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The neurological wake\u2010up test is a widely used assessment tool. However, many patients' behavioral responses during a short interruption of sedation are ambiguous or absent, yielding little prognostic value. This study assesses the brain's electroencephalogram response during an interruption of propofol sedation to complement behavioral assessment during the neurological wake\u2010up test to predict survival, recovery of consciousness, and long\u2010term functional outcomes in patients with acute severe brain injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recorded 128\u2010channel <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> from 41 severely brain\u2010injured patients during a clinically indicated neurological wake\u2010up test. Behavioral assessment was performed before and after interruption of propofol sedation, using the Glasgow Coma Scale. Brain response to sedation interruption was quantified using <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> power, spatial ratios, and the spectral exponent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recovery of responsiveness during the neurological wake\u2010up test is reflected in participants' brain response to sedation interruption. Electrophysiological patterns can be decoupled from participant behavioral response, with some individuals demonstrating neurophysiological signs of waking up despite an absent behavioral response. Using the brain response to complement behavioral assessment improved prognostic value, distinguished patients according to survival and outperformed outcome predictions of the patients' attending physician.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> can complement behavioral assessment during the neurological wake\u2010up test to improve prognostication, inform clinicians, family members, and caregivers, and to set realistic goals for treatment and therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.70085","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T11:55:46Z","timestamp":1748174146000},"page":"1480-1492","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>EEG<\/scp> Response to Sedation Interruption Complements Behavioral Assessment After Severe Brain 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