The difficulties of behavioral evaluation of prolonged disorders of consciousness (DOC) motivate the development of brain-based diagnostic approaches. The perturbational complexity index (PCI), which measures the complexity of electroencephalographic (EEG) responses to transcranial magnetic stimulation (TMS), showed a remarkable sensitivity in detecting minimal signs of consciousness in previous studies. Here, we tested the reliability of PCI in an independently collected sample of 24 severely brain-injured patients, including 11 unresponsive wakefulness syndrome (UWS), 12 minimally conscious state (MCS) patients, and 1 emergence from MCS patient. We found that the individual maximum PCI value across stimulation sites fell within the consciousness range (i.e., was higher than PCI*, which is an empirical cutoff previously validated on a benchmark population) in 11 MCS patients, yielding a sensitivity of 92% that surpassed qualitative evaluation of resting EEG. Most UWS patients (n = 7, 64%) showed a slow and stereotypical TMS-EEG response, associated with low-complexity PCI values (i.e., ≤PCI*). Four UWS patients (36%) provided high-complexity PCI values, which might suggest a covert capacity for consciousness. In conclusion, this study successfully replicated the performance of PCI in discriminating between UWS and MCS patients, further motivating the application of TMS-EEG in the workflow of DOC evaluation.
Detecting the potential for consciousness in unresponsive patients using the perturbational complexity index / D.O. Sinitsyn, A.G. Poydasheva, I.S. Bakulin, L.A. Legostaeva, E.G. Iazeva, D.V. Sergeev, A.N. Sergeeva, E.I. Kremneva, S.N. Morozova, D.Y. Lagoda, S. Casarotto, A. Comanducci, Y.V. Ryabinkina, N.A. Suponeva, M.A. Piradov. - In: BRAIN SCIENCES. - ISSN 2076-3425. - 10:12(2020 Dec), pp. 917.1-917.12.
|Titolo:||Detecting the potential for consciousness in unresponsive patients using the perturbational complexity index|
|Parole Chiave:||Diagnosis; Disorders of consciousness; Electroencephalography; Minimally conscious state; Perturbational complexity index; Reliability; Transcranial magnetic stimulation; Unresponsive wakefulness syndrome|
|Settore Scientifico Disciplinare:||Settore BIO/09 - Fisiologia|
|Data di pubblicazione:||dic-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.3390/brainsci10120917|
|Appare nelle tipologie:||01 - Articolo su periodico|
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