RT info:eu-repo/semantics/article T1 Altered brain dynamics index levels of arousal in complete locked-in syndrome A1 Zilio, Federico A1 Gomez-Pilar, Javier A1 Chaudhary, Ujwal A1 Fogel, Stuart A1 Fomina, Tatiana A1 Synofzik, Matthis A1 Schöls, Ludger A1 Cao, Shumei A1 Zhang, Jun A1 Huang, Zirui A1 Birbaumer, Niels A1 Northoff, Georg AB Complete locked-in syndrome (CLIS) resulting from late-stage amyotrophic lateral sclerosis (ALS) is characterised by loss of motor function and eye movements. The absence of behavioural indicators of consciousness makes the search for neuronal correlates as possible biomarkers clinically and ethically urgent. EEG-based measures of brain dynamics such as power-law exponent (PLE) and Lempel-Ziv complexity (LZC) have been shown to have explanatory power for consciousness and may provide such neuronal indices for patients with CLIS. Here, we validated PLE and LZC (calculated in a dynamic way) as benchmarks of a wide range of arousal states across different reference states of consciousness (e.g., awake, sleep stages, ketamine, sevoflurane). We show a tendency toward high PLE and low LZC, with high intra-subject fluctuations and inter-subject variability in a cohort of CLIS patients with values graded along different arousal states as in our reference data sets. In conclusion, changes in brain dynamics indicate altered arousal in CLIS. Specifically, PLE and LZC are potentially relevant biomarkers to identify or diagnose the arousal level in CLIS and to determine the optimal time point for treatment, including communication attempts. PB Springer Nature YR 2023 FD 2023 LK https://uvadoc.uva.es/handle/10324/82758 UL https://uvadoc.uva.es/handle/10324/82758 LA eng NO F. Zilio, J. Gomez-Pilar, et al. Altered brain dynamics index levels of arousal in complete locked-in syndrome, Communications Biology, vol. 6, n.º 1, 2023, doi: 10.1038/S42003-023-05109-1 DS UVaDOC RD 29-mar-2026