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research article

High density EEG and deep learning outcome prediction on the first day of coma after cardiac arrest

Pelentritou, Andria
•
Gruaz, Lucas  
•
Iten, Manuela
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January 1, 2026
NeuroImage

We assessed the coma outcome prediction using a deep learning analysis applied to resting EEG on the first and second day after cardiac arrest, and its complementarity to clinical prognosis. We recorded 62-channel resting-state EEG in comatose patients across three Swiss hospitals during the first ( N = 165) and second ( N = 100) day of coma. Patient outcome was classified as favorable if the best Cerebral Performance Category was 1–2. A convolutional neural network provided a predicted probability for favorable outcome for each patient and recording day. Predictive performance was additionally evaluated on an external 19-channel dataset collected outside Switzerland ( N = 60). The deep learning prediction was compared to EEG-based clinical markers, brainstem reflexes and motor responses. On the first day, for 62 channels, sensitivity and specificity for favorable outcome were 0.98±0.01 and 0.88±0.05 when maximizing both metrics. A sensitivity of 0.98±0.01 and a specificity of 0.64±0.14 was achieved when maximizing the sensitivity for favorable outcome and a sensitivity of 0.41±0.11 and a specificity of 0.99±0.01 when maximizing unfavorable outcome specificity. On the first day, using 19 channels, we obtained marginally lower values for sensitivity at 0.95±0.02 and specificity at 0.84±0.05 for favorable outcome. On the external dataset, sensitivity and specificity for favorable outcome were 0.83 and 0.92. The second day was less predictive with 0.80±0.09 sensitivity and 0.63±0.04 specificity for favorable outcome. The outcome prediction was consistent with clinical markers, except brainstem reflexes. On the first day of coma, a deep learning analysis of resting-state EEG provides accurate outcome prediction, complementing clinical markers.

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10.1016_j.neuroimage.2025.121658.pdf

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Main Document

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Published version

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openaccess

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CC BY

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3.4 MB

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368cf612a995f2fe8ee947b5ddfbcf84

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