{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:46:59Z","timestamp":1793191619246,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T00:00:00Z","timestamp":1594771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["5U01\u2010NS090415"],"award-info":[{"award-number":["5U01\u2010NS090415"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U01\u2010NS090405"],"award-info":[{"award-number":["U01\u2010NS090405"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropathology Appl Neurobio"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Sudden unexpected death in epilepsy (SUDEP) likely arises as a result of autonomic dysfunction around the time of a seizure. <jats:italic>In vivo<\/jats:italic> MRI studies report volume reduction in the medulla and other brainstem autonomic regions. Our aim, in a pathology series, is to correlate regional quantitative features on 9.4T MRI with pathology measures in medullary regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010seven medullae from 18 SUDEP, 18 nonepilepsy controls and 11 epilepsy controls were studied. In 16 cases, representing all three groups, <jats:italic>ex vivo<\/jats:italic> 9.4T MRI of the brainstem was carried out. Five regions of interest (ROI) were delineated, including the reticular formation zone (RtZ), and actual and relative volumes (RV), as well as T1, T2, T2* and magnetization transfer ratio (MTR) measurements were evaluated on MRI. On serial sections, actual and RV estimates using Cavalieri stereological method and immunolabelling indices for myelin basic protein, synaptophysin and Microtubule associated protein 2 (MAP2) were carried out in similar ROI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lower relative RtZ volumes in the rostral medulla but higher actual volumes in the caudal medulla were observed in SUDEP (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). No differences between groups for T1, T2, T2* and MTR values in any region was seen but a positive correlation between T1 values and MAP2 labelling index in RtZ (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). Significantly lower MAP2 LI were noted in the rostral medulla RtZ in epilepsy cases (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Rostro\u2010caudal alterations of medullary volume in SUDEP localize with regions containing respiratory regulatory nuclei. They may represent seizure\u2010related alterations, relevant to the pathophysiology of SUDEP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nan.12638","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T19:34:36Z","timestamp":1592595276000},"page":"157-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["MRI and pathology correlations in the medulla in sudden unexpected death in epilepsy (SUDEP): a postmortem study"],"prefix":"10.1111","volume":"47","author":[{"given":"S.","family":"Patodia","sequence":"first","affiliation":[{"name":"Department of Neuropathology UCL Queen Square Institute of Neurology London UK"},{"name":"Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Tachrount","sequence":"additional","affiliation":[{"name":"Neuroradiology Academic Unit Brain Repair and Rehabilitation UCL Queen Square Institute of Neurology London UK"},{"name":"FMRIB, Nuffield Department of Clinical Neurosciences Wellcome Centre for Integrative Neuroimaging University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Neuropathology UCL Queen Square Institute of Neurology London UK"},{"name":"Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Scheffer","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology) Epilepsy Research Centre University of Melbourne Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Yousry","sequence":"additional","affiliation":[{"name":"Neuroradiology Academic Unit Brain Repair and Rehabilitation UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Golay","sequence":"additional","affiliation":[{"name":"Neuroradiology Academic Unit Brain Repair and Rehabilitation UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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