Kseniia Kriukova

Objective: The development of posttraumatic epilepsy after traumatic brain injury (TBI) is potentially identifiable by measuring biomarkers of epileptogenesis, namely pathological high‐frequency oscillations (pHFOs). pHFOs are promising candidates, but it remains uncertain whether they can be detected early after TBI in clinical settings. This study was undertaken to determine the incidence and location of pHFOs as recorded from scalp and intracranial electroencephalography (EEG) during the first week after acute TBI and to determine the association of pHFOs with late posttraumatic seizures (PTS). Methods: We analyzed continuous EEG from 35 TBI patients with acute hemorrhagic TBI (Glasgow Coma Scale = 3–13) enrolled in the multicenter EpiBioS4Rx cohort. Automated pHFO detection was followed by independent experts' verification. The rate of two types of pHFO ripples (70–250 Hz) and fast ripples (250–500 Hz) were computed using scalp and intracranial EEG. Firth logistic regression models estimated associations between pHFOs rates and late PTS occurrence. Results: 16 of 35 patients (45.7%) developed late PTS. Verified scalp ripples were observed in 17 patients (48.6%), whereas no fast ripples were confirmed on expert review. Ripple activity was most frequent over frontal regions (13/17, 76.5%, p = .049, 95% confidence interval [CI] = .50–.93) and similarly frequent in perihemorrhagic locations (13/17, 76.5%, p = .049, 95% CI = .50–.93). Among 10 patients with intracranial EEG, verified ripples occurred in five (50%), including two of two with pericontusional strip electrodes. Significance: In critically ill patients with acute hemorrhagic TBI monitored in the intensive care unit, both scalp and intracranial EEG can detect pHFOs within the first week after injury, demonstrating the technical feasibility of capturing these signals in a real‐world clinical setting. Verified pHFOs were most frequently observed over frontal and perihemorrhagic regions, consistent with early perilesional hyperexcitability. pHFOs appear to be mechanistically grounded markers of perilesional hyperexcitability. Standardized, high‐sampling EEG studies with targeted pericontusional coverage are needed to establish prognostic performance for late PTS.

Traumatic brain injury (TBI) is one of the leading causes of acquired epilepsy, with a significant proportion of patients developing post-traumatic epilepsy (PTE) even months or years after the initial injury. The identification of reliable imaging biomarkers able to predict epileptogenesis remains a major clinical challenge. In recent years, diffusion-weighted imaging (DWI) and structural connectome analysis have emerged as promising tools to investigate brain network alterations associated with late seizure development. Machine learning approaches may further support the detection of predictive patterns in complex neuroimaging data. The goal of this study is to perform a binary classification between seizure-free and late seizure-affected patients following TBI, with a specific focus on the identification of the anatomical regions potentially connected with late seizure development. A dataset of 59 diffusion weighted images (DWI) scans from the EpiBioS4Rx project, including 42 seizure-free and 17 late seizure-affected TBI patients, was analyzed. A Random Forest classification algorithm was applied, incorporating network feature importance based on the Gini index to investigate model’s decisions and allow a clinical interpretation. The model reported a 69% ± 0.03 accuracy for discrimination and a 73% AUC ± 0.05. Despite the limited and imbalanced nature of the dataset, and the fact that the performance does not significantly exceed chance once all data-dependent steps are taken into account, our approach allows us to achieve accurate classification results compared to the literature and to identify brain regions potentially associated with epileptogenesis.

This review systematically analyzes potential biomarker candidates for post‐traumatic epilepsy (PTE) in humans who have experienced moderate to severe traumatic brain injury (TBI). Focusing on biomarkers across biofluid‐based protein, genetic, neuroimaging, and neurophysiological categories, this review distinguishes between TBI patients who develop PTE and those who do not. The review adheres to established methodologies outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Data presentation follows the Meta‐analyses of Observational Studies (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Medline, Embase, and Web of Science were systematically searched and yielded 7538 records, of which 18 met inclusion criteria (moderate–severe TBI in humans, follow‐up of at least 6 months, and no prior history of epilepsy). The review aggregates data from 15 cohort and 3 case–control studies (risk of bias was assessed using the Newcastle‐Ottawa Scale). Statistically significant biomarkers were identified, with neurophysiological biomarkers showing the strongest effect size in a two‐study meta‐analysis. PTE, a severe long‐term outcome of TBI affecting 2% to 53% of individuals with TBI, lacks validated biomarkers for forecasting development, crucial for designing preventive clinical trials. A multimodal approach, integrating biofluid‐based protein, genetic, neuroimaging, and neurophysiological data, offers a promising strategy to enhance the predictability of PTE development and, potentially, its treatment. The study's protocol is registered in the International Prospective Register of Systematic Reviews PROSPERO (Registration ID: CRD42023470245).

This study is aimed at investigating epileptic seizures, one of the consequences of traumatic brain injury (TBI). Immediate and early post-traumatic seizures, as well as late post-traumatic epileptic seizures or post-traumatic epilepsy, can have different pathogenetic bases. The following key risk factors associated with post-traumatic epilepsy are known: duration of unconsciousness, gunshot wounds, intracranial hemorrhage, diffuse axonal injury, prolonged (more than 3 days) post-traumatic amnesia, acute subdural hematoma with surgical evacuation, immediate and early post-traumatic epileptic seizures, fracture of the skull bones. The role of genetic factors in post-traumatic seizures is poorly understood due to the complexity and multiple causal mechanisms. This paper addresses the role of genetic factors in the occurrence and severity of epileptic events in patients with TBI. In particular, we investigated the role of the Cys112Arg single nucleotide polymorphism of the apolipoprotein E gene. Apolipoprotein E is known for its role in the transport and metabolism of lipids and, therefore, the development of cardiovascular diseases; it is also associated with Alzheimer's disease and has recently been studied in the context of association with epilepsy. The study shows an association between this polymorphism and the risk of immediate and early epileptic seizures in patients with severe TBI.

