Effect of propofol anaesthesia on the event-related potential mismatch negativity and the auditory-evoked potential N1

Simpson, Tom; Manara, Alex; Kane, Nick; Barton, Robert L.; Rowlands, C.A.; Butler, S.R.

doi:10.1093/bja/89.3.382

Cited by 38 publications

(19 citation statements)

References 19 publications

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“…ERPs have exhibited graded changes with increasing doses of sedative drugs in volunteers and surgical patients [6,7], but to date no parallel studies have been conducted in severely ill patients. We assessed ERPs together with EEG parameters in a heterogeneous group of intensive care patients under sedation with propofol.…”

Section: Discussionmentioning

confidence: 99%

“…ERPs have exhibited graded changes with increasing doses of sedative drugs in volunteers and surgical patients [6,7], but to date only few data are available concerning the use of ERPs for monitoring sedation level in the ICU. Despite the known superiority of ERP parameters over EEG parameters for monitoring sedation level, in this preliminary pilot study we hypothesized that both ERPs and EEG may be used to assess the level of sedation in a heterogeneous group of neurologically intact intensive care patients.…”

Section: Introductionmentioning

confidence: 99%

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Introduction In this observational pilot study we evaluated the electroencephalogram (EEG) and auditory event-related potentials (ERPs) before and after discontinuation of propofol sedation in neurologically intact intensive care patients. Methods Nineteen intensive care unit patients received a propofol infusion in accordance with a sedation protocol. The EEG signal and the ERPs were measured at the frontal region (Fz) and central region (Cz), both during propofol sedation and after cessation of infusion when the sedative effects had subsided. The EEG signal was subjected to power spectral estimation, and the total root mean squared power and spectral edge frequency 95% were computed. For ERPs, we used an oddball paradigm to obtain the N100 and the mismatch negativity components. Results Despite considerable individual variability, the root mean squared power at Cz and Fz (P = 0.004 and P = 0.005, respectively) and the amplitude of the N100 component in response to the standard stimulus at Fz (P = 0.022) increased significantly after interruption to sedation. The amplitude of the N100 component (at Cz and Fz) was the only parameter that differed between sedation levels during propofol sedation (deep versus moderate versus light sedation: P = 0.016 and P = 0.008 for Cz and Fz, respectively). None of the computed parameters correlated with duration of propofol infusion. Conclusion Our findings suggest that use of ERPs, especially the N100 potential, may help to differentiate between levels of sedation. Thus, they may represent a useful complement to clinical sedation scales in the monitoring of sedation status over time in a heterogeneous group of neurologically intact intensive care patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“…This is particularly true if one sub-categorizes stage 1 into responsive and non-responsive portions [243]. The MMN is equally sensitive to transitions between wakefulness and sedation under anaesthesia in that it is completely abolished during or even prior to behavioural unconsciousness [242,246]; even under light anaesthesia its amplitude is drastically reduced [244,247]. The situation is a bit more complicated in the disorders-of-consciousness literature, where the MMN has been observed during states of behavioural unconsciousness, although the inter-individual variability typical of evoked responses may partially explain the discrepancy across studies.…”

Section: Auditory Markers Of States/levels Of Consciousnessmentioning

confidence: 99%

A roadmap for the study of conscious audition and its neural basis

Dykstra

Cariani

Gutschalk

2017

Phil. Trans. R. Soc. B

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One contribution of 15 to a theme issue 'Auditory and visual scene analysis'. Subject Areas: cognition, neuroscience, behaviourKeywords: audition, auditory scene analysis, conscious perception, neural correlates of consciousness, perceptual awareness Author for correspondence: Andrew R. Dykstra e-mail: andrew.dykstra@med.uni-heidelberg.de A roadmap for the study of conscious audition and its neural basis Andrew R. Dykstra 1 , Peter A. Cariani 2 and Alexander Gutschalk 1 1 Department of Neurology, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany 2 Hearing Research Center, Boston University, Boston, MA, USA ARD, 0000-0001-8075-6374How and which aspects of neural activity give rise to subjective perceptual experience-i.e. conscious perception-is a fundamental question of neuroscience. To date, the vast majority of work concerning this question has come from vision, raising the issue of generalizability of prominent resulting theories. However, recent work has begun to shed light on the neural processes subserving conscious perception in other modalities, particularly audition. Here, we outline a roadmap for the future study of conscious auditory perception and its neural basis, paying particular attention to how conscious perception emerges (and of which elements or groups of elements) in complex auditory scenes. We begin by discussing the functional role of the auditory system, particularly as it pertains to conscious perception. Next, we ask: what are the phenomena that need to be explained by a theory of conscious auditory perception? After surveying the available literature for candidate neural correlates, we end by considering the implications that such results have for a general theory of conscious perception as well as prominent outstanding questions and what approaches/techniques can best be used to address them.This article is part of the themed issue 'Auditory and visual scene analysis'. IntroductionHow subjective perceptual experience-i.e. conscious perception-emerges from patterns of brain activity is a fundamental question of modern neuroscience. Although relationships between neural activity and conscious perception have been pondered since the beginning of the mind-brain sciences [1][2][3][4][5][6], many have viewed the problem as scientifically intractable. However, employing increasingly powerful methods [7], recent years have seen a dramatic increase in studies pursuing the so-called neural correlates of consciousness, or NCC [8], defined as the 'the minimal set of neural events jointly sufficient for a specific conscious experience' [9] (e.g. the phenomenal experience of hearing a sound). This definition, in contrast with others that distinguish between the NCC and the NCCC (neural correlates of the contents of consciousness), subsumes both the 'preconditions' and content-specific processes associated with specific conscious percepts [10], acknowledging that all conscious experiences have content (though varying in richness [11,12], an idea also underscored by early auditory selective-a...

