Neural Correlates of Sevoflurane-induced Unconsciousness Identified by Simultaneous Functional Magnetic Resonance Imaging and Electroencephalography.
Neural Correlates of Sevoflurane-induced Unconsciousness Identified by Simultaneous Functional Magnetic Resonance Imaging and Electroencephalography.
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DOI：
10.1097/aln.0000000000001322
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发表时间：
2016-11
期刊：
影响因子：
8.8
通讯作者：
Ilg R
中科院分区：
文献类型：
--
作者：
Ranft A;Golkowski D;Kiel T;Riedl V;Kohl P;Rohrer G;Pientka J;Berger S;Thul A;Maurer M;Preibisch C;Zimmer C;Mashour GA;Kochs EF;Jordan D;Ilg R
麻醉剂诱导的意识丧失的神经关联尚未完全阐明。异丙酚诱导的镇静和麻醉状态已被广泛研究，一致显示额顶叶和丘脑皮质的连接性降低。然而，人们对卤代醚对大脑功能网络的影响知之甚少。我们记录了16名人工呼吸志愿者在七氟醚麻醉时的静息功能磁共振成像(FMRI)和脑电图，分别记录了七氟醚镇静状态下的3%(VOL%)和2 VOL%稳态浓度(700%S)，以评估清醒状态下功能连接性的变化。使用符号传递熵(信息传递的替代物)和排列熵(皮层信息处理的替代物)对脑电数据进行分析。通过独立成分(ICA)和基于感兴趣区(ROI)的分析对fMRI数据进行分析。脑电分析显示前后符号传递熵和全局排列熵显着降低。当七氟醚浓度为2Vol%时，ICA确定的额叶和丘脑网络的连通性显著降低。初级感觉网络无明显变化。在猝发抑制时，所有皮质网络的功能连接性都显著降低。以ROI为基础的丘脑连通性在2VOL%时显著降低到额顶和后扣带回皮质，但没有减少到感觉区域。七氟醚降低了额叶和丘脑皮质的连接性。BOLD连接的变化与前后定向连接的减少和皮质信息处理的减少是一致的。这些数据促进了对七氟醚引起的意识丧失的理解，并有助于脑电测量的神经基础，为术中麻醉监测提供了希望。
The neural correlates of anesthetic-induced unconsciousness have yet to be fully elucidated. Sedative and anesthetic states induced by propofol have been studied extensively, consistently revealing a decrease of frontoparietal and thalamocortical connectivity. There is, however, less understanding of the effects of halogenated ethers on functional brain networks. We recorded simultaneous resting-state functional magnetic resonance imaging (fMRI) and electroencephalography in 16 artificially ventilated volunteers during sevoflurane anesthesia at burst suppression, 3 volume % (vol%) and 2 vol% steady-state concentrations for 700 s each to assess functional connectivity changes compared to wakefulness. Electroencephalographic data were analyzed using symbolic transfer entropy (surrogate of information transfer) and permutation entropy (surrogate of cortical information processing). fMRI data were analyzed by an independent components (ICA) and a region-of-interest-based (ROI-based) analysis. Electroencephalographic analysis showed a significant reduction of anterior-to-posterior symbolic transfer entropy and global permutation entropy. At 2 vol% sevoflurane concentrations, frontal and thalamic networks identified by ICA showed significantly reduced within-network connectivity. Primary sensory networks did not show a significant change. At burst suppression, all cortical networks showed significantly reduced functional connectivity. ROI-based thalamic connectivity at 2 vol% was significantly reduced to frontoparietal and posterior cingulate cortices but not to sensory areas. Sevoflurane decreased frontal and thalamocortical connectivity. The changes in BOLD connectivity were consistent with reduced anterior-to-posterior directed connectivity and reduced cortical information processing. These data advance the understanding of sevoflurane-induced unconsciousness and contribute to a neural basis of electroencephalographic measures that hold promise for intraoperative anesthesia monitoring.