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PTE was examined 7\u00a0months after LFPI, during 4\u2010week continuous video\u2010electroencephalographic monitoring. 16S ribosomal RNA gene sequencing was performed in fecal samples collected before LFPI\/sham\u2010LFPI and 1\u00a0week, 1 month, and 7\u00a0months thereafter. Longitudinal analyses of alpha diversity, beta diversity, and differential microbial abundance were performed. Short\u2010chain fatty acids (SCFAs) were measured in fecal samples collected before LFPI by liquid chromatography with tandem mass spectrometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Alpha diversity changed over time in both LFPI and sham\u2010LFPI subjects; no association was observed between alpha diversity and LFPI, the severity of post\u2010LFPI neuromotor impairments, and PTE. LFPI produced significant changes in beta diversity and selective changes in microbial abundances associated with the severity of neuromotor impairments. No association between LFPI\u2010dependent microbial perturbations and PTE was detected. PTE was associated with beta diversity irrespective of timepoint vis\u2010\u00e0\u2010vis LFPI, including at baseline. Preexistent fecal microbial abundances of four amplicon sequence variants belonging to the Lachnospiraceae family (three enriched and one depleted) predicted the risk of PTE, with area under the curve (AUC) of .73. Global SCFA content was associated with the increased risk of PTE, with AUC of .722, and with 2\u2010methylbutyric (depleted), valeric (depleted), isobutyric (enriched), and isovaleric (enriched) acids being the most important factors (AUC = .717). When the analyses of baseline microbial and SCFA compositions were combined, AUC to predict PTE increased to .78.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Whereas LFPI produces no perturbations in the gut microbiome that are associated with PTE, the risk of PTE can be stratified based on preexistent microbial abundances and SCFA content.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17248","type":"journal-article","created":{"date-parts":[[2022,4,2]],"date-time":"2022-04-02T12:48:58Z","timestamp":1648903738000},"page":"1835-1848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Susceptibility to epilepsy after traumatic brain injury is associated with preexistent gut microbiome profile"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1103-468X","authenticated-orcid":false,"given":"Jesus\u2010Servando","family":"Medel\u2010Matus","sequence":"first","affiliation":[{"name":"Department of Pediatrics David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venu","family":"Lagishetty","sequence":"additional","affiliation":[{"name":"Department of Medicine David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"},{"name":"Microbiome Center David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9163-5615","authenticated-orcid":false,"given":"Cesar","family":"Santana\u2010Gomez","sequence":"additional","affiliation":[{"name":"Department of Neurology David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhu","family":"Mowrey","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Staba","sequence":"additional","affiliation":[{"name":"Department of Neurology David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0472-2903","authenticated-orcid":false,"given":"Aristea S.","family":"Galanopoulou","sequence":"additional","affiliation":[{"name":"Saul Korey Department of Neurology Dominick Purpura Department of Neuroscience Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raman","family":"Sankar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"},{"name":"Department of Neurology David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"},{"name":"Children's Discovery and Innovation Institute David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Medicine David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"},{"name":"Microbiome Center David Geffen School of Medicine at the University of California, Los Angeles  Los Angeles California USA"},{"name":"Division of Gastroenterology, Hepatology, and Parenteral Nutrition Veterans Administration Greater Los Angeles Healthcare System  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9693-5297","authenticated-orcid":false,"given":"Andrey M.","family":"Mazarati","sequence":"additional","affiliation":[{"name":"Department of Pediatrics David Geffen School of Medicine at the 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