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“…Propofol, an agent used for induction and maintenance of general anesthesia, affects cortical activity evoked by auditory stimuli (Plourde, 1996; Schwender et al, 1997; Dutton et al, 1999; Simpson et al, 2002; Heinke et al, 2004; Dueck et al, 2005; Scheller et al, 2005; Plourde et al, 2006; Davis et al, 2007), likely by modulating GABA A receptors (Bai et al, 1999; Rudolph and Antkowiak, 2004; Franks, 2008) and reducing glutamate release (Ratnakumari and Hemmings, 1997; Yang et al, 2015). Evidence suggests that during induction of anesthesia, external sensory stimuli activate the cortex but fail to be experienced (Amzica et al, 2002; Velly et al, 2007; Murphy et al, 2011; Schrouff et al, 2011; Boly et al, 2012; Schroter et al, 2012; Jordan et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Electrocorticographic delineation of human auditory cortical fields based on effects of propofol anesthesia

et al. 2017

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The functional organization of human auditory cortex remains incompletely characterized. While the posteromedial two thirds of Heschl’s gyrus (HG) is generally considered to be part of core auditory cortex, additional subdivisions of HG remain speculative. To further delineate the hierarchical organization of human auditory cortex, we investigated regional heterogeneity in the modulation of auditory cortical responses under varying depths of anesthesia induced by propofol. Non-invasive studies have shown that propofol differentially affects auditory cortical activity, with a greater impact on non-core areas. Subjects were neurosurgical patients undergoing removal of intracranial electrodes placed to identify epileptic foci. Stimuli were 50 Hz click trains, presented continuously during an awake baseline period, and subsequently, while propofol infusion was incrementally titrated to induce general anesthesia. Electrocorticographic recordings were made with depth electrodes implanted in HG and subdural grid electrodes implanted over superior temporal gyrus (STG). Depth of anesthesia was monitored using spectral entropy. Averaged evoked potentials (AEPs), frequency-following responses (FFRs) and high gamma (70–150 Hz) event-related band power (ERBP) were used to characterize auditory cortical activity. Based on the changes in AEPs and FFRs during the induction of anesthesia, posteromedial HG could be divided into two subdivisions. In the most posteromedial aspect of the gyrus, the earliest AEP deflections were preserved and FFRs increased during induction. In contrast, the remainder of the posteromedial HG exhibited attenuation of both the AEP and the FFR. The anterolateral HG exhibited weaker activation characterized by broad, low-voltage AEPs and the absence of FFRs. Lateral STG exhibited limited activation by click trains, and FFRs there diminished during induction. Sustained high gamma activity was attenuated in the most posteromedial portion of HG, and was absent in all other regions. These differential patterns of auditory cortical activity during the induction of anesthesia may serve as useful physiological markers for field delineation. In this study, the posteromedial HG could be parcellated into at least two subdivisions. Preservation of the earliest AEP deflections and FFRs in the posteromedial HG likely reflects the persistence of feedforward synaptic activity generated by inputs from subcortical auditory pathways, including the medial geniculate nucleus.

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Effect of propofol anaesthesia on the event-related potential mismatch negativity and the auditory-evoked potential N1

Abstract: MMN is unlikely to be a clinically useful tool to detect awareness in surgical patients. In contrast, the loss of N1 may identify the transition from consciousness to unconsciousness and deserves further study.

Cited by 38 publications

References 19 publications

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A roadmap for the study of conscious audition and its neural basis

Electrocorticographic delineation of human auditory cortical fields based on effects of propofol anesthesia

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