Developing and Disseminating a Reliable Index to Detect Consciousness at the Patient’s Bedside

Overview:

The aim of this project is to develop and disseminate effective brain-based measures of consciousness that can be applied at the bedside of patients.

Abstract:

Detecting consciousness in unresponsive patients represents a major scientific challenge with obvious and profound ethical implications. The fundamental aim of this project is to develop and disseminate effective brain-based measures of consciousness that can be applied at the bedside of patients. 

Based on the combination of Transcranial Magnetic Stimulation (TMS) and electroencephalography (EEG), we formerly devised a practical index of consciousness (the Perturbational Complexity Index, or PCI) which quantifies the complexity of the spatiotemporal brain activation in response to a direct perturbation. With an extensive empirical effort, we demonstrated that PCI shows an unprecedented accuracy in discriminating consciousness irrespective of responsiveness across a variety of conditions—including sleep, anesthesia, dreaming, and disorders of consciousness. Further, we showed that adapted and simplified methods for PCI calculation can be applied across different scales and models, thus generalizing the original observations obtained in humans. The empirical evidence produced by these works were central in the context of a recent trend in the literature linking practical measures of brain complexity to early theoretical principles and offering interesting vistas on scientific and ethical open questions. 

In parallel, key practical progresses were made towards the implementation and dissemination of tools and protocols to simplify, standardize, and generalize brain complexity measures (i.e. PCI) in routine clinical settings. A first step in this direction is represented by the ongoing multi-centric study for the collection of a common dataset across different universities supported by The Tiny Blue Dot Foundation.

Broader Impact:

Developing and disseminating a reliable brain-based measure of consciousness will impact the way consciousness is assessed in hospitals and rehabilitation centers worldwide. This work will open a much wider spectrum of possibilities in our capacity to understand, manipulate and expand human experience.