{"doi":"10.1111/ejn.16299","title":"Dissociations between spontaneous electroencephalographic features and the perturbational complexity index in the minimally conscious state","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>\n                    The analysis of spontaneous electroencephalogram (EEG) is a cornerstone in the assessment of patients with disorders of consciousness (DoC). Although preserved EEG patterns are highly suggestive of consciousness even in unresponsive patients, moderately or severely abnormal patterns are difficult to interpret. Indeed, growing evidence shows that consciousness can be present despite either large delta or reduced alpha activity in spontaneous EEG. Quantifying the complexity of EEG responses to direct cortical perturbations (perturbational complexity index [PCI]) may complement the observational approach and provide a reliable assessment of consciousness even when spontaneous EEG features are inconclusive. To seek empirical evidence of this hypothesis, we compared PCI with EEG spectral measures in the same population of minimally conscious state (MCS) patients (\n                    <jats:italic>n</jats:italic>\n                     = 40) hospitalized in rehabilitation facilities. We found a remarkable variability in spontaneous EEG features across MCS patients as compared with healthy controls: in particular, a pattern of predominant delta and highly reduced alpha power—more often observed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients—was found in a non‐negligible number of MCS patients. Conversely, PCI values invariably fell above an externally validated empirical cutoff for consciousness in all MCS patients, consistent with the presence of clearly discernible, albeit fleeting, behavioural signs of awareness. These results confirm that, in some MCS patients, spontaneous EEG rhythms may be inconclusive about the actual capacity for consciousness and suggest that a perturbational approach can effectively compensate for this pitfall with practical implications for the individual patient's stratification and tailored rehabilitation.\n                  </jats:p>","journal":"European Journal of Neuroscience","year":2024,"id":611156,"datarank":0.4887144807032224,"base_score":3.258096538021482,"endowment":3.258096538021482,"self_citation_contribution":0.4887144807032224,"citation_network_contribution":0.0,"self_endowment_contribution":0.4887144807032224,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":25,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1500338,"name":"Gabriel Hassan","orcid":"0009-0007-4138-5954","position":1,"is_corresponding":false},{"id":991676,"name":"Mario Rosanova","orcid":"0000-0002-9107-4472","position":2,"is_corresponding":false},{"id":654805,"name":"Simone Sarasso","orcid":"0000-0001-9984-4710","position":3,"is_corresponding":false},{"id":991675,"name":"Chiara‐Camilla Derchi","orcid":"0000-0003-4573-2240","position":4,"is_corresponding":false},{"id":1571678,"name":"Pietro Davide Trimarchi","orcid":null,"position":5,"is_corresponding":false},{"id":991677,"name":"Alessandro Viganò","orcid":"0000-0002-8079-5354","position":6,"is_corresponding":false},{"id":1404301,"name":"Simone Russo","orcid":"0000-0001-5376-1522","position":7,"is_corresponding":false},{"id":196792,"name":"Matteo Fecchio","orcid":"0000-0002-0347-8531","position":8,"is_corresponding":false},{"id":1571679,"name":"Guya Devalle","orcid":null,"position":9,"is_corresponding":false},{"id":991681,"name":"Jorge Navarro","orcid":"0000-0003-1508-6727","position":10,"is_corresponding":false},{"id":245934,"name":"Marcello Massimini","orcid":"0000-0003-2271-957X","position":11,"is_corresponding":false},{"id":245922,"name":"Angela Comanducci","orcid":"0000-0001-6084-019X","position":12,"is_corresponding":false},{"id":847840,"name":"Silvia Casarotto","orcid":"0000-0002-7548-7664","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Dissociations between spontaneous electroencephalographic features and the perturbational complexity index in the minimally conscious state","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>\n                    The analysis of spontaneous electroencephalogram (EEG) is a cornerstone in the assessment of patients with disorders of consciousness (DoC). Although preserved EEG patterns are highly suggestive of consciousness even in unresponsive patients, moderately or severely abnormal patterns are difficult to interpret. Indeed, growing evidence shows that consciousness can be present despite either