},{"name":"UCL GOS Institute of Child Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-9661","authenticated-orcid":false,"given":"Josemir W.","family":"Sander","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6896-854X","authenticated-orcid":false,"given":"Beate","family":"Diehl","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4277-8000","authenticated-orcid":false,"given":"Matthias J.","family":"Koepp","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology  London UK"},{"name":"Chalfont Centre for Epilepsy  Chalfont St Peter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1010481"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae128"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awv233"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17804"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2014.06.010"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14689"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-024-03295-0"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(25)00273-X"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nan.12638"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008741"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)01636\u20108"},{"issue":"1147","key":"e_1_2_10_13_1","article-title":"Post\u2010mortem perinatal imaging: what is the evidence?","volume":"96","author":"Shelmerdine SC","year":"2023","journal-title":"Br J Radiol"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16416"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2015.2418298"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70214-X"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.73153"}],"container-title":["Epilepsia 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