Consciousness, Anesthesia, and Acetylcholine.
Consciousness, Anesthesia, and Acetylcholine.
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DOI：
10.1097/aln.0000000000003696
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发表时间：
2021-04-01
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：
Pal D;Mashour GA
Although the precise neural correlates of consciousness have not yet been identified, there is one neurochemical marker that appears to track with our capacity to experience something: acetylcholine concentration in the cerebral cortex. Cortical acetylcholine concentration is high during wakefulness, decreases during slow-wave sleep, and increases again during rapid eye movement sleep, when we can have the conscious experience of dreaming. 1 Based on the neuropharmacology of the particular anesthetic drug we might choose, the state of general anesthesia shows parallel changes. For example, effects of the GABAergic anesthetics propofol and sevoflurane are similar to slow-wave sleep and include low acetylcholine concentration, slower electroencephalographic frequency, and a low probability of experience2, 3 By contrast, effects of the non-GABAergic anesthetics ketamine and nitrous oxide are similar to rapid eye movement sleep and include high acetylcholine concentration, faster electroencephalographic frequency, and a higher probability of experience in the form of dreams or hallucinations. 2, 4 In both humans5, 6 and rodent models, 7, 8 interventions that raise acetylcholine concentration in the brain are associated with a reversal of anesthetic traits or a reduction in anesthetic potency. Conversely, lesions of cholinergic neurons in the basal forebrain—the main source of acetylcholine for the cortex—reduce anesthetic requirements for commonly used drugs such as isoflurane and propofol.
