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Using quantitative susceptibility mapping (QSM) alongside transverse relaxation rate (), we investigated regional brain susceptibility changes in 36 patients with left\u2010sided (LTLE) or right\u2010sided TLE (RTLE) secondary to hippocampal sclerosis, and 27 healthy controls (HC). We compared three susceptibility calculation methods to ensure image quality. Correlations of susceptibility and  with age of epilepsy onset, frequency of focal\u2010to\u2010bilateral tonic\u2013clonic seizures (FBTCS), and neuropsychological test scores were examined. Weak\u2010harmonic QSM (WH\u2010QSM) successfully reduced noise and removed residual background field artefacts. Significant susceptibility increases were identified in the left putamen in the RTLE group compared to the LTLE group, the right putamen\u00a0and right thalamus in the RTLE group compared to HC, and a significant susceptibility decrease in the left hippocampus in LTLE versus HC. LTLE patients who underwent epilepsy surgery showed significantly lower left\u2010versus\u2010right hippocampal susceptibility. Significant  changes were found between TLE and HC groups in the amygdala, putamen, thalamus, and in the hippocampus. Specifically, decreased\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sub>2<\/jats:sub>\n                    * was found in the left and right hippocampus in LTLE and RTLE, respectively, compared to HC. Susceptibility and  were significantly correlated with cognitive test scores in the hippocampus, globus pallidus, and thalamus. FBTCS frequency correlated positively with ipsilateral thalamic and contralateral putamen susceptibility and with  in bilateral globi pallidi. Age of onset was correlated with susceptibility in the hippocampus and putamen, and with  in the caudate. Susceptibility and  changes observed in TLE groups suggest selective loss of low\u2010myelinated neurons alongside iron redistribution in the hippocampi, predominantly ipsilaterally, indicating QSM's sensitivity to local pathology. Increased susceptibility and  in the thalamus and putamen suggest increased iron content and reflect disease severity.\n                  <\/jats:p>","DOI":"10.1002\/hbm.26432","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T08:47:23Z","timestamp":1690361243000},"page":"5047-5064","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Quantitative susceptibility mapping identifies hippocampal and other subcortical grey matter tissue composition changes in temporal lobe epilepsy"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-0514","authenticated-orcid":false,"given":"Oliver C.","family":"Kiersnowski","sequence":"first","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin P.","family":"Winston","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy University College London  London UK"},{"name":"Department of Medicine, Division of Neurology Queen's University  Kingston Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Caciagli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy University College London  London UK"},{"name":"Department of Bioengineering University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Biondetti","sequence":"additional","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering University College London  London UK"},{"name":"Department of Neuroscience, Imaging and Clinical Sciences Institute for Advanced Biomedical Technologies, \u201cD'Annunzio\u201d University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha","family":"Elbadri","sequence":"additional","affiliation":[{"name":"Department of Neurology Queen Elizabeth Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Buck","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Thornton","sequence":"additional","affiliation":[{"name":"Neuroradiological Academic Unit UCL Queen Square Institute of Neurology, University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Shmueli","sequence":"additional","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd B.","family":"Vos","sequence":"additional","affiliation":[{"name":"Neuroradiological Academic Unit UCL Queen Square Institute of Neurology, University College London  London UK"},{"name":"Centre for Microscopy, Characterisation, and Analysis The University of Western Australia  Nedlands Australia"},{"name":"Centre for Medical Image Computing, Computer Science department University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1907-15.2016"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081093"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57030294"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00544"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","unstructured":"Bilgic B. 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