{"doi":"10.1111/epi.18447","title":"Seizure‐onset zone lateralization in temporal lobe epilepsy using <scp>7T rs‐fMRI</scp>: Direct comparison with <scp>3T rs‐fMRI</scp>","abstract":"OBJECTIVE: Resting-state functional magnetic resonance imaging (rs-fMRI) at ultra-high field strengths (≥7T) is known to provide superior signal-to-noise to comparable acquisitions at lower field strengths. In this study, we provide a direct comparison of the seizure onset-zone (SOZ) lateralizing ability of 7T rs-fMRI and 3T rs-fMRI. METHODS: We investigated a cohort of 70 patients with temporal lobe epilepsy (TLE). A paired cohort of 19 patients had 3T and 7T rs-fMRI acquisitions for direct comparison between the two field strengths. Forty-three patients had only 3T, and eight patients had only 7T rs-fMRI acquisitions. We quantified the functional connectivity between the hippocampus and other nodes within the default mode network (DMN) using seed-to-voxel connectivity, and measured how hippocampal-DMN connectivity could inform SOZ lateralization at 7T and 3T field strengths. RESULTS: Differences in hippocampal-DMN connectivity ipsilateral and contralateral to the SOZ were significantly higher at 7T (Cohen's d = 0.51, p = 0.008) than at 3T (Cohen's d = 0.26, p = 0.68) when measured in the same subjects. We found that SOZ lateralization was superior at 7T (receiver-operating characteristic area under the curve [ROC AUC] = 0.97, 95% confidence interval [CI]: 0.92-1.00) than 3T (ROC AUC = 0.67, 95% CI: 0.36-0.98), for the same subjects scanned at both field strengths. Our findings were reproduced in extended cohorts of subjects scanned at either 3T or 7T. Our rs-fMRI findings at 7T, but not 3T, are consistent (Spearman ρ = 0.65, p = .01) with clinical fluorodeoxyglucose positron emission tomography (FDG-PET) lateralizing hypometabolism. SIGNIFICANCE: We show superior SOZ lateralization in patients with TLE when using 7T relative to 3T rs-fMRI, supporting the adoption of high field strength functional imaging in the epilepsy presurgical evaluation.","journal":"Epilepsia","year":2025,"id":538235,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8844,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":401963,"name":"Eli J. Cornblath","orcid":"0000-0002-2619-8778","position":1,"is_corresponding":false},{"id":644407,"name":"Nishant Sinha","orcid":"0000-0002-2090-4889","position":2,"is_corresponding":false},{"id":699104,"name":"Lorenzo Caciagli","orcid":"0000-0001-7189-9699","position":3,"is_corresponding":false},{"id":772466,"name":"Peter Hadar","orcid":"0000-0002-1681-4717","position":4,"is_corresponding":false},{"id":1050451,"name":"Ashley Tranquille","orcid":null,"position":5,"is_corresponding":false},{"id":240420,"name":"Joel M. Stein","orcid":"0000-0002-0741-1780","position":6,"is_corresponding":false},{"id":265855,"name":"Sandhitsu R. Das","orcid":"0000-0003-0530-2887","position":7,"is_corresponding":false},{"id":265854,"name":"Kathryn A. Davis","orcid":"0000-0002-7020-6480","position":8,"is_corresponding":false},{"id":324340,"name":"Alfredo Lucas","orcid":"0000-0001-9439-735X","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T02:52:21.389196Z","pmid":"40372884","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}