Navigated Transcranial Magnetic Stimulation (TMS) in combination with high-density electroencephalography (hd-EEG) is a non-invasive technique that allows the direct perturbation of a chosen cortical region and the recording of the brain’s response with a good spatiotemporal resolution. 

In the past years, TMS-EEG has been applied in different experimental conditions, such as during the transition from wakefulness to deep sleep, when consciousness fades, during anesthesia, and eventually in patients with disorders of consciousness (DoC). Changes in TMS evoked EEG responses, quantified through the Perturbational Complexity Index (PCI), has been demonstrated to distinguish conscious from unconscious states well enough to be used on an individual basis.

The NICC lab aims to implement this technique in the intensive care unit environment to detect covert consciousness in patients diagnosed with DoC and test whether PCI can predict long-term functional outcomes.