{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:24:23Z","timestamp":1789647863492,"version":"4.0.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS116504"],"award-info":[{"award-number":["R01NS116504"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"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"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Resting\u2010state functional magnetic resonance imaging (rs\u2010fMRI) at ultra\u2010high field strengths (\u22657T) is known to provide superior signal\u2010to\u2010noise to comparable acquisitions at lower field strengths. In this study, we provide a direct comparison of the seizure onset\u2010zone (SOZ) lateralizing ability of 7T rs\u2010fMRI and 3T rs\u2010fMRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated a cohort of 70 patients with temporal lobe epilepsy (TLE). A paired cohort of 19 patients had 3T and 7T rs\u2010fMRI acquisitions for direct comparison between the two field strengths. Forty\u2010three patients had only 3T, and eight patients had only 7T rs\u2010fMRI acquisitions. We quantified the functional connectivity between the hippocampus and other nodes within the default mode network (DMN) using seed\u2010to\u2010voxel connectivity, and measured how hippocampal\u2013DMN connectivity could inform SOZ lateralization at 7T and 3T field strengths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Differences in hippocampal\u2013DMN connectivity ipsilateral and contralateral to the SOZ were significantly higher at 7T (Cohen's <jats:italic>d<\/jats:italic>\u2009=\u20090.51, <jats:italic>p<\/jats:italic>\u2009=\u20090.008) than at 3T (Cohen's <jats:italic>d<\/jats:italic>\u2009=\u20090.26, <jats:italic>p<\/jats:italic>\u2009=\u20090.68) when measured in the same subjects. We found that SOZ lateralization was superior at 7T (receiver\u2010operating characteristic area under the curve [ROC AUC]\u2009=\u20090.97, 95% confidence interval [CI]: 0.92\u20131.00) than 3T (ROC AUC\u2009=\u20090.67, 95% CI: 0.36\u20130.98), for the same subjects scanned at both field strengths. Our findings were reproduced in extended cohorts of subjects scanned at either 3T or 7T. Our rs\u2010fMRI findings at 7T, but not 3T, are consistent (Spearman <jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.65, <jats:italic>p<\/jats:italic>\u2009=\u2009.01) with clinical fluorodeoxyglucose positron emission tomography (FDG\u2010PET) lateralizing hypometabolism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>We show superior SOZ lateralization in patients with TLE when using 7T relative to 3T rs\u2010fMRI, supporting the adoption of high field strength functional imaging in the epilepsy presurgical evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18447","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T12:28:15Z","timestamp":1747312095000},"page":"3440-3452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Seizure\u2010onset zone lateralization in temporal lobe epilepsy using <scp>7T rs\u2010fMRI<\/scp>: Direct comparison with <scp>3T rs\u2010fMRI<\/scp>"],"prefix":"10.1111","volume":"66","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2619-8778","authenticated-orcid":false,"given":"Eli J.","family":"Cornblath","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishant","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Caciagli","sequence":"additional","affiliation":[{"name":"Department of Bioengineering University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1681-4717","authenticated-orcid":false,"given":"Peter","family":"Hadar","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachussets General Hospital (Work conducted while at the University of Pennsylvania)  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Tranquille","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences University at Buffalo (Work conducted while at the University of Pennsylvania)  Buffalo New York 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7020-6480","authenticated-orcid":false,"given":"Kathryn A.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania 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