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After preprocessing of T1 structural images, the voxel\u2010based morphometry and source\u2010based morphometry (SBM) methods were applied in 60 SHE patients and 56 healthy controls to analyze the gray matter volumetric alterations. Furthermore, a causal network of structural covariance (CaSCN) was constructed using Granger causality analysis based on structural data of illness duration ordering to assess the causal impact of structural changes in abnormal gray matter regions. The GMVs of SHE patients were widely reduced, mainly in the bilateral cerebellums, fusiform gyri, the right angular gyrus, the right postcentral gyrus, and the left parahippocampal gyrus. In addition to those regions, the results of the SBM analysis also found decreased GMV in the bilateral frontal lobes, precuneus, and supramarginal gyri. The analysis of CaSCN showed that along with disease progression, the cerebellum was the prominent node that tended to affect other brain regions in SHE patients, while the frontal lobe was the transition node and the supramarginal gyrus was the prominent node that may be easily affected by other brain regions. Our study found widely affected regions of decreased GMVs in SHE patients; these regions underlie the morphological basis of epileptic networks, and there is a temporal precedence relationship between them.<\/jats:p>","DOI":"10.1002\/jnr.25203","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T01:16:21Z","timestamp":1684113381000},"page":"1447-1456","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Progressive structural damage in sleep\u2010related hypermotor epilepsy"],"prefix":"10.1002","volume":"101","author":[{"given":"Xinyue","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Radiology, Huaxi MR Research Center (HMRRC) West China Hospital of Sichuan University  Chengdu China"},{"name":"Department of Radiology, Huashan Hospital Fudan University  Shanghai 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