Electrophysiological biomarkers of epileptogenicity after traumatic brain injury

Piero Perucca, Gregory Smith, Cesar Santana-Gomez, Anatol Bragin, Richard Staba

Research output: Contribution to journalReview ArticleResearchpeer-review

21 Citations (Scopus)


Post-traumatic epilepsy is the architype of acquired epilepsies, wherein a brain insult initiates an epileptogenic process culminating in an unprovoked seizure after weeks, months or years. Identifying biomarkers of such process is a prerequisite for developing and implementing targeted therapies aimed at preventing the development of epilepsy. Currently, there are no validated electrophysiological biomarkers of post-traumatic epileptogenesis. Experimental EEG studies using the lateral fluid percussion injury model have identified three candidate biomarkers of post-traumatic epileptogenesis: pathological high-frequency oscillations (HFOs, 80–300 Hz); repetitive HFOs and spikes (rHFOSs); and reduction in sleep spindle duration and dominant frequency at the transition from stage III to rapid eye movement sleep. EEG studies in humans have yielded conflicting data; recent evidence suggests that epileptiform abnormalities detected acutely after traumatic brain injury carry a significantly increased risk of subsequent epilepsy. Well-designed studies are required to validate these promising findings, and ultimately establish whether there are post-traumatic electrophysiological features which can guide the development of ‘antiepileptogenic’ therapies.

Original languageEnglish
Pages (from-to)69-74
Number of pages6
JournalNeurobiology of Disease
Publication statusPublished - Mar 2019


  • Biomarker
  • EEG
  • Electrophysiology
  • Epileptogenesis
  • High-frequency oscillations
  • Post-traumatic epilepsy
  • Repetitive HFOs and spikes
  • Seizure
  • Sleep spindles
  • Traumatic brain injury

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