Functional Magnetic Resonance Imaging (fMRI) in Children Sedated With Propofol or Midazolam
Functional Magnetic Resonance Imaging (fMRI) in Children Sedated With Propofol or Midazolam
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DOI：
10.1097/ana.0b013e3181a7181d
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发表时间：
2009-07-01
影响因子：
3.7
通讯作者：
Beretta, Luigi
中科院分区：
文献类型：
--
作者：
Gemma, Marco;de Vitis, Assunta;Beretta, Luigi
磁共振成像（MRI）需要患者不动，儿童通常需要镇静。理想的镇静剂的功能磁共振成像（FMRI）应该只有最低限度地阻碍神经生理效应的感觉刺激。本研究比较了异丙酚和咪达唑仑对儿童fMRI听觉激活模式的影响。14名3 ~ 7岁无神经或听觉障碍的儿童随机分为两组，分别接受异丙酚或咪达唑仑镇静。咪达唑仑组2例患者因基线MRI阳性而被排除。孩子们被刺激使用被动的听力任务。使用各种函数（血流动力学响应函数、时间导数和色散导数）对fMRI信号进行建模，以检查各组之间信号的不同时间特性。异丙酚组的患者仅在初级听觉皮层显示激活，并且表现出与非镇静成年人更相似的模式。咪达唑仑组的患者表现出更复杂的模式，呈现除初级听觉皮层以外的激活区域;还观察到功能反应延迟和持续时间变异性较高。我们的样本量太小，无法得出结论性的结论。我们的初步研究鼓励这样的假设，即异丙酚是最好的咪达唑仑，以维持镇静，在3至7岁的儿童在听觉功能磁共振成像，因为它有助于激发一个更集中的听觉皮层激活模式，时间和空间的分散性较小。
Magnetic resonance imaging (MRI) requires patient immobility and children generally need to be sedated. The ideal sedative agent for functional MRI (FMRI) Should only minimally hamper the neurophysiologic effect of the administered sensorial stimulation. This study compares the effect of propofol and midazolam on the fMRI auditory activation pattern in children. Fourteen children in the 3 to 7 year age group Without neurologic or auditory deficits were randomly assigned to receive propofol or midazolam for sedation during auditory fMRI. Two patients in the midazolam group were excluded due to positive baseline MRIs. The children were stimulated using a passive listening task. The fMRI signal was modeled using various functions (hemodynamic response function, temporal derivative, and dispersion derivative) to check for the differing temporal characteristics of the signal between the groups. Patients in the propofol group showed activation only in the primary auditory cortex and exhibited a pattern more similar to that of nonsedated adults. Patients in the midazolam group exhibited a more complex pattern, presenting activation areas other than the primary auditory cortex; a delay in the functional response and higher duration variability were also observed. Our sample sizes are too small to derive a Conclusive inference. Our preliminary Study encourages the hypothesis that propofol is preferable to midazolam to maintain sedation in 3 to 7-year-old children during auditory fMRI because it facilitates the elicitation of a more focused auditory cortical activation pattern with less temporal and spatial dispersion.