Evidence map›Paper›PMID 40718992›Full record

Trial reportEuropean journal of neurology2025

Unreactive EEG Background Is Associated With Unfavorable Outcome in Patients With Disorders of Consciousness of Various Etiologies: An Adult Cohort Study.

Sarah Benghanem, Jan Novy, Kaspar A Schindler, Stephan Rüegg, Vincent Alvarez, A O Rossetti

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03129438 (Impact on Clinical Outcome of Continuous Video-electroencephalography), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03129438 nacompletednot on this map

Impact on Clinical Outcome of Continuous Video-electroencephalography (cEEG) Monitoring in Patients With Disorders of Consciousness: A Randomized Controlled Trial

TypeinterventionalSponsorAndrea Rossetti, MDRan2017 to 2019Enrolled404ConditionsEEG With Periodic Abnormalities, EEG With Abnormally Slow Frequencies, Coma, Outcome, FatalArmscontinuous EEG (cEEG), routine EEG (rEEG)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sarah BenghanemDepartment of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
Jan NovyDepartment of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
Kaspar A SchindlerSleep-Wake-Epilepsy-Center, Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Stephan RüeggDepartment of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland.
Vincent AlvarezDepartment of Neurology, Valais Hospital, Sion, Switzerland.
A O RossettiDepartment of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.

Funding

Swiss National Foundation (grant 320030_169379). grant 320030_169379
6 · The paper itself

Abstract

objectivePrognostication of neurological outcome in critically ill patients presents significant challenges. While EEG reactivity may be associated with outcome in hypoxic-ischemic 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.

methodThis is an ancillary study of the randomized CERTA trial (NCT03129438), which included adults with disorders of consciousness randomized to continuous EEG for 30-48 h or two routine EEGs (20-30 min). We explored the association between EEG characteristics and neurological outcome at 6 months, a modified Rankin Scale (mRS) 3-6 being considered unfavorable.

resultsA 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-metabolic encephalopathy, 7 encephalitis, and 114 had unknown or other etiologies. In the overall cohort, abnormal background continuity (OR 2.33, 95% CI [1.15-4.76], p = 0.019), ictal-interictal continuum features (OR 2.78, 95% CI [1.16-6.67], p = 0.021) and unreactive background (OR 10.9, 95% CI [1.97-58.82], p = 0.006) were independently associated with unfavorable outcome. In the overall cohort, unreactive EEG had specificity of 97.3% (95% CI [94.3-100]) and sensitivity of 22.1% (95% CI [17-27.2]) for unfavorable outcome. In HIBI, specificity was 97% (95% CI [91.1-100]) and sensitivity 46.8% (95% CI [35.8-57.8]); in ICH, specificity was 94.1% (95% CI [83-100]) and sensitivity 8.8% (95% CI [2.05-15.55]); in TBI, specificity was 94.1% (95% CI [83-100]) and sensitivity 22.6% (95% CI [7.8-37.3]).

conclusionIn this etiologically mixed cohort of critically ill adults, unreactive EEG predicted unfavorable outcome at 6 months 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.

Indexed as

Consciousness DisordersElectroencephalographyHypoxia-Ischemia, BrainAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedPrognosiscardiac arrestEEG reactivityintracranial hemorrhageneuroprognosticationtraumatic brain injury

Identifiers

PMID40718992
PMCPMC12301862

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.