Multicenter Study

. 2022 Aug;63(8):2081-2095.

doi: 10.1111/epi.17316. Epub 2022 Jun 25.

Event-based modeling in temporal lobe epilepsy demonstrates progressive atrophy from cross-sectional data

Seymour M Lopez¹, Leon M Aksman^{1

2}, Neil P Oxtoby³, Sjoerd B Vos^{1

4}, Jun Rao⁵, Erik Kaestner⁵, Saud Alhusaini^{6

7}, Marina Alvim⁸, Benjamin Bender⁹, Andrea Bernasconi¹⁰, Neda Bernasconi¹⁰, Boris Bernhardt¹¹, Leonardo Bonilha¹², Lorenzo Caciagli^{11

13}, Benoit Caldairou¹⁰, Maria Eugenia Caligiuri¹⁴, Angels Calvet¹⁵, Fernando Cendes⁸, Luis Concha¹⁶, Estefania Conde-Blanco^{17

18}, Esmaeil Davoodi-Bojd¹⁹, Christophe de Bézenac²⁰, Norman Delanty^{7

21}, Patricia M Desmond²², Orrin Devinsky²³, Martin Domin²⁴, John S Duncan^{12

25}, Niels K Focke²⁶, Sonya Foley²⁷, Francesco Fortunato²⁸, Marian Galovic^{13

29}, Antonio Gambardella^{14

28}, Ezequiel Gleichgerrcht³⁰, Renzo Guerrini³¹, Khalid Hamandi^{27

32}, Victoria Ives-Deliperi³³, Graeme D Jackson^{34

35

36}, Neda Jahanshad³⁷, Simon S Keller³⁸, Peter Kochunov³⁹, Raviteja Kotikalapudi^{9

40

41}, Barbara A K Kreilkamp^{38

42}, Angelo Labate^{14

28}, Sara Larivière¹¹, Matteo Lenge^{43

44}, Elaine Lui²², Charles Malpas^{45

46}, Pascal Martin³⁹, Mario Mascalchi⁴⁷, Sarah E Medland⁴⁸, Stefano Meletti^{49

50}, Marcia E Morita-Sherman^{51

52}, Thomas W Owen⁵³, Mark Richardson⁵⁴, Antonella Riva^{55

56}, Theodor Rüber⁵⁷, Ben Sinclair^{58

59}, Hamid Soltanian-Zadeh^{19

60}, Dan J Stein⁶¹, Pasquale Striano^{55

56}, Peter N Taylor^{13

53}, Sophia I Thomopoulos³⁷, Paul M Thompson³⁷, Manuela Tondelli^{49

62}, Anna Elisabetta Vaudano^{49

50}, Lucy Vivash^{58

59}, Yujiang Wang^{13

53}, Bernd Weber⁶³, Christopher D Whelan⁷, Roland Wiest⁶⁴, Gavin P Winston^{13

25

65}, Clarissa Lin Yasuda⁸, Carrie R McDonald⁵, Daniel C Alexander³, Sanjay M Sisodiya^{13

25}, Andre Altmann¹; ENIGMA-Epilepsy Working Group

Collaborators, Affiliations

Collaborators

ENIGMA-Epilepsy Working Group:
Núria Bargalló, Emanuele Bartolini, Terence J O'Brien, Rhys H Thomas

