To evaluate the efficacy of fast perturbational complexity index (PCIst) in assessing the
therapeutic responsiveness of repetitive transcranial magnetic stimulation (rTMS) in patients with disturbance
of consciousness (DoC). Methods: Total 84 patients with DoC admitted to our hospital from June 2023 to
March 2025 were selected as the study objects. All patients were treated with conventional awakening therapy
plus rTMS. According to the reactivity after rTMS treatment, all patients were divided into good response group
and poor response group, and then the clinical data and laboratory examination data (including PCIst) of the two
groups were compared. Logistic regression was used to analyze the related factors affecting rTMS treatment
responsiveness. Results: As of April 30, 2025, a total of 35 patients had escaped from MSC status after basic
therapy plus rTMS. The age of patients in the good response group was lower than that in the poor response
group, and the difference was statistically significant (P<0.05). The baseline EEG grading in the good response
group was better than that in the poor response group, and the PCIst was higher than that in the poor response
group, the difference was statistically significant (P<0.05). Age was an independent risk factor for rTMS
treatment responsiveness, PCIst and no complications during treatment were independent protective factors for
rTMS treatment responsiveness (P<0.05). RCS analysis showed that PCIst was significantly and linearly
associated with responsiveness to rTMS treatment in patients with disorders of consciousness (nonlinear P=
0.677, P=0.004); the ROC curve showed that the area under the curve of PCIst predicting responsiveness to
rTMS treatment in patients with disorders of consciousness was 0.853 (95% CI 0.798～0.896, P<0.001).
Conclusion: PCIst was significantly associated with rTMS treatment responsiveness in patients with DoC and
had good predictive efficacy
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