Adults older than age 55 years have the highest incidence rate and are the fastest-growing population among people with epilepsy. The aim of this study was to characterize the etiologies of new-onset seizures in older adults and to examine how seizure etiology varies across demographic groups. We used data from 7 US epilepsy centers from 2021 to 2025 and compared findings with those of previous population-based studies, providing an updated view and highlighting opportunities for prevention and improved risk stratification. We retrospectively reviewed medical charts of 2,052 patients aged ≥55 years at the time of a first seizure, who were evaluated at 7 epilepsy centers between 2021 and 2025. We categorized seizures by etiology as follows: ischemic stroke, hemorrhagic stroke, tumor, neurodegeneration, provoked seizures, traumatic brain injury, and unknown. We examined differences in etiology by demographic strata (age, sex, race, and primary language) using chi-square tests, Kruskal-Wallis tests, analysis of variance, and Cuzick tests. The most frequent seizure etiologies among older adults were unknown (29.9%), ischemic stroke (15.4%), and provoked seizures (14.9%). Neurodegenerative disease was the etiology for 5.3% of cases overall but increased in prevalence with age, accounting for 18.5% among patients aged 85-89 years. Seizure etiologies also differed by sex and race. Men more commonly had seizures caused by cerebrovascular disease and traumatic brain injury, while women more commonly had seizures due to neurodegenerative disease. Black patients had higher proportions of ischemic stroke and neurodegenerative disease, while unexplained epilepsy was more common among White patients. The causes of late-onset seizures vary based on age, sex, and race. Nearly one-third of cases of epilepsy in older adults remain unexplained despite advances in imaging techniques, underscoring the need for further research on the mechanisms and health implications of late-onset unexplained epilepsy. Improved prevention of cerebrovascular disease and optimized management of provoked seizures may reduce the growing burden of epilepsy in older adults.

The influence of mild traumatic brain injury on attentional Bias: Preliminary evidence.

Microglial GLUL loss worsens TBI outcomes by amplifying the arginine-citrulline pathway.

E-scooter related head trauma has emerged as a growing contributor to neurosurgical and critical care workload internationally, yet data describing injury patterns, resource utilisation and costs remain limited. This study characterises the epidemiology, clinical features and hospital costs of e-scooter related traumatic brain injury (TBI) within a state-wide Level 1 trauma centre. A retrospective study was conducted using the trauma registry of a state-wide Level 1 tertiary trauma centre in Western Australia, identifying e-scooter-related head injuries from 1 January 2019 to 30 June 2024. The registry captures the majority of moderate to severe TBI, although less severe injuries managed at other hospitals may be under-represented. Cases were stratified into a primary TBI cohort (ICD-10-AM S06) and a secondary cohort of isolated calvarial or skull base fractures (S02). Temporal trends were analysed using negative binomial regression. All clinical, neurosurgical, ICU and cost analyses were restricted to the TBI cohort to ensure internal validity. Multivariable logistic regression identified predictors of ICU admission. Hospital costing data were obtained from activity-based management systems. 93 e-scooter related head injury admissions were identified. TBI accounted for 82 cases (88.2%). There was a steep rise in annual incidence (IRR 1.98; 95% CI 1.58-2.48) over the study period. Most patients were male (81.7%) and intoxication due to alcohol or drugs was common (53.8%). Of the primary TBI cohort, calvarial or skull base fractures occurred in 42.7% of patients. Only 9.8% required neurosurgical intervention, yet 50.0% were admitted to the ICU. In univariate analysis, lower GCS (p=0.003) and concurrent skull fracture (p<0.001) were associated with ICU admission. In multivariable analysis, both GCS (OR 0.66 per point; 95% CI 0.44-0.87) and concurrent fracture (OR 7.47; 95% CI 2.47-25.85) remained independent predictors. Total hospital costs increased from $16,103.88 (AUD) in the 2019-2020 financial year to $1,842,153.68 in the 2023-2024 financial year with an annual percent change of 194% (95% CI 105-323). The median cost per TBI admission was $17,720.11 (IQR $9,155.99-$50,311.89). ICU admitted patients incurred significantly higher costs than non-ICU patients (median $30,767.26 vs. $12,906.19). Ward nursing was the largest cost driver. This study documents a growing neurosurgical and critical care challenge in Western Australia. Despite low operative rates, e-scooter related TBI is associated with substantial economic impact, exceeding that reported in other Australian trauma series. These findings highlight opportunities for targeted prevention and policy intervention, including helmet compliance, alcohol riding restrictions and ride-share safety governance.

Traumatic brain injury (TBI) is recognized as a significant diagnostic challenge due to the complex and evolving nature of its pathophysiology, which extends beyond the resolution of conventional neuroimaging techniques such as CT and MRI. In this review, the transformative potential of nanotechnology for bridging this diagnostic gap is discussed. A systematic overview is provided of engineered nanomaterials as advanced contrast agents that significantly enhance the capabilities of two pivotal imaging modalities: fluorescence imaging and MRI. In fluorescence imaging, rationally engineered nanoprobes facilitate high-sensitivity molecular profiling, enabling quantitative and objective assessment of traumatic injury severity, evaluation and prediction of secondary injury, and real-time guidance for surgical or therapeutic interventions across varying degrees of TBI. For MRI, nanomaterial-based contrast agents markedly improve sensitivity and specificity, allowing detection of previously undetectable micro-hemorrhage and supporting multiparametric imaging for a comprehensive perspective of trauma-induced abnormal vasculatures and the underlying pathophysiology of TBI. Collectively, these nanotechnology-driven advances are regarded as a paradigm shift from passive anatomical description toward the active, molecular-level interrogation of the dynamic TBI process. Although challenges in biosafety, manufacturing, and regulatory approval remain, these innovative approaches hold promise for personalizing diagnosis, improving prognostication, and guiding targeted therapies in neurotrauma. • Fluorescence nanomaterial-based molecular profiling, severity assessment, and intervention guidance of TBI were summarized. • Nanomaterial-based multiparametric MRI for detecting micro-hemorrhage and mapping abnormal vasculature in TBI was reviewed. • Benefits, challenges, and future perspectives of nanomaterial-based imaging strategies for TBI diagnosis were discussed.

Anacardic acid mitigates traumatic brain injury-induced inflammatory damage: involvement of TLR4/MyD88/NF-κB pathway regulation and inhibition of P300 HAT activity on NF-κB acetylation.

Aquaporin 4 knockdown alleviates traumatic brain edema and reduces neuronal axonal growth cone collapse via the RhoA/ROCK pathway.

Traumatic brain injury (TBI) is often associated with autonomic nervous system (ANS) dysregulation and reduced heart rate variability (HRV), potentially affecting cognition. This study tested whether HRV biofeedback (HRV-B) improved resting HRV and stress recovery in individuals with TBI compared to sham control. We also examined whether HRV changes related to physical symptoms, emotional well-being, cognitive performance, and adherence. Fifty-eight participants with TBI enrolled; 49 completed the study (HRV-B: 25, mean age 27.1; sham: 24, mean age 26.6). Participants attended five weekly sessions. Assessments included cognitive, emotional, and physical outcomes. HRV metrics (HF, LF, LF/HF, SDNN, RMSSD) were collected via electrocardiogram. The HRV-B group showed a higher LF/HF ratio at rest (F(1, 43) = 9.38, p = 0.004) and during stress recovery (F(1, 172) = 4.27, p = 0.040) than sham. A group-by-session interaction (F(1, 172) = 4.18, p = 0.04) indicated an LF/HF increase over time for HRV-B. Condition effects for HF (log), RMSSD, and SDNN at rest favored sham but disappeared after adjusting for pre-assessment values. LF (log) showed no significant effects. Both groups improved in Fluid Cognition and Total Composite scores, with no between-group differences. Anxiety and depression decreased over sessions, with greater depression improvement in HRV-B. No group effects emerged for stress or life satisfaction. HRV-B increased LF/HF ratio at rest and during stressor recovery, possibly reflecting baroreflex engagement. However, other HRV condition effects attenuated after adjusting for baseline values. Cognitive and emotional gains were observed in both groups.

Curcumin mitigates gas explosion-induced traumatic brain injury in male rats by regulating key molecular signatures: A multiomics analysis.

Considerations for enhancing the clinical translational potential of LLM-Based TBI mortality prediction models.

Outcomes associated with ketamine administration following traumatic brain injury.

