Treating Rhythmic and Periodic EEG Patterns in Comatose Survivors of Cardiac Arrest.


Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
24 02 2022
Historique:
entrez: 23 2 2022
pubmed: 24 2 2022
medline: 4 3 2022
Statut: ppublish

Résumé

Whether the treatment of rhythmic and periodic electroencephalographic (EEG) patterns in comatose survivors of cardiac arrest improves outcomes is uncertain. We conducted an open-label trial of suppressing rhythmic and periodic EEG patterns detected on continuous EEG monitoring in comatose survivors of cardiac arrest. Patients were randomly assigned in a 1:1 ratio to a stepwise strategy of antiseizure medications to suppress this activity for at least 48 consecutive hours plus standard care (antiseizure-treatment group) or to standard care alone (control group); standard care included targeted temperature management in both groups. The primary outcome was neurologic outcome according to the score on the Cerebral Performance Category (CPC) scale at 3 months, dichotomized as a good outcome (CPC score indicating no, mild, or moderate disability) or a poor outcome (CPC score indicating severe disability, coma, or death). Secondary outcomes were mortality, length of stay in the intensive care unit (ICU), and duration of mechanical ventilation. We enrolled 172 patients, with 88 assigned to the antiseizure-treatment group and 84 to the control group. Rhythmic or periodic EEG activity was detected a median of 35 hours after cardiac arrest; 98 of 157 patients (62%) with available data had myoclonus. Complete suppression of rhythmic and periodic EEG activity for 48 consecutive hours occurred in 49 of 88 patients (56%) in the antiseizure-treatment group and in 2 of 83 patients (2%) in the control group. At 3 months, 79 of 88 patients (90%) in the antiseizure-treatment group and 77 of 84 patients (92%) in the control group had a poor outcome (difference, 2 percentage points; 95% confidence interval, -7 to 11; P = 0.68). Mortality at 3 months was 80% in the antiseizure-treatment group and 82% in the control group. The mean length of stay in the ICU and mean duration of mechanical ventilation were slightly longer in the antiseizure-treatment group than in the control group. In comatose survivors of cardiac arrest, the incidence of a poor neurologic outcome at 3 months did not differ significantly between a strategy of suppressing rhythmic and periodic EEG activity with the use of antiseizure medication for at least 48 hours plus standard care and standard care alone. (Funded by the Dutch Epilepsy Foundation; TELSTAR ClinicalTrials.gov number, NCT02056236.).

Sections du résumé

BACKGROUND
Whether the treatment of rhythmic and periodic electroencephalographic (EEG) patterns in comatose survivors of cardiac arrest improves outcomes is uncertain.
METHODS
We conducted an open-label trial of suppressing rhythmic and periodic EEG patterns detected on continuous EEG monitoring in comatose survivors of cardiac arrest. Patients were randomly assigned in a 1:1 ratio to a stepwise strategy of antiseizure medications to suppress this activity for at least 48 consecutive hours plus standard care (antiseizure-treatment group) or to standard care alone (control group); standard care included targeted temperature management in both groups. The primary outcome was neurologic outcome according to the score on the Cerebral Performance Category (CPC) scale at 3 months, dichotomized as a good outcome (CPC score indicating no, mild, or moderate disability) or a poor outcome (CPC score indicating severe disability, coma, or death). Secondary outcomes were mortality, length of stay in the intensive care unit (ICU), and duration of mechanical ventilation.
RESULTS
We enrolled 172 patients, with 88 assigned to the antiseizure-treatment group and 84 to the control group. Rhythmic or periodic EEG activity was detected a median of 35 hours after cardiac arrest; 98 of 157 patients (62%) with available data had myoclonus. Complete suppression of rhythmic and periodic EEG activity for 48 consecutive hours occurred in 49 of 88 patients (56%) in the antiseizure-treatment group and in 2 of 83 patients (2%) in the control group. At 3 months, 79 of 88 patients (90%) in the antiseizure-treatment group and 77 of 84 patients (92%) in the control group had a poor outcome (difference, 2 percentage points; 95% confidence interval, -7 to 11; P = 0.68). Mortality at 3 months was 80% in the antiseizure-treatment group and 82% in the control group. The mean length of stay in the ICU and mean duration of mechanical ventilation were slightly longer in the antiseizure-treatment group than in the control group.
CONCLUSIONS
In comatose survivors of cardiac arrest, the incidence of a poor neurologic outcome at 3 months did not differ significantly between a strategy of suppressing rhythmic and periodic EEG activity with the use of antiseizure medication for at least 48 hours plus standard care and standard care alone. (Funded by the Dutch Epilepsy Foundation; TELSTAR ClinicalTrials.gov number, NCT02056236.).