Affiliations

¹ Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
² Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
³ Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK.
⁴ Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK.
⁵ Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.
⁶ Department of Neurology, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
⁷ Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
⁸ Department of Neurology and Neuroimaging Laboratory, University of Campinas, Campinas, Brazil.
⁹ Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany.
¹⁰ Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
¹¹ Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
¹² Department of Neurology, Emory University, Atlanta, USA.
¹³ Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
¹⁴ Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
¹⁵ Magnetic Resonance Image Core Facility, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain.
¹⁶ Institute of Neurobiology, National Autonomous University of Mexico, Querétaro, Mexico.
¹⁷ Epilepsy Program, Neurology Department, Hospital Clinic of Barcelona, Barcelona, Spain.
¹⁸ August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.
¹⁹ Radiology and Research Administration, Henry Ford Health System, Detroit, Michigan, USA.
²⁰ Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
²¹ FutureNeuro SFI Research Centre for Rare and Chronic Neurological Diseases, Dublin, Ireland.
²² Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.
²³ New York University Grossman School of Medicine, New York, New York, USA.
²⁴ Functional Imaging Unit, Department of Diagnostic Radiology and Neuroradiology, Greifswald University Medicine, Greifswald, Germany.
²⁵ Chalfont Centre for Epilepsy, Chalfont St Peter, UK.
²⁶ Department of Neurology, University Medical Center, Göttingen, Germany.
²⁷ Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK.
²⁸ Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
²⁹ Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
³⁰ Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA.
³¹ Neuroscience Department, University of Florence, Florence, Italy.
³² Wales Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK.
³³ Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
³⁴ Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, Victoria, Australia.
³⁵ University of Melbourne, Parkville, Victoria, Australia.
³⁶ Department of Neurology, Austin Health, Heidelberg, Victoria, Australia.
³⁷ Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA.
³⁸ Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
³⁹ Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.
⁴⁰ Department of Clinical Neurophysiology, University Hospital Göttingen, Göttingen, Germany.
⁴¹ Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
⁴² Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.
⁴³ Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, A. Meyer Children's Hospital, University of Florence, Florence, Italy.
⁴⁴ Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, A. Meyer Children's Hospital, University of Florence, Florence, Italy.
⁴⁵ Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁴⁶ Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
⁴⁷ Mario Serio Department of Clinical and Experimental Medical Sciences, University of Florence, Florence, Italy.
⁴⁸ Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
⁴⁹ Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
⁵⁰ Neurology Unit, OCB Hospital, Modena University Hospital, Modena, Italy.
⁵¹ Department of Neurology, University of Campinas, Campinas, Brazil.
⁵² Cleveland Clinic Neurological Institute, Cleveland, Ohio, USA.
⁵³ School of Computing, Newcastle University, Newcastle Upon Tyne, UK.
⁵⁴ Division of Neuroscience, King's College London, London, UK.
⁵⁵ Giannina Gaslini Institute, Scientific Institute for Research and Health Care, Genoa, Italy.
⁵⁶ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
⁵⁷ Department of Epileptology, University Hospital Bonn, Bonn, Germany.
⁵⁸ Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia.
⁵⁹ Departments of Medicine and Radiology, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
⁶⁰ School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.
⁶¹ SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁶² Primary Care Department, Local Health Authority of Modena, Modena, Italy.
⁶³ Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany.
⁶⁴ Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁶⁵ Department of Medicine, Division of Neurology, Queen's University, Kingston, Ontario, Canada.

PMID: 35656586
PMCID: PMC9540015
DOI: 10.1111/epi.17316

Multicenter Study

Event-based modeling in temporal lobe epilepsy demonstrates progressive atrophy from cross-sectional data

Seymour M Lopez et al. Epilepsia. 2022 Aug.

. 2022 Aug;63(8):2081-2095.

doi: 10.1111/epi.17316. Epub 2022 Jun 25.

Authors

Collaborators

ENIGMA-Epilepsy Working Group:
Núria Bargalló, Emanuele Bartolini, Terence J O'Brien, Rhys H Thomas

