{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:11:39Z","timestamp":1788779499740,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"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":["9055742"],"award-info":[{"award-number":["9055742"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"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"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Previous longitudinal neuroimaging studies suggest that epilepsy is a progressive disorder. To date, these findings have relied largely on populations from tertiary centers, resulting in ascertainment bias, as severely affected individuals are more likely to be rescanned. We aimed to determine rates of progressive brain atrophy in a prospective, population\u2010based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed longitudinal magnetic resonance imaging (MRI) data from 116 individuals with epilepsy and 89 age\u2010 and sex\u2010matched healthy controls recruited from a prospective, longitudinal, community\u2010based cohort in the United Kingdom. All participants underwent 2 scans 3.5\u2009years apart, regardless of seizure status. We quantified progressive changes in cortical thickness and subcortical volumes using state\u2010of\u2010the\u2010art longitudinal morphometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      People with epilepsy exhibited accelerated but modest global grey matter volume (GMV) loss compared with controls (2.7 vs 2.4\u2009ml\/year;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). This acceleration was associated with specific phenotypes: focal epilepsy, MRI\u2010identifiable lesions, and ongoing seizures. In contrast, generalized epilepsy and seizure\u2010free periods were associated with more stable global trajectories. Cortical regions identified as vulnerable were characterized by markedly accelerated thinning compared to controls (5.3 vs 3.4\u2009\u03bcm\/year;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and were pervasive across most epilepsy phenotypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Epilepsy is associated with progressive structural brain damage that exceeds normal aging, but the trajectory is heterogeneous. These prospective population\u2010based data confirm that vulnerable regions show progressive atrophy, particularly in focal and lesional epilepsy and individuals with ongoing seizures. ANN NEUROL 2026<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78319","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T03:47:06Z","timestamp":1787629626000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Accelerated Brain Atrophy in Epilepsy: A Prospective Population\u2010Based Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2307-071X","authenticated-orcid":false,"given":"Marian","family":"Galovic","sequence":"first","affiliation":[{"name":"Research Department of Epilepsy, UCL Queen Square Institute of Neurology University College London  London UK"},{"name":"Department of Neurology, Clinical Neuroscience Center University Hospital and University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S. N.","family":"Liu","sequence":"additional","affiliation":[{"name":"Research Department of Epilepsy, UCL Queen Square Institute of Neurology University College London  London UK"},{"name":"Royal Free London NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex D.","family":"Everitt","sequence":"additional","affiliation":[{"name":"Research Department of Epilepsy, UCL Queen Square Institute of Neurology University College London  London UK"},{"name":"St. Mary's Hospital, Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Terziev","sequence":"additional","affiliation":[{"name":"Department of Neurology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Lemieux","sequence":"additional","affiliation":[{"name":"Research Department of Epilepsy, UCL Queen Square Institute of Neurology University College London  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":"Research Department of Epilepsy, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Research Department of Epilepsy, UCL Queen Square Institute of Neurology University College London  London 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