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Lack of Responsiveness during the Onset and Offset of Sevoflurane Anesthesia Is Associated with Decreased Awake-Alpha Oscillation Power

Author(s)
Pavone, Kara J.; Su, Lijuan; Gao, Lei; Eromo, Ersne; Vazquez, Rafael; Rhee, James; Hobbs, Lauren E.; Ibala, Reine; Demircioglu, Gizem; Purdon, Patrick L.; Akeju, Oluwaseun; Brown, Emery Neal; ... Show more Show less
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Abstract
Anesthetic drugs are typically administered to induce altered states of arousal that range from sedation to general anesthesia (GA). Systems neuroscience studies are currently being used to investigate the neural circuit mechanisms of anesthesia-induced altered arousal states. These studies suggest that by disrupting the oscillatory dynamics that are associated with arousal states, anesthesia-induced oscillations are a putative mechanism through which anesthetic drugs produce altered states of arousal. However, an empirical clinical observation is that even at relatively stable anesthetic doses, patients are sometimes intermittently responsive to verbal commands during states of light sedation. During these periods, prominent anesthesia-induced neural oscillations such as slow-delta (0.1–4 Hz) oscillations are notably absent. Neural correlates of intermittent responsiveness during light sedation have been insufficiently investigated. A principled understanding of the neural correlates of intermittent responsiveness may fundamentally advance our understanding of neural dynamics that are essential for maintaining arousal states, and how they are disrupted by anesthetics. Therefore, we performed a high-density (128 channels) electroencephalogram (EEG) study (n = 8) of sevoflurane-induced altered arousal in healthy volunteers. We administered temporally precise behavioral stimuli every 5 s to assess responsiveness. Here, we show that decreased eyes-closed, awake-alpha (8–12 Hz) oscillation power is associated with lack of responsiveness during sevoflurane effect-onset and -offset. We also show that anteriorization—the transition from occipitally dominant awake-alpha oscillations to frontally dominant anesthesia induced-alpha oscillations—is not a binary phenomenon. Rather, we suggest that periods, which were defined by lack of responsiveness, represent an intermediate brain state. We conclude that awake-alpha oscillation, previously thought to be an idling rhythm, is associated with responsiveness to behavioral stimuli.
Date issued
2017-05
URI
http://hdl.handle.net/1721.1/112114
Department
Massachusetts Institute of Technology. Institute for Medical Engineering & Science; Harvard University--MIT Division of Health Sciences and Technology; Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences
Journal
Frontiers in Systems Neuroscience
Publisher
Frontiers Research Foundation
Citation
Pavone, Kara J. et al. “Lack of Responsiveness During the Onset and Offset of Sevoflurane Anesthesia Is Associated with Decreased Awake-Alpha Oscillation Power.” Frontiers in Systems Neuroscience 11 (May 2017) © 2017 Pavone, Su et al
Version: Final published version
ISSN
1662-5137

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