Abstract
Unconscious state has been investigated in numerous studies so far, but pathophysiology of this state is not fully understood. Recently, combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG) has been developed to allow for non-invasive assessment of neurophysiology in the cerebral cortex. We conducted a systematic literature search for TMS-EEG studies on human unconscious state using PubMed with cross-reference and manual searches. The initial search yielded 137 articles, and 19 of them were identified as relevant, including one article found by manual search. This review included 10 studies for unresponsive wakefulness syndrome (UWS), 9 for minimally conscious states (MCS), 5 for medication-induced unconscious states, and 6 for natural non-rapid eye movement states. These studies analyzed TMS-evoked potential to calculate perturbational complexity index (PCI) and OFF-periods. In particular, PCI was found to be a potentially useful marker to differentiate between UWS and MCS. This review demonstrated that TMS-EEG could represent a promising neuroscientific tool to investigate various unconscious states. Further TMS-EEG research may help elucidate the neural basis of unconscious state.
| Original language | English |
|---|---|
| Pages (from-to) | 293-312 |
| Number of pages | 20 |
| Journal | Neuroscience and Biobehavioral Reviews |
| Volume | 131 |
| DOIs | |
| Publication status | Published - 2021 Dec |
Keywords
- Disorders of consciousness
- Minimally conscious state
- Perturbational complexity index
- TMS-EEG
- Unconscious state
- Unresponsive wakefulness syndrome
ASJC Scopus subject areas
- Neuropsychology and Physiological Psychology
- Cognitive Neuroscience
- Behavioral Neuroscience
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In: Neuroscience and Biobehavioral Reviews, Vol. 131, 12.2021, p. 293-312.
Research output: Contribution to journal › Review article › peer-review
}
TY - JOUR
T1 - Insights of neurophysiology on unconscious state using combined transcranial magnetic stimulation and electroencephalography
T2 - A systematic review
AU - Arai, Naohiro
AU - Nakanishi, Tomoya
AU - Nakajima, Shinichiro
AU - Li, Xuemei
AU - Wada, Masataka
AU - Daskalakis, Zafiris J.
AU - Goodman, Michelle S.
AU - Blumberger, Daniel M.
AU - Mimura, Masaru
AU - Noda, Yoshihiro
N1 - Funding Information: N.A. has received a grant from Meiji Yasuda Mental Health Foundation and a Grant-in-Aid for Young Scientists (KAKENHI) from the Promotion of Science within the past three years. S.N. has received a Grant-in-Aid for Young Scientists A and Grants-in-Aid for Scientific Research B and C from JSPS, and research grants from Japan Research Foundation for Clinical Pharmacology, Naito Foundation, Takeda Science Foundation, Uehara Memorial Foundation, and Daiichi Sankyo Scholarship Do-nation Program within the past three years. S.N. has also received research support, manuscript fees or speaker’s honoraria from Dainippon Sumitomo Pharma, Meiji-Seika Pharma, Otsuka Pharmaceutical, Shionogi, and Yoshitomi Yakuhin within the past three years.X.L. has received the Mitsubishi Corporation International Scholarship and the Tokyu Foundation International Scholarship within the past three years.M.W. has received a Grant-in-Aid for Young Scientists (KAKENHI) from the Promotion of Science and a scholarship from Nakatani Foundation within the past three years.Z.J.D. has received research support from the Ontario Mental Health (OMH) Foundation, the CIHR, the Brain and Behaviour Research Foundation (Formerly NARSAD), and the Temerty family and Grant family through the CAMH Foundation and the Campbell Institute. He has received research and equipment in-kind support for an investigator-initiated study through Brainsway Inc., and a travel allowance through Merck. He has also received speaker funding through Sepracor Inc., and AstraZeneca, served on advisory boards for Hoffmann–La Roche Limited and Merck, and received speaker support from Eli Lilly.D.M.B has received research support from the Canadian Institutes of Health Research (CIHR), National Institute of Health (NIH), Brain Canada and the Temerty Family through the Centre for Addiction and Mental Health (CAMH) Foundation and the Campbell Research Institute. He received research support and in-kind equipment support for an investigator-initiated