{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T18:13:09Z","timestamp":1759342389462,"version":"build-2065373602"},"reference-count":22,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Autopsy studies of children dying of cerebral malaria (CM) have revealed that those with malarial retinopathy exhibited high levels of sequestration in the cerebral vasculature, whereas children with retinopathy-negative CM exhibited lower sequestration levels and possible nonmalarial causes of death. This suggests that children dying of retinopathy-negative CM have nonmalarial coma etiologies with concomitant incidental parasitemia, which is common in high malaria transmission areas. Subsequent studies have challenged this assertion, positing that retinopathy-negative CM and retinopathy-positive CM are variants of the same disease pathophysiology or host biology, both caused by acute malaria infection. We recently determined that electroencephalography (EEG) can be used to discriminate between a malarial coma (CM) and a nonmalarial coma. To better understand the contribution of acute malaria infection in the pathophysiology of retinopathy-negative CM, we compared qualitative and quantitative EEG findings from 30-minute EEG recordings of Malawian children aged 3 months to 14 years hospitalized at Queen Elizabeth Central Hospital with retinopathy-negative CM, retinopathy-positive CM, and nonmalarial coma. Neither qualitative nor quantitative EEG interpretation methods allow for the discrimination between children with retinopathy-positive CM and those with retinopathy-negative CM. Conversely, quantitative EEG readily differentiated children with retinopathy-negative CM from those with nonmalarial coma (area under the receiving operating characteristic [AUROC] curve of 0.83). When combining qualitative and quantitative EEG interpretation methods, the ability of EEG to distinguish retinopathy-negative CM from nonmalarial EEG increases (AUROC of 0.87). The EEGs of children with retinopathy-negative CM are similar to those of children with retinopathy-positive CM and significantly different from those of children with nonmalarial coma, supporting the hypothesis that acute malarial infection is pathophysiologically important in retinopathy-negative CM.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0377","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T16:07:54Z","timestamp":1753200474000},"page":"809-816","source":"Crossref","is-referenced-by-count":0,"title":["Using Electroencephalography to Assess Coma Etiology in Children with Retinopathy-Negative Cerebral Malaria"],"prefix":"10.4269","volume":"113","author":[{"given":"Mrinmayee","family":"Takle","sequence":"first","affiliation":[{"name":"Division of Neurology, The George Washington University\/Children\u2019s National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Andrews","sequence":"additional","affiliation":[{"name":"Division of Neurology, The George Washington University\/Children\u2019s National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany A.","family":"Riggle","sequence":"additional","affiliation":[{"name":"Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tesfaye","family":"Zelleke","sequence":"additional","affiliation":[{"name":"Division of Neurology, The George Washington University\/Children\u2019s National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Harrar","sequence":"additional","affiliation":[{"name":"Division of Neurology, The George Washington University\/Children\u2019s National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Washington, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle J.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Eye & Vision Sciences, University of Liverpool, Liverpool, United Kingdom;"},{"name":"Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi;"},{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas A. V.","family":"Beare","sequence":"additional","affiliation":[{"name":"Department of Eye & Vision Sciences, University of Liverpool, Liverpool, United Kingdom;"},{"name":"St. Paul\u2019s Eye Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terrie E.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi;"},{"name":"Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl B.","family":"Seydel","sequence":"additional","affiliation":[{"name":"Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi;"},{"name":"Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Ray","sequence":"additional","affiliation":[{"name":"Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi;"},{"name":"Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi;"},{"name":"Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas G.","family":"Postels","sequence":"additional","affiliation":[{"name":"Division of Neurology, The George Washington University\/Children\u2019s National Hospital, Washington, District of Columbia;"},{"name":"Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"year":"2023","key":"b1","article-title":"World Malaria Report 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