Neurophysiological correlates of sevoflurane-induced unconsciousness.
Neurophysiological correlates of sevoflurane-induced unconsciousness.
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DOI：
10.1097/aln.0000000000000482
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发表时间：
2015-02
期刊：
影响因子：
8.8
通讯作者：
Mashour GA
中科院分区：
文献类型：
--
作者：
Blain-Moraes S;Tarnal V;Vanini G;Alexander A;Rosen D;Shortal B;Janke E;Mashour GA
近期对人类麻醉诱导的无意识的研究主要集中在静脉注射药物丙泊酚上，并已确定α节律的前部优势和额叶相位 - 幅度耦合模式作为神经生理学标记。然而，尚不清楚丙泊酚诱导的无意识的相关特征是否可推广到吸入性麻醉剂，吸入性麻醉剂具有不同的分子靶点，且在临床实践中更常用。
我们在健康人类参与者有意识、七氟烷诱导无意识和恢复期间记录了64通道脑电图（n = 10；n = 7适合分析）。分析了低频（1赫兹）和α（10赫兹）功率的频谱图和头皮分布，并计算了额叶和顶叶区域这两个频率之间的相位 - 幅度调制。相位滞后指数用于评估整个大脑皮层的相位关系。
在足以导致无意识的浓度下，七氟烷并未导致α功率的前部一致性增强；额叶皮质中低频相位和α幅度之间的关系未发生特征性转变。相比之下，在有意识期间顶叶区域存在显著的跨频率耦合，而在失去意识后未观察到这种情况。此外，α频段中前后相位关系的可逆性破坏被确定为七氟烷诱导无意识的一个相关特征。
在人类中，七氟烷诱导的无意识与α的前部化及相关跨频率模式无关，而是与顶叶区域的相位 - 幅度耦合破坏以及整个大脑皮层的相位 - 相位关系有关。
Recent studies of anesthetic-induced unconsciousness in humans have focused predominantly on the intravenous drug propofol and have identified anterior dominance of alpha rhythms and frontal phase-amplitude coupling patterns as neurophysiological markers. However, it is unclear whether the correlates of propofol-induced unconsciousness are generalizable to inhaled anesthetics, which have distinct molecular targets and which are used more commonly in clinical practice. We recorded 64-channel electroencephalogram in healthy human participants during consciousness, sevoflurane-induced unconsciousness, and recovery (n=10; n=7 suitable for analysis). Spectrograms and scalp distributions of low-frequency (1 Hz) and alpha (10 Hz) power were analyzed, and phase-amplitude modulation between these two frequencies was calculated in frontal and parietal regions. Phase lag index was used to assess phase relationships across the cortex. At concentrations sufficient for unconsciousness, sevoflurane did not result in a consistent anteriorization of alpha power; the relationship between low-frequency phase and alpha amplitude in the frontal cortex did not undergo characteristic transitions. By contrast, there was significant cross-frequency coupling in the parietal region during consciousness that was not observed after loss of consciousness. Furthermore, a reversible disruption of anterior-posterior phase relationships in the alpha bandwidth was identified as a correlate of sevoflurane-induced unconsciousness. In humans, sevoflurane-induced unconsciousness is not correlated with anteriorization of alpha and related cross-frequency patterns, but rather by a disruption of phase-amplitude coupling in the parietal region and phase-phase relationships across the cortex.