ArticleNeuropathology and applied neurobiology2021
MRI and pathology correlations in the medulla in sudden unexpected death in epilepsy (SUDEP): a postmortem study.
Article in Neuropathology and applied neurobiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Multimodal Neuroimaging as a SUDEP Predictor: What Is Known and What Still Needs to Be Uncovered?European journal of neurology · 2025Pooled it
- Macro-structural brainstem volumetry in generalized epilepsy: assessment of subcortical network involvement.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Postmortem MRI reveals distinct structural features in sudden unexpected death in epilepsy.Epilepsia open · 2026Article
- Association of Interictal Respiratory Variability and Severity of Postictal Hypoxemia After Generalized Convulsive Seizures.Neurology · 2026Article
- The Crucial Interplay Between the Lungs, Brain, and Heart to Understand Epilepsy-Linked SUDEP: A Literature Review.Brain sciences · 2025Review
- Sudden Unexpected Death in Epilepsy: Central Respiratory Chemoreception.International journal of molecular sciences · 2025Review
- The bidirectional relationship between the cerebellum and seizure networks: a double-edged sword.Current opinion in behavioral sciences · 2023Article
- Sudden Unexpected Death in Epilepsy and Respiratory Defects in a Mouse Model of DEPDC5-Related Epilepsy.Annals of neurology · 2023Article
- Interictal respiratory variability predicts severity of hypoxemia after generalized convulsive seizures.Epilepsia · 2023Article
- Review
- Serotonin transporter in the temporal lobe, hippocampus and amygdala in SUDEP.Brain pathology (Zurich, Switzerland) · 2022Article
- Relation of Brain Perfusion Patterns to Sudden Unexpected Death Risk Stratification: A Study in Drug Resistant Focal Epilepsy.Behavioral sciences (Basel, Switzerland) · 2022Article
- Proteomic differences in hippocampus and cortex of sudden unexplained death in childhood.Acta neuropathologica · 2022Article
- Raphe and ventrolateral medulla proteomics in epilepsy and sudden unexpected death in epilepsy.Brain communications · 2022Article
- Review: Neuropathology findings in autonomic brain regions in SUDEP and future research directions.Autonomic neuroscience : basic & clinical · 2021Review
- Neuropathology in the North American sudden unexpected death in epilepsy registry.Brain communications · 2021Article
- Polyglucosan bodies in medullary catecholaminergic neurones in SUDEP.Epilepsy & behavior reports · 2021Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
Abstract
aimsSudden unexpected death in epilepsy (SUDEP) likely arises as a result of autonomic dysfunction around the time of a seizure. In vivo 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.
methodsForty-seven medullae from 18 SUDEP, 18 nonepilepsy controls and 11 epilepsy controls were studied. In 16 cases, representing all three groups, ex vivo 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.
resultsLower relative RtZ volumes in the rostral medulla but higher actual volumes in the caudal medulla were observed in SUDEP (P < 0.05). 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 (P < 0.05). Significantly lower MAP2 LI were noted in the rostral medulla RtZ in epilepsy cases (P < 0.05).
conclusionsRostro-caudal alterations of medullary volume in SUDEP localize with regions containing respiratory regulatory nuclei. They may represent seizure-related alterations, relevant to the pathophysiology of SUDEP.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.