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Assessment of Event-Related EEG Power After Single-Pulse TMS in Unresponsive Wakefulness Syndrome and Minimally Conscious State Patients

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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.

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Authors and Affiliations

  1. Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy

    Emanuela Formaggio, Marianna Cavinato, Paolo Tonin & Francesco Piccione

  2. Department of Computer Science, University of Verona, Verona, Italy

    Silvia Francesca Storti

  3. Department of Medicine, Surgery and Health Sciences, Clinical Neurology Unit, Cattinara University Hospital, Trieste, Italy

    Paolo Manganotti

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  1. Emanuela Formaggio
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  2. Marianna Cavinato
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  3. Silvia Francesca Storti
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  4. Paolo Tonin
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  5. Francesco Piccione
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  6. Paolo Manganotti
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Correspondence to Emanuela Formaggio.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Formaggio, E., Cavinato, M., Storti, S.F. et al. Assessment of Event-Related EEG Power After Single-Pulse TMS in Unresponsive Wakefulness Syndrome and Minimally Conscious State Patients. Brain Topogr 29, 322–333 (2016). https://doi.org/10.1007/s10548-015-0461-3

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  • DOI: https://doi.org/10.1007/s10548-015-0461-3

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