{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:32:55Z","timestamp":1779114775306,"version":"3.51.4"},"reference-count":66,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Prognostication of neurological outcome in critically ill patients presents significant challenges. While EEG reactivity may be associated with outcome in hypoxic\u2013ischemic brain injury (HIBI), it has received scarce attention in other etiological conditions. Our objective was to investigate the association of EEG reactivity to clinical outcome in patients with disorders of consciousness of various etiologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This is an ancillary study of the randomized CERTA trial (NCT03129438), which included adults with disorders of consciousness randomized to continuous EEG for 30\u201348\u2009h or two routine EEGs (20\u201330\u2009min). We explored the association between EEG characteristics and neurological outcome at 6\u2009months, a modified Rankin Scale (mRS) 3\u20136 being considered unfavorable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 364 patients were included. Among them, 112 patients had HIBI, 85 intracranial hemorrhage (ICH), 28 ischemic stroke, 48 traumatic brain injury (TBI), 23 toxic\u2010metabolic encephalopathy, 7 encephalitis, and 114 had unknown or other etiologies. In the overall cohort, abnormal background continuity (OR 2.33, 95% CI [1.15\u20134.76], <jats:italic>p<\/jats:italic>\u2009=\u20090.019), ictal\u2013interictal continuum features (OR 2.78, 95% CI [1.16\u20136.67], <jats:italic>p<\/jats:italic>\u2009=\u20090.021) and unreactive background (OR 10.9, 95% CI [1.97\u201358.82], <jats:italic>p<\/jats:italic>\u2009=\u20090.006) were independently associated with unfavorable outcome. In the overall cohort, unreactive EEG had specificity of 97.3% (95% CI [94.3\u2013100]) and sensitivity of 22.1% (95% CI [17\u201327.2]) for unfavorable outcome. In HIBI, specificity was 97% (95% CI [91.1\u2013100]) and sensitivity 46.8% (95% CI [35.8\u201357.8]); in ICH, specificity was 94.1% (95% CI [83\u2013100]) and sensitivity 8.8% (95% CI [2.05\u201315.55]); in TBI, specificity was 94.1% (95% CI [83\u2013100]) and sensitivity 22.6% (95% CI [7.8\u201337.3]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this etiologically mixed cohort of critically ill adults, unreactive EEG predicted unfavorable outcome at 6\u2009months with high specificity. EEG reactivity may reduce prognostic uncertainty not only for patients with HIBI, but also for other types of acute brain injury, such as TBI and ICH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70312","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T09:20:46Z","timestamp":1753694446000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Unreactive <scp>EEG<\/scp> Background Is Associated With Unfavorable Outcome in Patients With Disorders of Consciousness of Various Etiologies: An Adult Cohort Study"],"prefix":"10.1111","volume":"32","author":[{"given":"Sarah","family":"Benghanem","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences Lausanne University Hospital (CHUV), University of Lausanne  Lausanne Switzerland"},{"name":"Medical ICU Cochin Hospital, APHP Centre  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Novy","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences Lausanne University Hospital (CHUV), University of Lausanne  Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaspar A.","family":"Schindler","sequence":"additional","affiliation":[{"name":"Sleep\u2010Wake\u2010Epilepsy\u2010Center, Department of Neurology Inselspital, Bern University Hospital and University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"R\u00fcegg","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Basel and University of Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Department of Neurology Valais Hospital  Sion Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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