Affiliations

¹ Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
² Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
³ Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK.
⁴ Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK.
⁵ Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.
⁶ Department of Neurology, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
⁷ Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
⁸ Department of Neurology and Neuroimaging Laboratory, University of Campinas, Campinas, Brazil.
⁹ Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany.
¹⁰ Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
¹¹ Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
¹² Department of Neurology, Emory University, Atlanta, USA.
¹³ Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
¹⁴ Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
¹⁵ Magnetic Resonance Image Core Facility, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain.
¹⁶ Institute of Neurobiology, National Autonomous University of Mexico, Querétaro, Mexico.
¹⁷ Epilepsy Program, Neurology Department, Hospital Clinic of Barcelona, Barcelona, Spain.
¹⁸ August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.
¹⁹ Radiology and Research Administration, Henry Ford Health System, Detroit, Michigan, USA.
²⁰ Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
²¹ FutureNeuro SFI Research Centre for Rare and Chronic Neurological Diseases, Dublin, Ireland.
²² Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.
²³ New York University Grossman School of Medicine, New York, New York, USA.
²⁴ Functional Imaging Unit, Department of Diagnostic Radiology and Neuroradiology, Greifswald University Medicine, Greifswald, Germany.
²⁵ Chalfont Centre for Epilepsy, Chalfont St Peter, UK.
²⁶ Department of Neurology, University Medical Center, Göttingen, Germany.
²⁷ Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK.
²⁸ Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
²⁹ Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
³⁰ Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA.
³¹ Neuroscience Department, University of Florence, Florence, Italy.
³² Wales Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK.
³³ Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
³⁴ Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, Victoria, Australia.
³⁵ University of Melbourne, Parkville, Victoria, Australia.
³⁶ Department of Neurology, Austin Health, Heidelberg, Victoria, Australia.
³⁷ Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA.
³⁸ Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
³⁹ Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.
⁴⁰ Department of Clinical Neurophysiology, University Hospital Göttingen, Göttingen, Germany.
⁴¹ Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
⁴² Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.
⁴³ Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, A. Meyer Children's Hospital, University of Florence, Florence, Italy.
⁴⁴ Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, A. Meyer Children's Hospital, University of Florence, Florence, Italy.
⁴⁵ Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁴⁶ Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
⁴⁷ Mario Serio Department of Clinical and Experimental Medical Sciences, University of Florence, Florence, Italy.
⁴⁸ Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
⁴⁹ Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
⁵⁰ Neurology Unit, OCB Hospital, Modena University Hospital, Modena, Italy.
⁵¹ Department of Neurology, University of Campinas, Campinas, Brazil.
⁵² Cleveland Clinic Neurological Institute, Cleveland, Ohio, USA.
⁵³ School of Computing, Newcastle University, Newcastle Upon Tyne, UK.
⁵⁴ Division of Neuroscience, King's College London, London, UK.
⁵⁵ Giannina Gaslini Institute, Scientific Institute for Research and Health Care, Genoa, Italy.
⁵⁶ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
⁵⁷ Department of Epileptology, University Hospital Bonn, Bonn, Germany.
⁵⁸ Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia.
⁵⁹ Departments of Medicine and Radiology, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
⁶⁰ School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.
⁶¹ SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁶² Primary Care Department, Local Health Authority of Modena, Modena, Italy.
⁶³ Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany.
⁶⁴ Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁶⁵ Department of Medicine, Division of Neurology, Queen's University, Kingston, Ontario, Canada.

PMID: 35656586
PMCID: PMC9540015
DOI: 10.1111/epi.17316

Abstract

Objective: Recent work has shown that people with common epilepsies have characteristic patterns of cortical thinning, and that these changes may be progressive over time. Leveraging a large multicenter cross-sectional cohort, we investigated whether regional morphometric changes occur in a sequential manner, and whether these changes in people with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS) correlate with clinical features.

Methods: We extracted regional measures of cortical thickness, surface area, and subcortical brain volumes from T1-weighted (T1W) magnetic resonance imaging (MRI) scans collected by the ENIGMA-Epilepsy consortium, comprising 804 people with MTLE-HS and 1625 healthy controls from 25 centers. Features with a moderate case-control effect size (Cohen d ≥ .5) were used to train an event-based model (EBM), which estimates a sequence of disease-specific biomarker changes from cross-sectional data and assigns a biomarker-based fine-grained disease stage to individual patients. We tested for associations between EBM disease stage and duration of epilepsy, age at onset, and antiseizure medicine (ASM) resistance.

Results: In MTLE-HS, decrease in ipsilateral hippocampal volume along with increased asymmetry in hippocampal volume was followed by reduced thickness in neocortical regions, reduction in ipsilateral thalamus volume, and finally, increase in ipsilateral lateral ventricle volume. EBM stage was correlated with duration of illness (Spearman ρ = .293, p = 7.03 × 10^-16 ), age at onset (ρ = -.18, p = 9.82 × 10^-7 ), and ASM resistance (area under the curve = .59, p = .043, Mann-Whitney U test). However, associations were driven by cases assigned to EBM Stage 0, which represents MTLE-HS with mild or nondetectable abnormality on T1W MRI.

Significance: From cross-sectional MRI, we reconstructed a disease progression model that highlights a sequence of MRI changes that aligns with previous longitudinal studies. This model could be used to stage MTLE-HS subjects in other cohorts and help establish connections between imaging-based progression staging and clinical features.

Keywords: MTLE; disease progression; duration of illness; event-based model; patient staging.

PubMed Disclaimer

Conflict of interest statement

B.Ben. is cofounder of AIRAmed, a company that offers brain segmentation. C.D.W. is an employee of Biogen. D.J.S. has received research grants and/or consultancy honoraria from Lundbeck and Sun. K.H. has received honoraria and speaker fees from UCB, Eisai, and GW Pharma L.V. reports research funding from Biogen Australia, Life Molecular Imaging, and Eisai. N.K.F. has received honoraria from Arvelle, Bial, Eisai, Philips/EGI, and UCB. N.J. is MPI of a research grant from Biogen for work unrelated to the contents of this article. P.S. has received speaker fees and served on advisory boards for Biomarin, Zogenyx, GW and Pharmaceuticals; has received research funding from ENECTA, GW Pharmaceuticals, Kolfarma, and Eisai. P.M.T. has received a research grant from Biogen and was a paid consultant for Kairos Venture Capital for projects unrelated to this work. None of the other authors has any conflict of interest to disclose. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Figures