study from Brainsway Ltd. and he is the site principal investigator for three sponsor-initiated studies for Brainsway Ltd. He also receives in-kind equipment support from Magventure for an investigator-initiated studies. He received medication supplies for an investigator-initiated trial from Indivior.M.M. received grants and/or speaker’s honoraria from Asahi Kasei Pharma, Astellas Pharma, Daiichi Sankyo, Sumitomo Dainippon Pharma, Eisai, Eli Lilly, Fuji Film RI Pharma, Janssen Pharmaceutical, Kracie, Meiji-Seika Pharma, Mochida Pharmaceutical, Merck Sharp and Dohme, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Shionogi, Takeda Pharmaceutical, Mitsubishi Tanabe Pharma, and Yoshitomi Yakuhin.Y.N. has received a Grant-in-Aid for Young Scientists (18K15375) and a Grant-in-Aid for Scientific Research (B) (21H02813) from the Japan Society for the Promotion of Science (JSPS), research grants from Japan Agency for Medical Research and Development (AMED), investigator-initiated clinical study grants from TEIJIN PHARMA LIMITED and Inter Reha Co., Ltd. Y.N. also receives research grants from Japan Health Foundation, Meiji Yasuda Mental Health Foundation, Mitsui Life Social Welfare Foundation, Takeda Science Foundation, SENSHIN Medical Research Foundation, Health Science Center Foundation, Mochida Memorial Foundation for Medical and Pharmaceutical Research, Taiju Life Social Welfare Foundation, and Daiichi Sankyo Scholarship Donation Program. Y.N. has received speaker’s honoraria from Dainippon Sumitomo Pharma, MOCHIDA PHARMACEUTICAL CO., LTD., and Yoshitomiyakuhin Corporation, TEIJIN OHARMA LIMITED within the past three years. Y.N. also receives equipment-in-kind support for an investigator-initiated study from Magventure Inc., Inter Reha Co., Ltd., BrainBox Ltd., and Miyuki Giken Co., Ltd. Funding Information: N.A. has received a grant from Meiji Yasuda Mental Health Foundation and a Grant-in-Aid for Young Scientists (KAKENHI) from the Promotion of Science within the past three years. S.N. has received a Grant-in-Aid for Young Scientists A and Grants-in-Aid for Scientific Research B and C from JSPS, and research grants from Japan Research Foundation for Clinical Pharmacology, Naito Foundation, Takeda Science Foundation, Uehara Memorial Foundation, and Daiichi Sankyo Scholarship Do-nation Program within the past three years. S.N. has also received research support, manuscript fees or speaker's honoraria from Dainippon Sumitomo Pharma, Meiji-Seika Pharma, Otsuka Pharmaceutical, Shionogi, and Yoshitomi Yakuhin within the past three years.X.L. has received the Mitsubishi Corporation International Scholarship and the Tokyu Foundation International Scholarship within the past three years.M.W. has received a Grant-in-Aid for Young Scientists (KAKENHI) from the Promotion of Science and a scholarship from Nakatani Foundation within the past three years.Z.J.D. has received research support from the Ontario Mental Health (OMH) Foundation, the CIHR, the Brain and Behaviour Research Foundation (Formerly NARSAD), and the Temerty family and Grant family through the CAMH Foundation and the Campbell Institute. He has received research and equipment in-kind support for an investigator-initiated study through Brainsway Inc. and a travel allowance through Merck. He has also received speaker funding through Sepracor Inc. and AstraZeneca, served on advisory boards for Hoffmann?La Roche Limited and Merck, and received speaker support from Eli Lilly.D.M.B has received research support from the Canadian Institutes of Health Research (CIHR), National Institute of Health (NIH), Brain Canada and the Temerty Family through the Centre for Addiction and Mental Health (CAMH) Foundation and the Campbell Research Institute. He received research support and in-kind equipment support for an investigator-initiated study from Brainsway Ltd. and he is the site principal investigator for three sponsor-initiated studies for Brainsway Ltd. He also receives in-kind equipment support from Magventure for an investigator-initiated studies. He received medication supplies for an investigator-initiated trial from Indivior.M.M. received grants and/or speaker's honoraria from Asahi Kasei Pharma, Astellas Pharma, Daiichi Sankyo, Sumitomo Dainippon Pharma, Eisai, Eli Lilly, Fuji Film RI Pharma, Janssen Pharmaceutical, Kracie, Meiji-Seika