EEG Response to Sedation Interruption Complements Behavioral Assessment After Severe Brain Injury.
Annals of Clinical and Translational Neurology May 25, 2025 Charlotte Maschke, Loretta Norton, Catherine Duclos et al.
In patients with severe brain injury, the neurological wake-up test—a brief interruption of sedation to check responsiveness—often yields ambiguous or absent behavioral responses, limiting its prognostic value. Recording 128-channel EEG from 41 such patients during propofol sedation interruption revealed that brain responses, measured by EEG power, spatial ratios, and the spectral exponent, can show signs of waking even when behavior does not. Combining EEG with behavioral assessment improved predictions of survival, recovery of consciousness, and long-term functional outcomes, outperforming the predictions of attending physicians. EEG can complement the wake-up test to better inform clinicians, families, and treatment planning.