title: Assessment of Event-Related EEG Power After Single-Pulse TMS in Unresponsive Wakefulness Syndrome and Minimally Conscious State Patients.
abstract: In patients without a behavioral response, non-invasive techniques and new methods of data analysis can complement existing diagnostic tools by providing a method for detecting covert signs of residual cognitive function and awareness. The aim of this study was to investigate the brain oscillatory activities synchronized by single-pulse transcranial magnetic stimulation (TMS) delivered over the primary motor area in the time-frequency domain in patients with the unresponsive wakefulness syndrome or in a minimally conscious state as compared to healthy controls. A time-frequency analysis based on the wavelet transform was used to characterize rapid modifications of oscillatory EEG rhythms induced by TMS in patients as compared to healthy controls. The pattern of EEG changes in the patients differed from that of healthy controls. In the controls there was an early synchronization of slow waves immediately followed by a desynchronization of alpha and beta frequency bands over the frontal and centro-parietal electrodes, whereas an opposite early synchronization, particularly over motor areas for alpha and beta and over the frontal and parietal electrodes for beta power, was seen in the patients. In addition, no relevant modification in slow rhythms (delta and theta) after TMS was noted in patients. The clinical impact of these findings could be relevant in neurorehabilitation settings for increasing the awareness of these patients and defining new treatment procedures.
authors.affiliation: Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy. emanuela.formaggio@ospedalesancamillo.net.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Formaggio
authors.affiliation: Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Cavinato
authors.affiliation: Department of Computer Science, University of Verona, Verona, Italy.
authors.forename: Silvia Francesca
authors.initials: SF
authors.lastname: Storti
authors.affiliation: Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tonin
authors.affiliation: Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Piccione
authors.affiliation: Department of Medicine, Surgery and Health Sciences, Clinical Neurology Unit, Cattinara University Hospital, Trieste, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Manganotti
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001703:Biophysics; D058256:Brain Waves / Q000502:physiology; D003344:Cortical Synchronization / Q000502:physiology*; D004569:Electroencephalography; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000534:rehabilitation*; D012720:Severity of Illness Index; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D014851:Wakefulness / Q000502:physiology*
keywords: Event-related EEG; Minimally conscious state; Transcranial magnetic stimulation; Unresponsive wakefulness syndrome