A method to assess the default EEG macrostate and its reactivity to stimulation.

• We identified the default EEG macrostate (DEM) by topographic spectral clustering. • The DEM occurrence probability decreased during photic stimulation. • The DEM reactivity to stimulation was impaired in post-stroke comatose patients. The default mode network (DMN) is deactivated by stimulation. We aimed to assess the DMN reactivity impairment by routine EEG recordings in stroke patients with impaired consciousness. Binocular light flashes were delivered at 1 Hz in 1-minute epochs, following a 1-minute baseline (PRE). The EEG was decomposed in a series of binary oscillatory macrostates by topographic spectral clustering. The most deactivated macrostate was labeled the default EEG macrostate (DEM). Its reactivity (DER) was quantified as the decrease in DEM occurrence probability during stimulation. A normalized DER index (DERI) was calculated as DER/PRE. The measures were compared between 14 healthy controls and 32 comatose patients under EEG monitoring following an acute stroke. The DEM was mapped to the posterior DMN hubs. In the patients, these DEM source dipoles were 3–4 times less frequent and were associated with an increased theta activity. Even in a reduced 6-channel montage, a DER below 6.26% corresponding to a DERI below 0.25 could discriminate the patients with sensitivity and specificity well above 80%. The method detected the DMN impairment in post-stroke coma patients. The DEM and its reactivity to stimulation could be useful to monitor the DMN function at bedside. [ABSTRACT FROM AUTHOR]