Aug 16, 2013

A theoretically based index of consciousness independent of sensory processing and behavior

Science Translational Medicine
Adenauer CasaliMarcello Massimini

Abstract

One challenging aspect of the clinical assessment of brain-injured, unresponsive patients is the lack of an objective measure of consciousness that is independent of the subject's ability to interact with the external environment. Theoretical considerations suggest that consciousness depends on the brain's ability to support complex activity patterns that are, at once, distributed among interacting cortical areas (integrated) and differentiated in space and time (information-rich). We introduce and test a theory-driven index of the level of consciousness called the perturbational complexity index (PCI). PCI is calculated by (i) perturbing the cortex with transcranial magnetic stimulation (TMS) to engage distributed interactions in the brain (integration) and (ii) compressing the spatiotemporal pattern of these electrocortical responses to measure their algorithmic complexity (information). We test PCI on a large data set of TMS-evoked potentials recorded in healthy subjects during wakefulness, dreaming, nonrapid eye movement sleep, and different levels of sedation induced by anesthetic agents (midazolam, xenon, and propofol), as well as in patients who had emerged from coma (vegetative state, minimally conscious state, and lock...Continue Reading

  • References54
  • Citations127

References

  • References54
  • Citations127

Citations

Mentioned in this Paper

Cortex Bone Disorders
Adrenal Cortex Diseases
Coma (genus)
Sleep, Slow-Wave
Brain
Quadriplegia
Locked-In Syndrome
Cell Differentiation Process
Apraxia, Oculomotor, Cogan Type
Structure of Cortex of Kidney

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