Pharma, Mochida Pharmaceutical, Merck Sharp and Dohme, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Shionogi, Takeda Pharmaceutical, Mitsubishi Tanabe Pharma, and Yoshitomi Yakuhin.Y.N. has received a Grant-in-Aid for Young Scientists (18K15375) and a Grant-in-Aid for Scientific Research (B) (21H02813) from the Japan Society for the Promotion of Science (JSPS), research grants from Japan Agency for Medical Research and Development (AMED), investigator-initiated clinical study grants from TEIJIN PHARMA LIMITED and Inter Reha Co. Ltd. Y.N. also receives research grants from Japan Health Foundation, Meiji Yasuda Mental Health Foundation, Mitsui Life Social Welfare Foundation, Takeda Science Foundation, SENSHIN Medical Research Foundation, Health Science Center Foundation, Mochida Memorial Foundation for Medical and Pharmaceutical Research, Taiju Life Social Welfare Foundation, and Daiichi Sankyo Scholarship Donation Program. Y.N. has received speaker's honoraria from Dainippon Sumitomo Pharma, MOCHIDA PHARMACEUTICAL CO. LTD. and Yoshitomiyakuhin Corporation, TEIJIN OHARMA LIMITED within the past three years. Y.N. also receives equipment-in-kind support for an investigator-initiated study from Magventure Inc. Inter Reha Co. Ltd. BrainBox Ltd. and Miyuki Giken Co. Ltd. Publisher Copyright: © 2021 Elsevier Ltd
PY - 2021/12
Y1 - 2021/12
N2 - Unconscious state has been investigated in numerous studies so far, but pathophysiology of this state is not fully understood. Recently, combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG) has been developed to allow for non-invasive assessment of neurophysiology in the cerebral cortex. We conducted a systematic literature search for TMS-EEG studies on human unconscious state using PubMed with cross-reference and manual searches. The initial search yielded 137 articles, and 19 of them were identified as relevant, including one article found by manual search. This review included 10 studies for unresponsive wakefulness syndrome (UWS), 9 for minimally conscious states (MCS), 5 for medication-induced unconscious states, and 6 for natural non-rapid eye movement states. These studies analyzed TMS-evoked potential to calculate perturbational complexity index (PCI) and OFF-periods. In particular, PCI was found to be a potentially useful marker to differentiate between UWS and MCS. This review demonstrated that TMS-EEG could represent a promising neuroscientific tool to investigate various unconscious states. Further TMS-EEG research may help elucidate the neural basis of unconscious state.
AB - Unconscious state has been investigated in numerous studies so far, but pathophysiology of this state is not fully understood. Recently, combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG) has been developed to allow for non-invasive assessment of neurophysiology in the cerebral cortex. We conducted a systematic literature search for TMS-EEG studies on human unconscious state using PubMed with cross-reference and manual searches. The initial search yielded 137 articles, and 19 of them were identified as relevant, including one article found by manual search. This review included 10 studies for unresponsive wakefulness syndrome (UWS), 9 for minimally conscious states (MCS), 5 for medication-induced unconscious states, and 6 for natural non-rapid eye movement states. These studies analyzed TMS-evoked potential to calculate perturbational complexity index (PCI) and OFF-periods. In particular, PCI was found to be a potentially useful marker to differentiate between UWS and MCS. This review demonstrated that TMS-EEG could represent a promising neuroscientific tool to investigate various unconscious states. Further TMS-EEG research may help elucidate the neural basis of unconscious state.
KW - Disorders of consciousness
KW - Minimally conscious state
KW - Perturbational complexity index
KW - TMS-EEG
KW - Unconscious state
KW - Unresponsive wakefulness syndrome
UR - http://www.scopus.com/inward/record.url?scp=85120327065&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120327065&partnerID=8YFLogxK
U2 - 10.1016/j.neubiorev.2021.09.029
DO - 10.1016/j.neubiorev.2021.09.029
M3 - Review article
C2 - 34555384
AN - SCOPUS:85120327065
SN - 0149-7634
VL - 131
SP - 293
EP - 312
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
ER -