{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:45:48Z","timestamp":1792759548197,"version":"4.5.0"},"reference-count":57,"publisher":"SAGE Publications","issue":"15-16","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100022720","name":"Fondazione Regionale per la Ricerca Biomedica","doi-asserted-by":"crossref","award":["Project ERAPERMED2019-101, GA 779282"],"award-info":[{"award-number":["Project ERAPERMED2019-101, GA 779282"]}],"id":[{"id":"10.13039\/501100022720","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["Ricerca Corrente 2025-2027"],"award-info":[{"award-number":["Ricerca Corrente 2025-2027"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>\n                    Post-traumatic amnesia (PTA), recently conceptualized as part of the broader syndrome known as post-traumatic confusional state (PTCS), marks a critical phase of recovery following traumatic brain injury (TBI). Indeed, this state is characterized not only by anterograde memory impairment but also by disorientation, agitation, and attention deficits. Given the phenotypic overlap between PTA\/PTCS and delirium\u2014both marked by fluctuating cognitive and attentional disturbances\u2014electroencephalography (EEG) represents a promising tool for elucidating shared pathophysiological mechanisms. While delirium is typically associated with diffuse EEG slowing and the presence of slow-wave activity (SWA), thought to reflect underlying global cortical disruption, it remains unclear whether PTCS exhibits similar EEG underpinnings. In this prospective longitudinal study, we assessed dynamic EEG correlates of PTCS using the grand total EEG (GTE) score, a composite measure that incorporates background slowing and superimposed SWA. We enrolled 42 consecutive TBI patients (mean age = 40.3 \u00b115 years) classifying them at baseline (T0) into two groups based on the Confusion Assessment Protocol (CAP): those in PTA\/PTCS (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 22; median time from injury 24 days; median CAP total score 5) and those already emerged from PTA\/PTCS (i.e., TBI controls,\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 20; median time from injury 24 days; median CAP total score 0). At T0, patients with PTA\/PTCS exhibited significantly higher baseline GTE scores compared with TBI controls, 16.6 \u00b1 4.5 versus 5.1 \u00b1 2.8;\n                    <jats:italic toggle=\"yes\">t<\/jats:italic>\n                    (35.75) = 10.04,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001;\n                    <jats:italic toggle=\"yes\">d<\/jats:italic>\n                    = 3.04, reflecting severe EEG abnormalities characterized by diffuse slowing and disrupted rhythmic activity, as captured by the GTE subdomains. Longitudinal follow-up (T1) at emergence from PTCS revealed a significant EEG improvement paralleling clinical recovery, with GTE scores dropping from 16.5 (interquartile range [IQR]: 6.5) to 8, IQR: 3.75;\n                    <jats:italic toggle=\"yes\">t<\/jats:italic>\n                    (21) = 8.03,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001;\n                    <jats:italic toggle=\"yes\">d<\/jats:italic>\n                    = 1.71, confirming EEG\u2019s sensitivity to dynamic clinical changes. Furthermore, the severity of EEG abnormalities at follow-up (T1) significantly correlated with the total duration of PTA\/PTCS (\u03c1 = 0.56,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.0001), underscoring EEG\u2019s potential as an objective biomarker for disease burden and for monitoring recovery trajectories. Notably, these findings were independent of pharmacological confounders, as medication regimens were not significantly different across groups and time points. Our results support a reconceptualization of PTA\/PTCS as a functional (i.e., non-structural) encephalopathy that shares key clinical and neurophysiological features with delirium, with EEG slowing reflecting widespread, often reversible cortical dysfunction. By capturing these transient yet clinically critical changes, clinical EEG\u2014quantified via the granular, multifaceted GTE\u2014offers a novel tool for diagnosing PTA\/PTCS, stratifying its severity, and objectively monitoring its evolution in intensive care unit and subacute rehabilitation settings.\n                  <\/jats:p>","DOI":"10.1177\/08977151251408801","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T17:02:48Z","timestamp":1767114168000},"page":"1226-1237","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["EEG Correlates of the Confusional State after Traumatic Brain Injury"],"prefix":"10.1177","volume":"43","author":[{"given":"Angela","family":"Comanducci","sequence":"first","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara-Camilla","family":"Derchi","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Atzori","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Valota","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Arcuri","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro Davide","family":"Trimarchi","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Angelo","family":"Colombo","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Chieregato","sequence":"additional","affiliation":[{"name":"NeuroIntensive Care, Niguarda Hospital, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Massimini","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."},{"name":"Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Navarro","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/0269905031000149542"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1999.90.4.0635"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.06.030"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(74)91639-0"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2015.4025"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.111187"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.06.021"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/AITC202010060"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.09.009"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.2.153"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008164"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(98)00076-5"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0987-7053(97)83777-X"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-013-1070-5"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1989.tb03040.x"},{"key":"e_1_3_5_17_2","volume-title":"Rehabilitation of the Head Injured Adult: Comprehensive Physical Management","author":"Professional Staff Association of the Rancho Los Amigos Hospital","year":"1979","unstructured":"Professional Staff Association of the Rancho Los Amigos Hospital. 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