Evidence map›Paper›PMID 42090748›Full record

ArticleCortex; a journal devoted to the study of the nervous system and behavior2026

Covert brain complexity in the intensive care unit.

Matteo Fecchio, David R Schreier, Morgan K Cambareri, Veronica Nisticò, Holly J Freeman, Phoebe K Lawrence, Yelena G Bodien, Michael J Young, Ona Wu, Brian L Edlow

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Cortex; a journal devoted to the study of the nervous system and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Matteo FecchioCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: mfecchio@mgh.harvard.edu.
David R SchreierCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA.
Morgan K CambareriCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Biomedical Engineering, Boston University, Boston, MA, USA.
Veronica NisticòCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Science, University of Milan, Milan, Italy; Department of Psychology, University of Milano-Bicocca, Milan, Italy.
Holly J FreemanCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Phoebe K LawrenceCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Yelena G BodienCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Surgery, Department of Neurological Surgery, Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
Michael J YoungCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Ona WuAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
Brian L EdlowCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.

Funding

Bridge2AI: Patient-Focused Collaborative Hospital Repository Uniting Standards (CHoRUS) for Equitable AIOT2OD032701 · OD · MASSACHUSETTS GENERAL HOSPITAL · PI BIHORAC, AZRA, CLERMONT, GILLES · 2022 to 2025
$24.6M
Multimodal Network Connectivity Architecture (MOCA) of the Brain and its Role in the Recovery of Consciousness in Comatose Cardiac Arrest PatientsR01NS102574 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GREER, DAVID MATTHEW, WU, ONA · 2018 to 2022
$3.4M
A Connectome-Based Clinical Trial Platform to Promote Early Recovery of Consciousness after Traumatic ComaDP2HD101400 · NICHD · MASSACHUSETTS GENERAL HOSPITAL · PI EDLOW, BRIAN L. · 2019 to 2019
$2.5M
Measuring Brain Complexity to Detect and Predict Recovery of Consciousness in the ICUR01NS138257 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI Melanie Boly, Brian L. Edlow · 2024 to 2026
$1.9M
Brainstem Connectome Mapping to Guide Targeted Stimulant Therapy in Patients with Traumatic ComaR21NS109627 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI EDLOW, BRIAN L. · 2019 to 2020
$480k
Promoting Recovery from Brain Injury with Non-Invasive Thalamic UltrasoundK23NS140495 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI Michael J Young · 2025 to 2026
$469k
An Ethical Approach to Detecting Covert ConsciousnessF32MH123001 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI YOUNG, MICHAEL J · 2020 to 2022
$159k
NICHD NIH HHS DP2 HD101400NIH HHS OT2 OD032701NIMH NIH HHS F32 MH123001NINDS NIH HHS K23 NS140495NINDS NIH HHS R01 NS102574NINDS NIH HHS R01 NS138257NINDS NIH HHS R21 NS109627
6 · The paper itself

Abstract

Early detection of consciousness in critically ill patients with severe brain injuries can profoundly impact prognostication and clinical care decisions. Advanced multimodal protocols to detect signs of consciousness include standardized behavioral assessments, task-based functional magnetic resonance imaging (fMRI), and task-based electroencephalography (EEG). However, these approaches have limited diagnostic sensitivity because patients may lack auditory function, attention, language, or other cognitive capacities required to perform a task or process a sensory stimulus, even if they are conscious. Transcranial magnetic stimulation EEG (TMS-EEG) has the potential to overcome these limitations by directly engaging corticothalamic circuits to compute the perturbational complexity index (PCI), an emerging indicator of consciousness. To date, TMS-EEG studies have focused on patients in the subacute or chronic stage of recovery from severe brain injury. Here, we report the proof-of-concept application of TMS-EEG for a critically ill patient in the acute stage of brain injury, in which multimodal assessments suggested a vegetative state/unresponsive wakefulness syndrome. We demonstrate that TMS-EEG may detect signs of consciousness that elude current advanced evaluations, showing the feasibility of TMS-EEG as part of a multimodal protocol for assessing consciousness in the intensive care unit.

Indexed as

BrainBrain InjuriesConsciousnessCritical IllnessElectroencephalographyHumansIntensive Care UnitsMalePersistent Vegetative StateTranscranial Magnetic StimulationComaConsciousnessElectroencephalographyIntensive Care UnitTranscranial Magnetic Stimulation

Identifiers

PMID42090748
PMCPMC13150136

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.