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| Transcranial Magnetic Stimulation-Electroencephalography and Classified Diagnosis of Consciousness |
| Cheng Pengfei1,2, Ge Xingyu1,2, Gong Anjuan2,3, Wang Qijun2,3, Feng Zhen1,3, Bai Yang1,3* |
1(Affiliated Rehabilitation Hospital,Jiangxi Medical College, Nanchang University, Nanchang 330006, China)
2(The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310000, China)
3(Rehabilitation Medicine Clinical Research Center of Jiangxi Province, Nanchang 330006, China) |
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Abstract In recent years, there has still been a lack of an objective measure for the level of consciousness in specific states such as sleep, anesthesia, and disorders of consciousness. Attention has increasingly focused on non-invasive techniques for examining brain states. Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) has emerged as one of the most effective techniques in this field. TMS-EEG has become a promising brain assessment tool in contemporary brain science and clinical neuroscience research. This paper presented a systematic review of the development of TMS-EEG technology, focusing on the combination of TMS and EEG, denoising techniques, and characterization methods, as well as summarizing important research advances in the use of TMS-EEG for consciousness grading. The application of the perturbational complexity index (PCI) in differentiating levels of consciousness across wakefulness, different types of anesthesia and sleep, as well as in quantifying the grading diagnosis of patients with disorders of consciousness, has demonstrated that TMS-EEG is poised to become an objective gold standard for consciousness grading and diagnosis. Examples of objective metrics such as TMS-evoked potentials (TEP), global mean field power (GMFP), and the fractional dimensional index of perturbation complexity (FDI) for grading levels of consciousness in patients with disorders of consciousness, as well as for differentiating between healthy controls, were briefly described. The strengths, shortcomings and future directions of TMS-EEG were also summarized.
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Received: 16 October 2023
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