{"doi":"10.31219/osf.io/fbnwk_v2","title":"Covert Brain Complexity in the Intensive Care Unit","abstract":"Early detection of consciousness in critically ill patients with severe brain injuries has a profound impact on prognostication and decisions about whether to continue or limit life-sustaining therapy. The current state-of-the-art protocol to detect signs of consciousness includes standardized behavioral assessments, task-based functional magnetic resonance imaging (fMRI), and task-based electroencephalography (EEG). However, this approach has limited diagnostic sensitivity because auditory pathways may be disrupted, and conscious patients may lack attention, language, or other cognitive functions required to perform a task. Transcranial magnetic stimulation EEG (TMS-EEG) has the potential to overcome these limitations by directly perturbing the cerebral cortex to compute the perturbational complexity index, a neural correlate of consciousness. To date, TMS-EEG studies have focused on patients in the subacute or chronic stage of recovery from severe brain injury. Here, we report the proof-of-concept application of TMS-EEG for a critically ill patient in the acute stage of brain injury recovery. We show that TMS-EEG is feasible to perform as part of a multimodal protocol in the intensive care unit and that TMS-EEG may detect signs of consciousness that elude current state-of-the-art assessments.","journal":null,"year":2025,"id":566633,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9612,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1309732,"name":"David R. Schreier","orcid":"0000-0001-6088-2015","position":1,"is_corresponding":false},{"id":283549,"name":"Morgan K. Cambareri","orcid":null,"position":2,"is_corresponding":false},{"id":1470668,"name":"Veronica Nisticò","orcid":"0000-0003-0249-9266","position":3,"is_corresponding":false},{"id":818379,"name":"Holly J. Freeman","orcid":"0009-0004-8217-2937","position":4,"is_corresponding":false},{"id":1097530,"name":"Phoebe K. Lawrence","orcid":null,"position":5,"is_corresponding":false},{"id":278375,"name":"Yelena G. Bodien","orcid":"0000-0003-4858-2903","position":6,"is_corresponding":false},{"id":644019,"name":"Michael J. Young","orcid":"0000-0001-6661-0811","position":7,"is_corresponding":false},{"id":249915,"name":"Ona Wu","orcid":"0000-0002-5509-9461","position":8,"is_corresponding":false},{"id":109379,"name":"Brian L. Edlow","orcid":"0000-0001-7235-8456","position":9,"is_corresponding":false},{"id":196792,"name":"Matteo Fecchio","orcid":"0000-0002-0347-8531","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:56:40.491968Z","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":[]}