{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:56Z","timestamp":1792471136545,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"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 Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Patterns within the ictal\u2013interictal continuum (IIC) are frequently encountered in critically ill patients undergoing continuous electroencephalographic studies and may reflect ongoing ictal activity or secondary brain injury. Peri\u2010ictal neuroimaging abnormalities (PNA) have been described in association with status epilepticus (SE), but their occurrence in patients with IIC across different neuroimaging modalities remains incompletely characterized. We aimed to assess the occurrence of PNA in adults with IIC across structural and functional neuroimaging techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic review and meta\u2010analysis following PRISMA 2020 guidelines. PubMed, Embase, and Scopus were searched up to January 2026 for studies reporting PNA in adults with IIC. Eligible modalities included magnetic resonance imaging (MRI), CT perfusion (CTP), and positron emission tomography (PET). Pooled detection rates were estimated using random\u2010effects generalized linear mixed models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 8400 records identified, seven studies met the inclusion criteria. Of these, four contributed MRI data (98 patients), two\u2014CTP data (38 patients), and two\u2014PET data (30 patients); no SPECT study was identified. One study contributed data to two modalities. Pooled proportion of PNA was 0.41 (95% CI: 0.30\u20130.52;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200930.4%) for MRI, 0.34 (95% CI: 0.21\u20130.50;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%) for CTP, and 0.90 (95% CI: 0.73\u20130.97;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%) for PET.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>There are currently a limited number of studies evaluating PNA in IIC. PET showed the highest pooled proportion of PNA, although these findings should be interpreted cautiously. Further studies are required to better define the neuroimaging spectrum within the IIC and to clarify its clinical and diagnostic implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70335","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:06:26Z","timestamp":1786118786000},"page":"1426-1436","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimaging of the ictal\u2013interictal continuum: Where do we stand? A systematic review and meta\u2010analysis of current evidence"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2344-6323","authenticated-orcid":false,"given":"Panagiota\u2010Eleni","family":"Tsalouchidou","sequence":"first","affiliation":[{"name":"Second Department of Neurology National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital  Athens Greece"},{"name":"Faculty of Medicine, Department of Neurology Epilepsy Center Hessen, Philipps\u2010Universit\u00e4t Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9397-8699","authenticated-orcid":false,"given":"Kateriine","family":"Orav","sequence":"additional","affiliation":[{"name":"Department of Neurology North Estonia Medical Centre  Tallinn Estonia"},{"name":"Department of Neurology Christian Doppler University Hospital, Centre for Cognitive Neuroscience, Member of the European Reference Network EpiCARE, Paracelsus Medical University of Salzburg  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8482-5785","authenticated-orcid":false,"given":"Tiago","family":"Lerda\u2010Casaccia","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian Doppler University Hospital, Centre for Cognitive Neuroscience, Member of the European Reference Network EpiCARE, Paracelsus Medical University of Salzburg  Salzburg Austria"},{"name":"Neuroscience Institute, Christian Doppler University Hospital, Centre for Cognitive Neuroscience, Paracelsus Medical University of Salzburg  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6562-1196","authenticated-orcid":false,"given":"Leona","family":"M\u00f6ller","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Neurology Epilepsy Center Hessen, 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