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Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018726","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The intricate neuroanatomical structure of the cerebellum is of longstanding interest in epilepsy, but has been poorly characterized within the current corticocentric models of this disease. We quantified cross\u2010sectional regional cerebellar lobule volumes using structural magnetic resonance imaging in 1602 adults with epilepsy and 1022 healthy controls across 22 sites from the global ENIGMA\u2010Epilepsy working group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A state\u2010of\u2010the\u2010art deep learning\u2010based approach was employed that parcellates the cerebellum into 28 neuroanatomical subregions. Linear mixed models compared total and regional cerebellar volume in (1) all epilepsies, (2) temporal lobe epilepsy with hippocampal sclerosis (TLE\u2010HS), (3) nonlesional temporal lobe epilepsy, (4) genetic generalized epilepsy, and (5) extratemporal focal epilepsy (ETLE). Relationships were examined for cerebellar volume versus age at seizure onset, duration of epilepsy, phenytoin treatment, and cerebral cortical thickness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across all epilepsies, reduced total cerebellar volume was observed (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009.42). Maximum volume loss was observed in the corpus medullare (\n                      <jats:italic>d<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      \u2009=\u2009.49) and posterior lobe gray matter regions, including bilateral lobules VIIB (\n                      <jats:italic>d<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      \u2009=\u2009.47), crus I\/II (\n                      <jats:italic>d<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      \u2009=\u2009.39), VIIIA (\n                      <jats:italic>d<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      \u2009=\u2009.45), and VIIIB (\n                      <jats:italic>d<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      \u2009=\u2009.40). Earlier age at seizure onset (\u2009=\u2009.05) and longer epilepsy duration (\u2009=\u2009.06) correlated with reduced volume in these regions. Findings were most pronounced in TLE\u2010HS and ETLE, with distinct neuroanatomical profiles observed in the posterior lobe. Phenytoin treatment was associated with reduced posterior lobe volume. Cerebellum volume correlated with cerebral cortical thinning more strongly in the epilepsy cohort than in controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>We provide robust evidence of deep cerebellar and posterior lobe subregional gray matter volume loss in patients with chronic epilepsy. Volume loss was maximal for posterior subregions implicated in nonmotor functions, relative to motor regions of both the anterior and posterior lobe. Associations between cerebral and cerebellar changes, and variability of neuroanatomical profiles across epilepsy syndromes argue for more precise incorporation of cerebellar subregional damage into neurobiological models of epilepsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.17881","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T07:35:51Z","timestamp":1709019351000},"page":"1072-1091","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Patterns of subregional cerebellar atrophy across epilepsy syndromes: An ENIGMA\u2010Epilepsy study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-9904","authenticated-orcid":false,"given":"Rebecca","family":"Kerestes","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Central Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Perry","sequence":"additional","affiliation":[{"name":"Monash Bioinformatics Platform Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1182-0907","authenticated-orcid":false,"given":"Lucy","family":"Vivash","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence J.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School Monash University  Melbourne Victoria Australia"},{"name":"Department of Medicine and Neurology, The Royal Melbourne Hospital The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina K. M.","family":"Alvim","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Campinas  Campinas Brazil"},{"name":"Brazilian Institute of Neuroscience and Neurotechnology  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatello","family":"Arienzo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Center for Multimodal Imaging and Genetics University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00cdtalo K.","family":"Aventurato","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Campinas  Campinas Brazil"},{"name":"Brazilian Institute of Neuroscience and Neurotechnology  Campinas 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Neurology University \u201cMagna Gr\u00e6cia\" of Catanzaro  Catanzaro 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, Department of Medical and Surgical Sciences University \u201cMagna Gr\u00e6cia\" of Catanzaro  Catanzaro Italy"},{"name":"Department of Medical and Surgical Sciences, Institute of Neurology University \u201cMagna Gr\u00e6cia\" of Catanzaro  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7802-8789","authenticated-orcid":false,"given":"Thea","family":"Giacomini","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa  Genoa 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