Identifiants

pubmed: 35196426
doi: 10.1056/NEJMoa2115998
doi:

Substances chimiques

Anticonvulsants 0

Banques de données

ClinicalTrials.gov
['NCT02056236']

Types de publication

Journal Article Multicenter Study Pragmatic Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

724-734

Subventions

Organisme : Stichting Epilepsie Instellingen Nederland
ID : NEF14-18

Investigateurs

B J Ruijter (BJ)
H M Keijzer (HM)
M C Tjepkema-Cloostermans (MC)
M J Blans (MJ)
F H Bosch (FH)
A B Glimmerveen (AB)
A Beishuisen (A)
C J Eertman (CJ)
S C Tromp (SC)
E Scholten (E)
A A Seeber (AA)
L L Teunissen (LL)
M Datema (M)
P G Noordzij (PG)
H S Moeniralam (HS)
J Horn (J)
A F van Rootselaar (AF)
M M Admiraal (MM)
D C Velseboer (DC)
J H T M Koelman (JHTM)
W M van den Bergh (WM)
J W J Elting (JWJ)
G Drost (G)
N A Foudraine (NA)
F H M Kornips (FHM)
V H J M van Kranen-Mastenbroek (VHJM)
R P W Rouhl (RPW)
D M W Hilkman (DMW)
M J Aries (MJ)
W N K A van Mook (WNKA)
M C G Vlooswijk (MCG)
E C Thomeer (EC)
W Moudrous (W)
F A P Nijhuis (FAP)
S J Booij (SJ)
H J J A Bernsen (HJJA)
C W E Hoedemaekers (CWE)
J Doorduin (J)
F S Taccone (FS)
N Gaspard (N)
J A M van der Palen (JAM)
M J A M van Putten (MJAM)
J Hofmeijer (J)

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2022 Massachusetts Medical Society.

Auteurs

Barry J Ruijter (BJ)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Hanneke M Keijzer (HM)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Marleen C Tjepkema-Cloostermans (MC)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Michiel J Blans (MJ)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Albertus Beishuizen (A)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Selma C Tromp (SC)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Erik Scholten (E)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Janneke Horn (J)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Anne-Fleur van Rootselaar (AF)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Marjolein M Admiraal (MM)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Walter M van den Bergh (WM)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Jan-Willem J Elting (JJ)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Norbert A Foudraine (NA)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Francois H M Kornips (FHM)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Vivianne H J M van Kranen-Mastenbroek (VHJM)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Rob P W Rouhl (RPW)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Elsbeth C Thomeer (EC)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Walid Moudrous (W)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Frouke A P Nijhuis (FAP)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Suzanne J Booij (SJ)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Cornelia W E Hoedemaekers (CWE)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Jonne Doorduin (J)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Fabio S Taccone (FS)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Job van der Palen (J)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Michel J A M van Putten (MJAM)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

Jeannette Hofmeijer (J)

From the Department of Clinical Neurophysiology, Technical Medical Center (B.J.R., M.C.T.-C., M.J.A.M.P., J. Hofmeijer), and the Section of Cognition, Data, and Education (J.P.), University of Twente, and the Departments of Neurology and Clinical Neurophysiology (M.C.T.-C., M.J.A.M.P.), the Intensive Care Center (A.B.), and the Department of Epidemiology (J.P.), Medisch Spectrum Twente, Enschede, the Departments of Neurology (H.M.K., J. Hofmeijer) and Intensive Care (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Intensive Care Medicine (H.M.K., C.W.E.H.) and Neurology (H.M.K., J.D.) and the Donders Institute for Brain, Cognition, and Behavior (H.M.K.), Radboud University Medical Center, and the Department of Neurology, Canisius Wilhelmina Hospital (F.A.P.N., S.J.B.), Nijmegen, the Departments of Neurology and Clinical Neurophysiology (S.C.T.) and Intensive Care (E.S.), St. Antonius Hospital, Nieuwegein, the Department of Neurology, Leiden University Medical Center, Leiden (S.C.T.), the Amsterdam Coma Group (J. Horn, A.-F.R., M.M.A.), the Department of Intensive Care (J. Horn), and the Department of Neurology and Clinical Neurophysiology (A.-F.R., M.M.A.), Amsterdam University Medical Center, Amsterdam, the Departments of Critical Care (W.M.B.) and Neurology and Clinical Neurophysiology (J.W.J.E.), University Medical Center Groningen, University of Groningen, Groningen, the Departments of Intensive Care (N.A.F.) and Neurology (F.H.M.K.), VieCuri Medical Center, Venlo, the Departments of Clinical Neurophysiology (V.H.J.M.K.-M.) and Neurology (R.P.W.R.), Maastricht University Medical Center, and the Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ (V.H.J.M.K.-M., R.P.W.R.), Maastricht, and the Department of Neurology, Maasstad Hospital, Rotterdam (E.C.T., W.M.) - all in the Netherlands; and the Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels (F.S.T.).

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