Lateralisation of subcortical functional connectivity during and after general anaesthesia.
Lateralisation of subcortical functional connectivity during and after general anaesthesia.
复制标题
全身麻醉期间和之后皮质下功能连接的侧化。
DOI：
10.1016/j.bja.2021.08.033
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发表时间：
2022
影响因子：
9.8
通讯作者：
Livny,Abig
中科院分区：
文献类型：
--
作者：
Nir,Tommer;Raizman,Reut;Meningher,Inbar;Jacob,Yael;Huang,Kuang-Han;Schwartz,ArthurE;Brallier,JessW;Ahn,Helen;Kundu,Prantik;Tang,CheukY;Delman,BradleyN;McCormick,PatrickJ;Scarpa,Julia;Sano,Mary;Deiner,StacieG;Livny,Abig
背景意识和意识是意识状态的两个重要组成部分。功能神经成像加深了我们对大脑皮层和丘脑皮质知觉机制的理解。由于脑干结构和丘脑核团的体积相对较小，以及它们在大脑中的深度较大，因此研究皮质下功能连接与觉醒的关系一直是一个具有挑战性的问题。方法72名健康志愿者在七氟醚全麻前、麻醉后1h和麻醉后1d分别进行静态功能MRI扫描。对感兴趣区和皮质下感兴趣区进行功能连通性和同源功能连通性分析，以评估左右对称性。这两项分析都使用了深部脑刺激产生的高分辨率图谱。结果在麻醉下，丘脑皮质下区域和上行网状激活系统的功能连接受到严格限制，表现为连接的一般偏侧化。同样，在麻醉状态下，左右同源性急剧降低。麻醉苏醒后，双侧皮质下的功能连接并未完全恢复，尽管在上升网状激活系统基因座和特定的丘脑核团之间出现了更大的恢复，这些核团被认为参与促进和维持觉醒。第二天功能连接完全恢复到基线水平。结论在全身麻醉下，皮质下的功能连接受到严格的限制和偏侧化。这一限制可能在意识丧失和恢复的过程中发挥作用。
BackgroundArousal and awareness are two important components of consciousness states. Functional neuroimaging has furthered our understanding of cortical and thalamocortical mechanisms of awareness. Investigating the relationship between subcortical functional connectivity and arousal has been challenging owing to the relatively small size of brainstem structures and thalamic nuclei, and their depth in the brain.MethodsResting state functional MRI scans of 72 healthy volunteers were acquired before, during, 1 h after, and 1 day after sevoflurane general anaesthesia. Functional connectivity of subcortical regions of interestvswhole brain and homotopic functional connectivity for assessment of left–right symmetry analyses of both cortical and subcortical regions of interest were performed. Both analyses used high resolution atlases generated from deep brain stimulation applications.ResultsFunctional connectivity in subcortical loci within the thalamus and of the ascending reticular activating system was sharply restricted under anaesthesia, featuring a general lateralisation of connectivity. Similarly, left–right homology was sharply reduced under anaesthesia. Subcortical bilateral functional connectivity was not fully restored after emergence from anaesthesia, although greater restoration was seen between ascending reticular activating system loci and specific thalamic nuclei thought to be involved in promoting and maintaining arousal. Functional connectivity was fully restored to baseline by the following day.ConclusionsFunctional connectivity in the subcortex is sharply restricted and lateralised under general anaesthesia. This restriction may play a part in loss and return of consciousness.Clinical trial registrationNCT02275026.