Transcranial magnetic stimulation and electroencephalography

Abstract

Diagnostic assessment in severely brain-injured patients with disorders of consciousness is largely based on behavioral examinations. This approach can lead to misdiagnosis, giving rise to inaccurate prognosis and inappropriate treatment care. Concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) may provide a biological measure of the level of consciousness at the individual level by assessing functional integration and differentiation in the brain. Here we review a series of recent TMS-EEG studies that assess brain complexity in normal wakefulness, during physiological (sleep), pharmacological (anesthesia), and pathological (brain injury) conditions. TMS-EEG may contribute to unveiling the pathophysiology of disorders of consciousness due to severe acquired brain injury. This technique could also help clinicians in their decision making and provide support for treatment intervention.