Widespread, depth-dependent microstructural damage in the cortex of children with focal epilepsy: A quantitative T1 and T2 mapping study

We assessed cortical microstructure in children with drug-resistant focal epilepsy using T1 and T2 relaxometry (qT1 and qT2). We show widespread, depth-mediated qT1 and qT2 increases, and alterations in intracortical organisation in patients. Changes did not correlate with clinical parameters, suggesting that they may be independent of disease severity. Using a random forest algorithm, we also show that qT1 and qT2 surface-features from patients with radiologically defined abnormalities (MRI-positive) and controls, can classify patients without reported radiological abnormalities (MRI-negative). This suggests a common imaging endophenotype of focal epilepsy irrespective of visible abnormalities that may be present at a pre-symptomatic disease-stage.