ArticleAnnals of neurology2016
Bedside quantitative electroencephalography improves assessment of consciousness in comatose subarachnoid hemorrhage patients.
Article in Annals of neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.
- EEG-based Brain-Computer Interfaces for people with Disorders of Consciousness: Features and applications. A systematic review.Frontiers in human neuroscience · 2022Pooled it
- Efficacy of melatonin for prolonged disorders of consciousness: a double-blind, randomized clinical trial.BMC medicine · 2024Trial
- Article
- Brain-computer interface: an update for the clinicians.Frontiers in human neuroscience · 2026Review
- Article
- Sleep spindles as a predictor of cognitive motor dissociation and recovery of consciousness after acute brain injury.Nature medicine · 2025Observational
- Spinal Cord Stimulation for Prolonged Disorders of Consciousness: A Study on Scalp Electroencephalography.CNS neuroscience & therapeutics · 2024Article
- Resting-State EEG Signature of Early Consciousness Recovery in Comatose Patients with Traumatic Brain Injury.Neurocritical care · 2024Article
- Recovery of consciousness after acute brain injury: a narrative review.Journal of intensive care · 2024Review
- Cognitive Motor Dissociation: Gap Analysis and Future Directions.Neurocritical care · 2024Article
- Article
- Injury patterns associated with cognitive motor dissociation.Brain : a journal of neurology · 2023Article
- Quantitative Electroencephalography Analysis for Improved Assessment of Consciousness Levels in Deep Coma Patients Using a Proposed Stimulus Stage.Diagnostics (Basel, Switzerland) · 2023Article
- The reticular activating system: a narrative review of discovery, evolving understanding, and relevance to current formulations of brain death.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Review
- Classification of Level of Consciousness in a Neurological ICU Using Physiological Data.Neurocritical care · 2023Observational
- Resting-state EEG microstates as electrophysiological biomarkers in post-stroke disorder of consciousness.Frontiers in neuroscience · 2023Article
- Spontaneous subarachnoid haemorrhage.Lancet (London, England) · 2022Review
- Article
- Corticothalamic Connectivity in Aneurysmal Subarachnoid Hemorrhage: Relationship with Disordered Consciousness and Clinical Outcomes.Neurocritical care · 2022Article
- A Framework to Advance Biomarker Development in the Diagnosis, Outcome Prediction, and Treatment of Traumatic Brain Injury.Journal of neurotrauma · 2022Review
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveAccurate behavioral assessments of consciousness carry tremendous significance in guiding management, but are extremely challenging in acutely brain-injured patients. We evaluated whether electroencephalography (EEG) and multimodality monitoring parameters may facilitate assessment of consciousness in patients with subarachnoid hemorrhage.
methodsA retrospective analysis was performed of 83 consecutively treated adults with subarachnoid hemorrhage. All patients were initially comatose and had invasive brain monitoring placed. Behavioral assessments were performed during daily interruption of sedation and categorized into 3 groups based on their best examination as (1) comatose, (2) arousable (eye opening or attending toward a stimulus), and (3) aware (command following). EEG features included spectral power and complexity measures. Comparisons were made using bootstrapping methods and partial least squares regression.
resultsWe identified 389 artifact-free EEG clips following behavioral assessments. Increasing central gamma, posterior alpha, and diffuse theta-delta oscillations differentiated patients who were arousable from those in coma. Command following was characterized by a further increase in central gamma and posterior alpha, as well as an increase in alpha permutation entropy. These EEG features together with basic neurological examinations (eg, pupillary light reflex) contributed heavily to a linear model predicting behavioral state, whereas brain physiology measures (eg, brain oxygenation), structural injury, and clinical course added less.
interpretationEEG measures of behavioral states provide distinctive signatures that complement behavioral assessments of patients with subarachnoid hemorrhage shortly after the injury. Our data support the hypothesis that impaired connectivity of cortex with both central thalamus and basal forebrain underlies decreasing levels of consciousness. Ann Neurol 2016;80:541-553.
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