**FIGURE 1**
Event‐based model (EBM) workflow. A set of k biomarkers and case–control status are provided for each subject. Then, mixture modeling is used to estimate distributions of the biomarkers in cases and controls, respectively. The maximum likelihood sequence (i.e., optimal ordering) of the k biomarkers is estimated using Markov chain Monte Carlo (MCMC) with 500 000 iterations. The MCMC sequence is initialized using 10 random starting solutions and a greedy ascent (GA) run for 10 000 iterations. Finally, in a third step, we used 100 bootstrap samples to determine the uncertainty and variability of the sequence. Init, initialization.

**FIGURE 2**
Regional differences in sclerosis of hippocampus or mesial temporal lobe (MTLE‐HS) compared to controls. Effect sizes between MTLE‐HS cases and controls measured as *robust Cohen d* for surface area, cortical thickness, and volume are depicted ipsilateral or contralateral to the seizure focus (top three rows). The bottom two rows depict effect sizes for asymmetry features.

**FIGURE 3**
Sequential accumulation of pathology in sclerosis of hippocampus or mesial temporal lobe. Data‐driven sequence of atrophy or increased asymmetry of brain regions is shown. Color intensity in the positional variance diagram (PVD) the proportion of certainty (.0 in white to 1.0 in dark blue) in which biomarkers (y‐axis) appear in a particular position (x‐axis) in the event order obtained through bootstrapping. BASI, brain asymmetry index; C, contralateral; CT, cortical thickness; I, ipsilateral; V, volume.

**FIGURE 4**
Event‐based model (EBM) stage distribution. Histogram shows stages (x‐axis) assigned to controls and people with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE‐HS) and the corresponding count (y‐axis). Stage 0 is assigned to subjects with no statistically detectable abnormal brain region based on the T1‐weighted magnetic resonance imaging scans. EBM places subjects with abnormal features progressively, such that subjects in Stage 7 exhibit abnormality in all seven regional measures.

**FIGURE 5**
Distribution of duration of illness per event‐based model (EBM) stage. Violin plots showing distribution of duration of illness (in years) of corresponding EBM Stages 0–7 of sclerosis of hippocampus or mesial temporal lobe (MTLE‐HS) patients. MTLE‐HS cases assigned to EBM Stage 0 showed a shorter duration of illness compared to cases assigned to the remaining EBM stages.

See this image and copyright information in PMC

References

1. Whelan CD, Altmann A, Botía JA, Jahanshad N, Hibar DP, Absil J, et al. Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study. Brain. 2018;141(2):391–408. 10.1093/brain/awx341 - DOI - PMC - PubMed
1. Park B, Lariviere S, Rodriguez‐Cruces R, Royer J, Tavakol S, Wang Y, et al. Topographic divergence of atypical cortical asymmetry and atrophy patterns in temporal lobe epilepsy. Brain. 2022;145(4):1285–98. 10.1093/brain/awab417 - DOI - PMC - PubMed
1. Alhusaini S, Doherty CP, Palaniyappan L, Scanlon C, Maguire S, Brennan P, et al. Asymmetric cortical surface area and morphology changes in mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsia. 2012;53(6):995–1003. 10.1111/j.1528-1167.2012.03457.x - DOI - PubMed
1. Bernasconi N, Natsume J, Bernasconi A. Progression in temporal lobe epilepsy: differential atrophy in mesial temporal structures. Neurology. 2005;65(2):223–8. 10.1212/01.wnl.0000169066.46912.fa - DOI - PubMed
1. Bernhardt BC, Worsley KJ, Kim H, Evans AC, Bernasconi A, Bernasconi N. Longitudinal and cross‐sectional analysis of atrophy in pharmacoresistant temporal lobe epilepsy. Neurology. 2009;72(20):1747–54. 10.1212/01.wnl.0000345969.57574.f5 - DOI - PMC - PubMed

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Event-based modeling in temporal lobe epilepsy demonstrates progressive atrophy from cross-sectional data

Collaborators

Affiliations

Event-based modeling in temporal lobe epilepsy demonstrates progressive atrophy from cross-sectional data

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous