A consensus roadmap for post-traumatic epilepsy: Clinical biomarkers, research priorities, policy barriers, and pathways to interventional trials

Understanding the mechanisms underlying post-traumatic epilepsy (PTE) following traumatic brain injury (TBI), and developing strategies to prevent or modify its progression, has been the focus of large collaborative efforts within the epilepsy and TBI research communities for over a decade. However, to date, preclinical and clinical researchers with expertise in these areas have not formally convened to discuss ways to move the field forward. To enable communication and collaboration, scientific experts as well as individuals with lived experience of PTE were gathered during the inaugural International Conference on Post-Traumatic Epilepsy (IC-PTE) held in Milan, Italy, in May 2024, to identify challenges and solutions for advancing research toward clinical trials. The IC-PTE focused on potential therapeutic approaches, clinical and preclinical biomarker discovery, and methods to predict PTE risk early following TBI, which is an important consideration in clinical trial design. In addition, conference attendees discussed animal model development with a focus on clinically relevant translational endpoints and data harmonization and sharing across the PTE research community. This article identifies recommendations for the field and outlines a strategic roadmap for interventional trials targeting PTE.