This systematic review explores the application of Raman spectroscopy (RS) in traumatic brain injury (TBI) research, emphasizing the need for innovative and efficient diagnostic tools. The development of such techniques aims to alleviate healthcare costs while providing timely assessment of injury severity. A systematic literature search for the use of RS in TBI was conducted in PubMed, Scopus, and Web of Science from inception to July 28, 2025, following PRISMA guidelines. We included only original English-language studies (animals and humans) in free full-text format. Risk of bias was assessed using specific tools for both animal and human models. Findings were classified according to the cohorts, and spectroscopic technique alongside their particularities. The initial search found 261 articles, with 26 studies meeting the inclusion criteria. Among them: 15 were animal studies and 11 translational/human-relevant studies. Among animal studies, 3 focused on in-situ monitoring and TBI classification, 2 on blast-induced models, 5 on blood biomarker analysis, 2 on retinal-based point-of-care diagnostics, and 3 on Raman microscopy. The translational research studies aimed to identify and validate TBI biomarkers for developing future diagnostic strategies in human patients. RS distinguished injured from control tissue through spectral changes reflecting protein and lipid alterations and differentiated lesion areas by revealing astrogliosis-related reorganization. Instantaneous in-situ RS devices achieved >92% accuracy in severity classification and detected biomarker-related molecular changes. Point-of-care RS platforms using lateral flow strips enabled rapid detection of specific TBI biomarkers (GFAP, NAA, NSE, S100B, UCH-L1), showing performance comparable to ELISA while offering faster, simpler, and cost-efficient testing.

Post-traumatic epilepsy is a major complication of traumatic brain injury (TBI), with limited predictive tools and preventive strategies. Although intraoperative electrocorticography (ECoG) is widely used in epilepsy and tumor surgeries, its role in brain injury remains underexplored. This study evaluates the predictive value of intraoperative ECoG for seizure development and functional outcomes in patients with TBI. This prospective observational study included 110 patients with head injury who underwent surgery and intraoperative ECoG evaluation. The ECoG recordings were categorized as normal (Group A) or abnormal (Group B) based on epileptiform activity. Patients were followed for 12 months to assess seizure incidence, mortality, and functional outcomes using the International League Against Epilepsy, modified Rankin Scale, and Glasgow Outcome Scale. Statistical analysis was performed to determine associations between ECoG findings and clinical outcomes. Among the 110 patients, 50 (45.5%) had normal ECoG, while 60 (54.5%) exhibited abnormal findings. Patients with abnormal intraoperative ECoG had significantly higher seizure incidence at 30 days ( P < .001, 95% CI = 2.36-138.1) and 6 months ( P < .001, 95% CI = 3.19-186.72). Burst suppression patterns were associated with 100% mortality. Functional outcomes were significantly worse in the abnormal ECoG group at 12 months, with higher modified Rankin Scale scores ( P < .001, 95% CI = 7.48-72.3) and lower Glasgow Outcome Scale scores ( P < .001, 95% CI = 3.86-51.55). Intraoperative ECoG abnormalities correlate with increased seizure risk, higher mortality, and worse functional outcomes in patients with TBI. These findings suggest that intraoperative ECoG can serve as a prognostic tool, guiding antiseizure medication use and rehabilitation strategies in neurosurgical practice.

Incidence and independent predictors of heterotopic ossification after posterior acetabular fixation without routine prophylaxis: A large cohort study.

Selective head cooling intervention improves mental health markers: A multimodal feasibility study.

Astragaloside IV alleviates post-traumatic cytotoxic edema via inhibition of AQP4 expression and subcellular localization.

Epidemiology, management, and outcomes of pediatric traumatic brain injury: a prospective study from a tertiary trauma centre in North India.

The label-free electrochemical S100B-TBI immunosensor for sensitive detection of S100B protein as a biomarker for traumatic brain injury using FFT-SWV voltammetry.

Identification of immune cell subsets involved in retinal ganglion cell damage following blast exposure.

Traumatic brain injury (TBI) induced by rotational loading is a major contributor to neurological dysfunction, yet the biomechanical mechanisms underlying these injuries remain poorly understood. In this study, a high-resolution, anatomically accurate three-dimensional finite element model of the mouse brain (FEM-MB) was developed. The FEM-MB was validated against previously published experimental data, showing good agreement in both the timing and magnitude of strain responses. The FEM-MB was then subjected to unidirectional and multidirectional rotational loading scenarios at low (100 rad/s), moderate (150 rad/s), and high (200 rad/s) peak angular velocities to investigate the mouse brain's response to multidirectional rotational loading. The FEM-MB results consistently revealed that deep brain regions, particularly the thalamic-hippocampal region, hypothalamus, and brainstem, experienced the highest maximum principal strains. These results highlight that not only the magnitude, but also the direction and temporal asymmetry of rotational loading, significantly affect the strain distribution across brain regions. In particular, the thalamic-hippocampal and brainstem regions had the highest strains under coronal and axial plane rotations, aligning with known injury patterns. These findings underscore the critical role of rotation direction and loading profile on strain magnitude and distribution in the mouse brain under dynamic rotational loading. Overall, the FEM-MB provides a robust in silico platform to investigate the effects of dynamic rotation loading in preclinical models of TBI.