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Structural MRI has provided an in vivo window into whole-brain grey matter structural alterations in temporal lobe epilepsy relative to controls, by either mapping (i) atypical inter-hemispheric asymmetry; or (ii) regional atrophy. However, similarities and differences of both atypical asymmetry and regional atrophy measures have not been systematically investigated.<\/jats:p>\n                  <jats:p>Here, we addressed this gap using the multisite ENIGMA-Epilepsy dataset comprising MRI brain morphological measures in 732 temporal lobe epilepsy patients and 1418 healthy controls. We compared spatial distributions of grey matter asymmetry and atrophy in temporal lobe epilepsy, contextualized their topographies relative to spatial gradients in cortical microstructure and functional connectivity calculated using 207 healthy controls obtained from Human Connectome Project and an independent dataset containing 23 temporal lobe epilepsy patients and 53 healthy controls and examined clinical associations using machine learning.<\/jats:p>\n                  <jats:p>We identified a marked divergence in the spatial distribution of atypical inter-hemispheric asymmetry and regional atrophy mapping. The former revealed a temporo-limbic disease signature while the latter showed diffuse and bilateral patterns. Our findings were robust across individual sites and patients. Cortical atrophy was significantly correlated with disease duration and age at seizure onset, while degrees of asymmetry did not show a significant relationship to these clinical variables.<\/jats:p>\n                  <jats:p>Our findings highlight that the mapping of atypical inter-hemispheric asymmetry and regional atrophy tap into two complementary aspects of temporal lobe epilepsy-related pathology, with the former revealing primary substrates in ipsilateral limbic circuits and the latter capturing bilateral disease effects. These findings refine our notion of the neuropathology of temporal lobe epilepsy and may inform future discovery and validation of complementary MRI biomarkers in temporal lobe epilepsy.<\/jats:p>","DOI":"10.1093\/brain\/awab417","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T07:10:14Z","timestamp":1637046614000},"page":"1285-1298","source":"Crossref","is-referenced-by-count":52,"title":["Topographic divergence of atypical cortical asymmetry and atrophy patterns in temporal lobe epilepsy"],"prefix":"10.1093","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7096-337X","authenticated-orcid":false,"given":"Bo-yong","family":"Park","sequence":"first","affiliation":[{"name":"Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada"},{"name":"Department of Data Science, Inha University, Incheon, Republic of Korea"},{"name":"Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5701-1307","authenticated-orcid":false,"given":"Sara","family":"Larivi\u00e8re","sequence":"additional","affiliation":[{"name":"Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Rodr\u00edguez-Cruces","sequence":"additional","affiliation":[{"name":"Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Royer","sequence":"additional","affiliation":[{"name":"Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Tavakol","sequence":"additional","affiliation":[{"name":"Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yezhou","family":"Wang","sequence":"additional","affiliation":[{"name":"Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Caciagli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK"},{"name":"MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK"},{"name":"Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eugenia","family":"Caligiuri","sequence":"additional","affiliation":[{"name":"Neuroscience Research Center, University Magna Gr\u00e6cia, Catanzaro, CZ, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7384-3074","authenticated-orcid":false,"given":"Antonio","family":"Gambardella","sequence":"additional","affiliation":[{"name":"Neuroscience Research Center, University Magna Gr\u00e6cia, Catanzaro, CZ, Italy"},{"name":"Institute of Neurology, University Magna Gr\u00e6cia, Catanzaro, CZ, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7842-3869","authenticated-orcid":false,"given":"Luis","family":"Concha","sequence":"additional","affiliation":[{"name":"Institute of Neurobiology, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Quer\u00e9taro, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5247-9795","authenticated-orcid":false,"given":"Simon S","family":"Keller","sequence":"additional","affiliation":[{"name":"Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK"},{"name":"Walton Centre NHS Foundation Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Cendes","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Campinas\u2013UNICAMP, Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina K M","family":"Alvim","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Campinas\u2013UNICAMP, Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Campinas\u2013UNICAMP, Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Bonilha","sequence":"additional","affiliation":[{"name":"Department of Neurology, Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4212-4146","authenticated-orcid":false,"given":"Ezequiel","family":"Gleichgerrcht","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of South Carolina, Charleston, SC, 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Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soenke","family":"Langner","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Rummel","sequence":"additional","affiliation":[{"name":"Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rebsamen","sequence":"additional","affiliation":[{"name":"Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Wiest","sequence":"additional","affiliation":[{"name":"Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raviteja","family":"Kotikalapudi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of T\u00fcbingen, T\u00fcbingen, Germany"},{"name":"Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Bender","sequence":"additional","affiliation":[{"name":"Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence J","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia"},{"name":"Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia"},{"name":"Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Vivash","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia"},{"name":"Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia"},{"name":"Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia M","family":"Desmond","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B","family":"Malpas","sequence":"additional","affiliation":[{"name":"Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, 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Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Delanty","sequence":"additional","affiliation":[{"name":"Department of Molecular and Cellular Therapeutics,\u00a0The Royal\u00a0College of Surgeons in Ireland, Dublin, Ireland"},{"name":"FutureNeuro SFI Research Centre, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reetta","family":"K\u00e4lvi\u00e4inen","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland"},{"name":"Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7917-5326","authenticated-orcid":false,"given":"Graeme D","family":"Jackson","sequence":"additional","affiliation":[{"name":"Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Kowalczyk","sequence":"additional","affiliation":[{"name":"Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mascalchi","sequence":"additional","affiliation":[{"name":"Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira","family":"Semmelroch","sequence":"additional","affiliation":[{"name":"Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhys H","family":"Thomas","sequence":"additional","affiliation":[{"name":"Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7302-6856","authenticated-orcid":false,"given":"Hamid","family":"Soltanian-Zadeh","sequence":"additional","affiliation":[{"name":"Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran"},{"name":"Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmaeil","family":"Davoodi-Bojd","sequence":"additional","affiliation":[{"name":"Department of Neurology, Henry Ford Health System, Detroit, MI, 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