Introduction. The COVD-19 pandemic caused by the SARS-CoV-2 continues from March 2020. The virus primarily affects the respiratory system. Moreover, there is new data about the various organ damage caused by COVID-19 such as heart, skin, kidney and central nervous system. That’s why it is necessary to investigate the neurological features of the COVID-19.The aim of the study. To investigate the effect of COVID-19 on the cognitive functions of hospitalized patients.Materials and methods. the PCR-positive patients hospitalized at the University Clinical Hospital No. 3 had been included in the study since March 2020 for May 2021. Thorax CT scan, physical and neurological examination, the biochemical blood test was provided for all patients. The neuropsychological examination was made by: MoCA, TMTA, TMTB, and emotional condition was tested by HADS.Results. 33 patients (21 (64.6%) women) were included; the median age was 73.0 [67.0; 76.0]. The average MoCA value was 22.64 points, median: 24.00 points [20.00; 25.00], median TMTA execution speed: 68 seconds [49.00; 84.00], TMTB: 194 seconds [153; 245.75]. HADS (depression) median: 7.0 [5.00; 9.00], for HADS (anxiety) median: 8.0 [4.00; 10.00]. A link between the olfactory disorders and low MoCA results (p = 0.015) was found according to the regression analysis. Moreover, the patient’s age, lung damage degree had a negative impact on the duration of TMTB (p = 0.001 and p = 0.049). The propensity score matching was made to confirm that the olfactory disturbances, regardless of other factors, are associated with a lower MoCA result (p = 0.012).Conclusion. The potential mechanisms, modality, defect duration and pharmacological response of cognitive disorders have a great interest. That’s why it is necessary to conduct clinical and experimental studies on patients, pathomorphological material and animal models.

Background. The export of medical services is one of the most dynamically developing areas both in the structure of the world economy and in the structure of world health care. By decree of V.V. Putin of May 7, 2018 On national goals and strategic objectives of the development of the Russian Federation the need to increase the volume of exports of medical services was outlined. The real experience of receiving medical care by foreign citizens living in the territory of the Russian Federation has a serious impact on the broadcasted image of Russian medicine. Sociological research aimed at studying the opinion of foreign citizens about domestic medicine is a promising tool for ensuring a targeted approach in the export of medical services. Aims to study the opinion on the Russian medicine among foreign citizens of the CIS countries living in the territory of the Russian Federation in order to form an effective strategy for promoting medical services provided for foreigners in the territory of the Russian Federation. Methods. The focus group interviews with citizens of the CIS countries who received medical services and residing in Russia were held. For the analysis, the text data encoding procedure was carried out. At the same time, the study was not aimed at revealing the prevalence of opinions, statistical criteria were not used. An adapted COM-B model was used as a theoretical basis for the analysis, and the BCW (Behavior change wheel) method was used to develop recommendations. Results. The study examined some important details of the image of Russian medicine in the opinion of group participants (good equipment, reliable ambulance, feeling of conveyor belt, bureaucracy, etc.). The results are structured using the adapted COM-B model. The study identified the main strategies used by foreign citizens when seeking medical care. Insufficient awareness of foreign citizens about their rights in the field of medical provision in the territory of the Russian Federation was revealed. The main channels of communication used by citizens of the CIS to select a medical organization / specialist for seeking help have been studied, it is primarily word of mouth. It has been established that in order to be attractive, for Russian medicine its not enough to have advantages, they should be perceived as sufficient to overcome the convenience of conservative respondents to refer to native, familiar, as well as the fear of the stranger. Based on the results obtained using the BCW model, the recommendations have been developed and interventions have been proposed to promote medical services provided in the Russian Federation among foreigners.

Ежегодно в мире от черепно-мозговых травм (ЧМТ) страдают около 50 млн человек. Опасным осложнением ЧМТ любой степени тяжести является посттравматическая эпилепсия (ПТЭ). ПТЭ развивается у 20% пациентов с ЧМТ. Лечение пациентов с ПТЭ представляет особую сложность, поскольку у них наблюдается выраженная тенденция к фармакорезистентности. В настоящее время отсутствуют валидированные предиктивные биомаркеры развития ПТЭ. Разработка системы валидированных предиктивных биомаркеров позволила бы повысить качество прогнозирования ПТЭ и улучшить терапевтическую тактику ведения указанной группы пациентов. В обзоре проанализированы и обобщены актуальные сведения об имеющихся наиболее перспективных предиктивных биомаркерах ПТЭ в свете их потенциального использования в клинической практике.

Currently, an epileptic seizure is considered to involve a temporary network that exists for a finite period of time. Formation of this network evolves through spread of epileptiform activity from a seizure onset zone (SOZ). Propagation of seizures evoked by kainic acid injection in hippocampus to different brain areas was analyzed at macro- and micro-intervals. The mean latency of seizure occurrence in different brain areas varied between 0.5 sec and 85 sec (mean 14.9 ± 14.5 (SD)), and it increased after each consecutive seizure in areas located contralateral to the area of injection, but not in the ipsilateral sites. We have shown that only 41% of epileptic individual events in target brain areas were driven by epileptic events generated in the SOZ once the seizure began. Fifty-nine percent of epileptiform events in target areas occurred one millisecond before or after events in the SOZ. These data illustrate that during seizure maintenance, only some individual epileptiform events in areas outside of SOZ could be consistently triggered by the SOZ; and the majority must be triggered by a driver located outside the SOZ or brain areas involved in ictal activity could be coupled to each other via an unknown mechanism such as stochastic resonance.