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).