large delta or reduced alpha activity in spontaneous EEG. Quantifying the complexity of EEG responses to direct cortical perturbations (perturbational complexity index [PCI]) may complement the observational approach and provide a reliable assessment of consciousness even when spontaneous EEG features are inconclusive. To seek empirical evidence of this hypothesis, we compared PCI with EEG spectral measures in the same population of minimally conscious state (MCS) patients (\n                    <jats:italic>n</jats:italic>\n                     = 40) hospitalized in rehabilitation facilities. We found a remarkable variability in spontaneous EEG features across MCS patients as compared with healthy controls: in particular, a pattern of predominant delta and highly reduced alpha power—more often observed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients—was found in a non‐negligible number of MCS patients. Conversely, PCI values invariably fell above an externally validated empirical cutoff for consciousness in all MCS patients, consistent with the presence of clearly discernible, albeit fleeting, behavioural signs of awareness. These results confirm that, in some MCS patients, spontaneous EEG rhythms may be inconclusive about the actual capacity for consciousness and suggest that a perturbational approach can effectively compensate for this pitfall with practical implications for the individual patient's stratification and tailored rehabilitation.\n                  </jats:p>","is_dataset_classified":null,"base_score":3.1354942159291497,"endowment":3.1354942159291497,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38440949","pmcid":null,"openalex_id":"https://openalex.org/W4392471961","authors":[],"funders":[{"funder_name":"Ministero della Salute","grant_id":"GR‐2016‐02361494","title":null},{"funder_name":"Ministero della Salute","grant_id":"Ricerca Corrente 2022‐2024","title":null},{"funder_name":"Ministero dell'Università e della Ricerca","grant_id":"PRIN2022","title":null},{"funder_name":"European Union's Horizon 2020","grant_id":"945539","title":"Human Brain Project Specific Grant Agreement 3"},{"funder_name":"European Union's Horizon 2020","grant_id":"785907","title":"Human Brain Project Specific Grant Agreement 2"},{"funder_name":"Fondazione Regionale per la Ricerca Biomedica, Project ERAPERMED2019-101","grant_id":"779282","title":null},{"funder_name":"Ministero della Salute","grant_id":"GR-2016-02361494","title":null},{"funder_name":"Ministero della Salute","grant_id":"Ricerca Corrente 2022-2024","title":null},{"funder_name":"European Commission","grant_id":"101071900","title":"NEurological MEchanismS of Injury, and Sleep-like  cellular dynamics"},{"funder_name":"Canadian Institute for Advanced Research","grant_id":"","title":null},{"funder_name":"Tiny Blue Dot Foundation","grant_id":"","title":null}],"total_grants":11,"fwci":6.2415,"citation_percentile":0.97294908,"influential_citations":0,"citation_trend":[{"year":2024,"count":5},{"year":2025,"count":15},{"year":2026,"count":2}],"oa_status":"hybrid","license":"cc-by-nc","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ejn.16299","host_type":"journal"},{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ejn.16299","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/ejn.16299","host_type":"publisher"},{"url":"https://doi.org/10.1111/ejn.16299","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38440949","host_type":"repository"},{"url":"https://hdl.handle.net/2434/1035869","host_type":"repository"},{"url":"https://air.unimi.it/bitstream/2434/1035869/2/EJN_March2024_2.pdf","host_type":"repository"},{"url":"http://dx.doi.org/10.1111/EJN.16299","host_type":""}],"fields_of_study":["Traumatic Brain Injury Research","Cardiac Arrest and Resuscitation","Functional Brain Connectivity Studies","0301 basic medicine","03 medical and health sciences","0302 clinical medicine"],"mesh_terms":["Consciousness","Consciousness Disorders","Electroencephalography","Humans","Wakefulness","Persistent Vegetative State"],"keywords":["Electroencephalography","Consciousness","Wakefulness","Minimally conscious state","Psychology","Persistent vegetative state","Quantitative electroencephalography","Consciousness Disorders","Population","Neuroscience","Audiology","Cardiology","Medicine","Alpha","DELTA","Electroencephalogram","Pci","Mcs","Humans","MCS; PCI; alpha; delta; electroencephalogram;"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-01T16:04:49.288888Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}