A theoretically based index of consciousness independent of sensory processing and behavior
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A theory-derived index of consciousness, which quantifies the complexity of the brain’s response to a stimulus, measures the level of consciousness in awake, sleeping, anesthetized, and brain-damaged subjects.
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A reduction in the length and complexity of response to stimulation distinguished vegetative state patients from minimally conscious state patients or healthy controls.
“One key study demonstrated a reduction in the length and complexity of response to stimulation that distinguished patients with a diagnosis of vegetative state from those in a minimally conscious state or healthy controls (Casali et al., 2013).”
From Conscious Processing and the Global Neuronal Workspace Hypothesis (2020) · cites this paper as Casali et al., 2013
The section ‘PCI discriminates the level of consciousness in brain-injured patients’ reports significantly lower complexity-index values in vegetative-state patients than in minimally conscious patients; the Discussion also compares those values with healthy awake subjects. Our copy does not report that the duration or length of the stimulation response itself distinguished the patient groups. Its description of a ‘short-lasting response’ concerns healthy subjects during NREM sleep, not vegetative-state patients. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSurrogate measures such as the perturbational complexity index might have originated in IIT, but their results are consistent with other theories, including GNW, which proposes that conscious processing depends on integration of differentiated processors across a network.
“Similarly, surrogate measures, such as the perturbational complexity index that have shown promise (Casali et al., 2013), might have originated in one theory (in this case, IIT), but, as noted earlier, the results are consistent with other theories, e.g., the GNW, which also proposes that conscious processing critically depends on the integration of differentiated processors across a network.”
From Conscious Processing and the Global Neuronal Workspace Hypothesis (2020) · cites this paper as Casali et al., 2013
The reduction identified by the perturbational complexity index was consistent across pathologic unconsciousness, sleep, and general anesthesia.
“Remarkably, this reduction, identified by the perturbational complexity index, was consistent across pathologic unconsciousness, sleep, and general anesthesia.”
From Conscious Processing and the Global Neuronal Workspace Hypothesis (2020) · cites this paper as Casali et al., 2013
IIT has served as a theoretical framework for the perturbational complexity index, which has been successful in differentiating levels of consciousness in physiological, pharmacological, and pathological perturbations.
“Nevertheless, IIT has served as a theoretical framework for more practical measures, such as the perturbational complexity index, which has been successful in differentiating levels of consciousness in the setting of physiological, pharmacological, and pathological perturbations (Casali et al., 2013).”
From Conscious Processing and the Global Neuronal Workspace Hypothesis (2020) · cites this paper as Casali et al., 2013
Complexity measures rely either on characterization of spontaneous brain dynamics or on quantification of patterns of interactions evoked by direct cortical perturbations.
“Complexity measures rely either on the characterization of spontaneous brain dynamics (through the analysis of functional connectivity networks and graph theory metrics) 33,34 or on the quantification of the patterns of interactions evoked by direct cortical perturbations.35”
From An integrative, multiscale view on neural theories of consciousness (2024) · cites this paper as [35]
The activation triggered by exogenous stimuli during REM sleep may be incongruent with the activation triggered endogenously by the dream.
“Another possibility is that the activation triggered by exogenous stimuli during REM sleep may be incongruent with the activation triggered endogenously by the dream.”
From Consciousness and sleep (2024) · cites this paper as [164]
The Study design section mentions TMS-evoked potentials recorded during REM sleep in one subject. It does not address whether activation from external stimuli may be incongruent with activation arising from a dream; searches for dreaming and for exogenous versus endogenous activation found no such passage in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measuredSimilar to binocular rivalry, the causes and effects of dream states would be incompatible with those specified by the stimulus, and therefore remain unconscious.
“Specifically, similar to what may happen during binocular rivalry164, the causes and effects of dream states would be incompatible with those specified by the stimulus, and therefore remain unconscious, in line with theoretical notions109.”
From Consciousness and sleep (2024) · cites this paper as [164]
The Discussion describes PCI as distinguishing levels of consciousness during dreaming and other states, but does not say that dream-state causes and effects are incompatible with those specified by a stimulus or that a stimulus therefore remains unconscious. Searches of our copy for dreaming, binocular rivalry, and stimulus incompatibility found no passage addressing that proposed mechanism; page numbers were not available. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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“This measure of the spread of a local perturbation in activity can be successfully used to quantify the level of consciousness [18].”
MethodRobust EEG-based cross-site and cross-protocol classification of states of consciousness
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Consciousness in humans and non-human animals: recent advances and future directions
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Self-citationConsciousness-specific dynamic interactions of brain integration and functional diversity
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Bistability breaks-off deterministic responses to intracortical stimulation during non-REM sleep
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Self-citationBifurcation in brain dynamics reveals a signature of conscious processing independent of report
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Neural correlates of unconsciousness in large-scale brain networks
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Measuring Integrated Information from the Decoding Perspective
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Making the hard problem of consciousness easier
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Consciousness and complexity: a consilience of evidence
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Coupling the State and Contents of Consciousness
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Cortical activity is more stable when sensory stimuli are consciously perceived
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Self-citationTests for consciousness in humans and beyond
Bayne, T., Seth, A. K., Massimini, M., Shepherd, J., Cleeremans, A., Fleming, S. M., Malach, R., Mattingley, J. B., Menon, D. K., Owen, A. M., et al. (2024) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2024.01.010 · Cited by 163 · see citing works
“Perturbational complexity index (PCI) test [35,36]: A transcranial magnetic stimulation (TMS) pulse is applied to the target and electroencephalography (EEG) is used to measure the complexity of the neural response to that pulse.”
