In epilepsy patients, decreased MBP occurs inmedullary subregions,13hippocampus and frontal cortex,33 as well as in the hippocampus of an epilepsy animal model.49 Increased Tf can occur aftertraumatic brain injury (TBI) or haemorrhage with BBB disruption.50 BBB disruption can occur inepilepsy, with IgG leakage, increased perivascular albumin and decreased ZO-1 in epilepsypatients and animal models.51,52 In our study, BBB permeability inthe VLM was suggested by increased IGHG2 and HPX and decreased TJP1 (also known as ZO-1)in SUDEP compared with PWE and non-epilepsy controls. Here, MBP is linked to Sudden unexpected death in epilepsy.