{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:02:40Z","timestamp":1791511360306,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100001454","name":"American Epilepsy Society","doi-asserted-by":"publisher","award":["953257"],"award-info":[{"award-number":["953257"]}],"id":[{"id":"10.13039\/100001454","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01NS116504"],"award-info":[{"award-number":["R01NS116504"]}],"id":[{"id":"10.13039\/100000065","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>Epilepsy patients are often grouped together by clinical variables. Quantitative neuroimaging metrics can provide a data\u2010driven alternative for grouping of patients. In this work, we leverage ultra\u2010high\u2010field 7\u2010T structural magnetic resonance imaging (MRI) to characterize volumetric atrophy patterns across hippocampal subfields and thalamic nuclei in drug\u2010resistant focal epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty\u2010two drug\u2010resistant epilepsy patients and 13 controls with 7\u2010T structural neuroimaging were included in this study. We measured hippocampal subfield and thalamic nuclei volumetry, and applied an unsupervised machine learning algorithm, Latent Dirichlet Allocation (LDA), to estimate atrophy patterns across the hippocampal subfields and thalamic nuclei of patients. We studied the association between predefined clinical groups and the estimated atrophy patterns. Additionally, we used hierarchical clustering on the LDA factors to group patients in a data\u2010driven approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In patients with mesial temporal sclerosis (MTS), we found a significant decrease in volume across all ipsilateral hippocampal subfields (false discovery rate\u2010corrected\n                      <jats:italic>p<\/jats:italic>\n                      [\n                      <jats:italic>p<\/jats:italic>\n                      FDR]\u2009&lt;\u2009.01) as well as in some ipsilateral (\n                      <jats:italic>p<\/jats:italic>\n                      FDR\u2009&lt;\u2009.05) and contralateral (\n                      <jats:italic>p<\/jats:italic>\n                      FDR\u2009&lt;\u2009.01) thalamic nuclei. In left temporal lobe epilepsy (L\u2010TLE) we saw ipsilateral hippocampal and some bilateral thalamic atrophy (\n                      <jats:italic>p<\/jats:italic>\n                      FDR\u2009&lt;\u2009.05), whereas in right temporal lobe epilepsy (R\u2010TLE) extensive bilateral hippocampal and thalamic atrophy was observed (\n                      <jats:italic>p<\/jats:italic>\n                      FDR\u2009&lt;\u2009.05). Atrophy factors demonstrated that our MTS cohort had two atrophy phenotypes: one that affected the ipsilateral hippocampus and one that affected the ipsilateral hippocampus and bilateral anterior thalamus. Atrophy factors demonstrated posterior thalamic atrophy in R\u2010TLE, whereas an anterior thalamic atrophy pattern was more common in L\u2010TLE. Finally, hierarchical clustering of atrophy patterns recapitulated clusters with homogeneous clinical properties.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Leveraging 7\u2010T MRI, we demonstrate widespread hippocampal and thalamic atrophy in epilepsy. Through unsupervised machine learning, we demonstrate patterns of volumetric atrophy that vary depending on disease subtype. Incorporating these atrophy patterns into clinical practice could help better stratify patients to surgical treatments and specific device implantation strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.17908","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T08:44:37Z","timestamp":1707727477000},"page":"1092-1106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Mapping hippocampal and thalamic atrophy in epilepsy: A 7\u2010T magnetic resonance imaging study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9439-735X","authenticated-orcid":false,"given":"Alfredo","family":"Lucas","sequence":"first","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Bioengineering University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Mouchtaris","sequence":"additional","affiliation":[{"name":"Department of Bioengineering University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Tranquille","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2090-4889","authenticated-orcid":false,"given":"Nishant","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Mojena","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel M.","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhitsu","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn A.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13709"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx341"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2023.103418"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1528\u20101157.2003.32701.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.22627"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.04.042"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2018.09.032"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2015.09.004"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17378"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201016046\u20105"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.682615"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.25447"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24530"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23887"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.26083"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.03.021"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2018.08.012"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.810186"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234\u2010019\u201002299\u20106"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","unstructured":"HaastRA TestudB MakhalovaJ DaryH CabaneA Le TroterA et\u00a0al.Multi\u2010scale structural alterations of the thalamus and basal ganglia in focal epilepsy as demonstrated by 7T MRI.bioRxiv. 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