Park, Bo-YongBo-YongParkLarivière, SaraSaraLarivièreRodríguez-Cruces, RaulRaulRodríguez-CrucesRoyer, JessicaJessicaRoyerTavakol, ShahinShahinTavakolWang, YezhouYezhouWangCaciagli, LorenzoLorenzoCaciagliCaligiuri, Maria EugeniaMaria EugeniaCaligiuriGambardella, AntonioAntonioGambardellaConcha, LuisLuisConchaKeller, Simon SSimon SKellerCendes, FernandoFernandoCendesAlvim, Marina K MMarina K MAlvimYasuda, ClarissaClarissaYasudaBonilha, LeonardoLeonardoBonilhaGleichgerrcht, EzequielEzequielGleichgerrchtFocke, Niels KNiels KFockeKreilkamp, Barbara A KBarbara A KKreilkampDomin, MartinMartinDominvon Podewils, FelixFelixvon PodewilsLangner, SoenkeSoenkeLangnerRummel, ChristianChristianRummelRebsamen, Michael AndreasMichael AndreasRebsamen0000-0002-8441-1485Wiest, Roland Gerhard RudiRoland Gerhard RudiWiestMartin, PascalPascalMartinKotikalapudi, RavitejaRavitejaKotikalapudiBender, BenjaminBenjaminBenderO'Brien, Terence JTerence JO'BrienLaw, MengMengLawSinclair, BenjaminBenjaminSinclairVivash, LucyLucyVivashKwan, PatrickPatrickKwanDesmond, Patricia MPatricia MDesmondMalpas, Charles BCharles BMalpasLui, ElaineElaineLuiAlhusaini, SaudSaudAlhusainiDoherty, Colin PColin PDohertyCavalleri, Gianpiero LGianpiero LCavalleriDelanty, NormanNormanDelantyKälviäinen, ReettaReettaKälviäinenJackson, Graeme DGraeme DJacksonKowalczyk, MagdalenaMagdalenaKowalczykMascalchi, MarioMarioMascalchiSemmelroch, MiraMiraSemmelrochThomas, Rhys HRhys HThomasSoltanian-Zadeh, HamidHamidSoltanian-ZadehDavoodi-Bojd, EsmaeilEsmaeilDavoodi-BojdZhang, JunsongJunsongZhangLenge, MatteoMatteoLengeGuerrini, RenzoRenzoGuerriniBartolini, EmanueleEmanueleBartoliniHamandi, KhalidKhalidHamandiFoley, SonyaSonyaFoleyWeber, BerndBerndWeberDepondt, ChantalChantalDepondtAbsil, JulieJulieAbsilCarr, Sarah J ASarah J ACarrAbela, EugenioEugenioAbelaRichardson, Mark PMark PRichardsonDevinsky, OrrinOrrinDevinskySeverino, MariasavinaMariasavinaSeverinoStriano, PasqualePasqualeStrianoParodi, CostanzaCostanzaParodiTortora, DomenicoDomenicoTortoraHatton, Sean NSean NHattonVos, Sjoerd BSjoerd BVosDuncan, John SJohn SDuncanGalovic, MarianMarianGalovicWhelan, Christopher DChristopher DWhelanBargalló, NúriaNúriaBargallóPariente, JoseJoseParienteConde-Blanco, EstefaniaEstefaniaConde-BlancoVaudano, Anna ElisabettaAnna ElisabettaVaudanoTondelli, ManuelaManuelaTondelliMeletti, StefanoStefanoMelettiKong, Xiang-ZhenXiang-ZhenKongFrancks, ClydeClydeFrancksFisher, Simon ESimon EFisherCaldairou, BenoitBenoitCaldairouRyten, MinaMinaRytenLabate, AngeloAngeloLabateSisodiya, Sanjay MSanjay MSisodiyaThompson, Paul MPaul MThompsonMcDonald, Carrie RCarrie RMcDonaldBernasconi, AndreaAndreaBernasconiBernasconi, NedaNedaBernasconiBernhardt, Boris CBoris CBernhardt2024-10-092024-10-092022-05-24https://boris-portal.unibe.ch/handle/20.500.12422/69727Temporal lobe epilepsy, a common drug-resistant epilepsy in adults, is primarily a limbic network disorder associated with predominant unilateral hippocampal pathology. Structural MRI has provided an in vivo window into whole-brain grey matter structural alterations in temporal lobe epilepsy relative to controls, by either mapping (i) atypical inter-hemispheric asymmetry; or (ii) regional atrophy. However, similarities and differences of both atypical asymmetry and regional atrophy measures have not been systematically investigated. Here, we addressed this gap using the multisite ENIGMA-Epilepsy dataset comprising MRI brain morphological measures in 732 temporal lobe epilepsy patients and 1418 healthy controls. We compared spatial distributions of grey matter asymmetry and atrophy in temporal lobe epilepsy, contextualized their topographies relative to spatial gradients in cortical microstructure and functional connectivity calculated using 207 healthy controls obtained from Human Connectome Project and an independent dataset containing 23 temporal lobe epilepsy patients and 53 healthy controls and examined clinical associations using machine learning. We identified a marked divergence in the spatial distribution of atypical inter-hemispheric asymmetry and regional atrophy mapping. The former revealed a temporo-limbic disease signature while the latter showed diffuse and bilateral patterns. Our findings were robust across individual sites and patients. Cortical atrophy was significantly correlated with disease duration and age at seizure onset, while degrees of asymmetry did not show a significant relationship to these clinical variables. Our findings highlight that the mapping of atypical inter-hemispheric asymmetry and regional atrophy tap into two complementary aspects of temporal lobe epilepsy-related pathology, with the former revealing primary substrates in ipsilateral limbic circuits and the latter capturing bilateral disease effects. These findings refine our notion of the neuropathology of temporal lobe epilepsy and may inform future discovery and validation of complementary MRI biomarkers in temporal lobe epilepsy.enasymmetry cortical thickness gradients multi-site temporal lobe epilepsy600 - Technology::610 - Medicine & healtharticle10.48350/1686863533331210.1093/brain/awab417