2. Phase 2: the emergence of fluctuating signs of consciousness (weeks 6-13)
2.1. Emergence of behavioral responsiveness and TMS-EEG changes
Starting at week 6 the patient showed the first reproducible, albeit fluctuating, signs of consciousness, such as object manipulation followed by the appearance of visual tracking at week 8, consistent with a diagnosis of low-behavioral MCS, or MCS “minus” (MCS-) (Figure 1). During this transition period (week 7), the patient underwent a second TMS-EEG measurement to assess possible changes in cortical reactivity and complexity related to the behavioral evolution. Brain complexity remained above the threshold (PCImax>0.31) for consciousness detection and increased for both left and right parietal stimulation (PCI from 0.33 to 0.40 and from 0.34 to 0.35 respectively; Figure 4 panel B, red circle and red square); in the case of right frontal stimulation PCI slightly increased but remained below threshold (PCI from 0.25 to 0.27; Figure 4 panel B, red diamond).