Multimodal Functional Imaging of Auditory Perception Under General Anesthesia

全身麻醉下听觉感知的多模态功能成像

• 批准号: 7320053
• 负责人: Patrick L. Purdon
• 金额: $ 17.7万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7320053
• 关键词: Adverse effects; Anesthesia procedures; Anesthetics; Anxiety; Area; Auditory; Auditory Evoked Potentials; Auditory Perception; Auditory system; Award; Awareness; Biomedical Research; Brain; Brain region; Clinic; Clinical; Clinical Pharmacology; Clinical assessments; Conscious; Daily; Depth; Dose; Dreams; Drug Monitoring; Electroencephalogram; Event; Event-Related Potentials; Functional Imaging; Functional Magnetic Resonance Imaging; General Anesthesia; Goals; Hearing; K-Series Research Career Programs; Knowledge; Light; Measures; Mediating; Medical; Medicine; Memory; Mentors; Methods; Modern Medicine; Monitor; Morbidity - disease rate; Multimodal Imaging; NIH Program Announcements; Nausea and Vomiting; Neuraxis; Neurobiology; Neurosciences; Nightmare; Operative Surgical Procedures; Parietal; Patients; Pattern; Perception; Pharmaceutical Preparations; Pharmacodynamics; Physiological; Post-Traumatic Stress Disorders; Postoperative Period; Problem Solving; Process; Process Measure; Propofol; Range; Research; Research Personnel; Research Project Grants; Rest; Safety; Sedation procedure; Site; Sleep disturbances; Slow-Wave Sleep; Stereotyping; Stimulus; Structure; System; Training; Unconscious Personality Factor; Unconscious State; Ventilatory Depression; Work; base; career; day; heart rhythm; improved; neurophysiology; programs; response; sound

DESCRIPTION (provided by applicant): A fundamental problem in neuroscience and medicine is to understand the mechanisms of general anesthesia. This proposal, "Multimodal Functional Imaging of Auditory Perception Under General Anesthesia", is submitted in response to the NINDS program announcement for Mentored Quantitative Research Career Development Awards (K25). The candidate seeks to gain training in the neurobiology and clinical pharmacology of anesthesia in order to apply multimodal functional imaging methods to the study of the mechanisms of general anesthesia. Loss of consciousness under general anesthesia is measured clinically by observing the loss of response to external stimuli. However, auditory perception and memory are possible in patients who are clinically unconscious, which may result in post-operative recall of events during anesthesia. Consequences of post-operative recall include sleep disturbances, dreams, nightmares, flashbacks and anxiety, as well as post-traumatic stress disorder. Clinical anesthetic brain monitors are based on empirical relationships between stereotyped anesthesia-related electroencephalographic (EEG) patterns and clinical assessments of patient awareness, but cannot measure activity within functional brain regions responsible for auditory perception under anesthesia. The goal of this project is to characterize anesthesia-induced changes of function in the auditory system using simultaneous EEG and fMRI. FMRI responses to perception of sound temporal envelope will be measured at varying levels of propofol anesthesia, ranging from light sedation to deep anesthesia, with simultaneous EEG. Changes in auditory perceptual processing measured with fMRI will be related to clinical level of consciousness, propofol drug levels, and anesthesia-related EEG patterns. These studies will provide a means to quantify the amount of perceptual processing that occurs after anesthesia-induced loss of consciousness, as well as the EEG patterns that correlate with loss of perceptual processing. Through this research project, as well as didactic courses and tutorials, the candidate will be trained in the neurobiology and clinical pharmacology of anesthesia. The training provided by this Award will help the candidate achieve the long-term career goal of leading an independent biomedical research program to study the systems neuroscience of anesthesia. General anesthesia is administered to over 50,000 patients daily for medical and surgical procedures, but its basic brain mechanisms are not known. Despite safety improvements, anesthesia results in serious side effects such as cardio-respiratory depression or post-operative recall. Through these studies, we hope to begin developing the fundamental neuroscience knowledge necessary to improve anesthetic drugs and monitoring, and to one day solve the problem of anesthesia-related morbidity.

描述（由申请人提供）：神经科学和医学的一个基本问题是了解全身麻醉的机制。本提案“全麻下听觉感知的多模态功能成像”是为了响应NINDS指导定量研究职业发展奖（K25）的计划公告而提交的。候选人寻求获得麻醉的神经生物学和临床药理学方面的培训，以便将多模式功能成像方法应用于全身麻醉机制的研究。全身麻醉下的意识丧失在临床上通过观察对外部刺激的反应丧失来测量。然而，听觉感知和记忆在临床无意识的患者中是可能的，这可能导致麻醉期间的事件的术后回忆。术后回忆的后果包括睡眠障碍、做梦、噩梦、闪回和焦虑，以及创伤后应激障碍。临床麻醉脑监测器基于刻板的麻醉相关脑电图（EEG）模式和患者意识的临床评估之间的经验关系，但不能测量负责麻醉下听觉感知的功能性脑区域内的活动。本项目的目标是使用同步EEG和fMRI来表征麻醉诱导的听觉系统功能变化。将在不同水平的丙泊酚麻醉（从轻度镇静到深度麻醉）下测量FMRI对声音时间包络感知的反应，同时进行EEG。用fMRI测量的听觉感知处理的变化将与临床意识水平、丙泊酚药物水平和麻醉相关的EEG模式相关。这些研究将提供一种方法来量化麻醉诱导的意识丧失后发生的感知处理量，以及与感知处理丧失相关的EEG模式。通过这个研究项目，以及教学课程和辅导，候选人将接受麻醉的神经生物学和临床药理学培训。该奖项提供的培训将帮助候选人实现领导一个独立的生物医学研究项目的长期职业目标，以研究麻醉的系统神经科学。全身麻醉每天用于超过50，000名患者的医疗和外科手术，但其基本的大脑机制尚不清楚。尽管安全性有所改善，但麻醉会导致严重的副作用，如心肺抑制或术后回忆。通过这些研究，我们希望开始发展必要的基础神经科学知识，以改善麻醉药物和监测，并有一天解决麻醉相关的发病率问题。