MethodSelf-citationDimensions of consciousness and the psychedelic state
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Can the macro beat the micro? Integrated information across spatiotemporal scales
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Are there islands of awareness?
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On the axiomatic foundations of the integrated information theory of consciousness
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Dynamic functional connectivity and brain metastability during altered states of consciousness
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Improved measures of integrated information
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An integrative, multiscale view on neural theories of consciousness
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“35 The latter approach, instantiated by the PCI, shows high sensitivity in challenging clinical conditions and points to a mechanistic link between brain complexity and feedback interactions.”
Self-citationAnesthesia and the neurobiology of consciousness
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Detecting and interpreting conscious experiences in behaviorally non-responsive patients
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Consciousness in the cradle: on the emergence of infant experience
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“In addition, the community’s efforts have resulted not only in increased theoretical understanding of the nature of consciousness but also in the development of practical, clinical applications such as the ability to diagnose the presence of residual consciousness in braindamaged, non-communicative patients using neur…”
BackgroundDisruption of corticocortical information transfer during ketamine anesthesia in the primate brain
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Non-human consciousness and the specificity problem: a modest theoretical proposal
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Split-brain: what we know now and why this is important for understanding consciousness
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Consciousness science: real progress and lingering misconceptions
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Self-citationConsciousness as a memory system.
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Consciousness and cortical responsiveness: a within-state study during non-rapid eye movement sleep
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Self-citationConsciousness and the fallacy of misplaced objectivity
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Measuring Consciousness in the Intensive Care Unit
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The Mathematical Structure of Integrated Information Theory
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Lucid dreaming occurs in activated rapid eye movement sleep, not a mixture of sleep and wakefulness
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Measuring the Complexity of Consciousness
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Four-dimensional graded consciousness
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Leveraging Nonhuman Primate Multisensory Neurons and Circuits in Assessing Consciousness Theory
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EEG Signal Diversity Varies With Sleep Stage and Aspects of Dream Experience
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Testing circuit-level theories of consciousness in humans
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- Authors
- Casali, A. G., Gosseries, O., Rosanova, M., Boly, M., Sarasso, S., Casali, K. R., Casarotto, S., Bruno, M.-A., Laureys, S., Tononi, G., & Massimini, M.
- Affiliations
- University of Milan (IT)
- University of Liège (BE)
- University of Wisconsin–Madison (US)
- Corresponding author
- Casali, Adenauer G.
- Gosseries, Olivia
- Boly, Mélanie
- Massimini, Marcello
- ORCID
- Venue
- Science Translational Medicine
- Published
- 2013-08-14
- Volume
- 5
- Issue
- 198
- Pages
- 198ra105-198ra105
- ISSN
- 1946-6234 (ISSN-L)
- 1946-6242
- OpenAlex
- W2102204212
- Cited by
- 1,246
- References
- 63
- Citations by year
- 2026: 120 · 2025: 120 · 2024: 119 · 2023: 124 · 2022: 102 · 2021: 105 · 2020: 81 · 2019: 111 · 2018: 94 · 2017: 69 · 2016: 59 · 2015: 74 · 2014: 52 · 2013: 13 · 2012: 1
- FWCI
- 48.18
- Type
- journal article
- Language
- en
- Open access
- green
- orbi.uliege.be
- Licence
- other-oa
- Locations
- Science Translational Medicine (publishedVersion)
- PubMed (publishedVersion)
- ORBi (University of Liège) (submittedVersion, other-oa)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Funders
- James S. McDonnell Foundation (ARC 06/11-340)
- Mind Science Foundation
- Università degli Studi di Milano (PUR 2009)
- European Commission (FP7 ICT, ICT-2011, FP7-ICT-2011-9, 600806, FP7‐ICT‐2011)
- Fonds De La Recherche Scientifique - FNRS
- Fonds Léon Fredericq
- Regione Lombardia
- FP7 Information and Communication Technologies (600806)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Philosophy and Theoretical Science
- Keywords
- level of consciousness, perturbational complexity index, transcranial magnetic stimulation, TMS-evoked potentials, algorithmic complexity, cortical integration, information theory, vegetative state, minimally conscious state, locked-in syndrome, coma, anesthesia, midazolam, xenon, propofol, sleep, dreams
- MeSH terms
- Anesthetics, Brain, Consciousness, Evoked Potentials, Female, Humans, Male, Midazolam, Xenon, Propofol, Transcranial Magnetic Stimulation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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