Simultaneous Electroencephalography and Functional Magnetic Resonance Imaging of General Anesthesia

Purdon, Patrick L.; Pierce, Eric T.; Bonmassar, Giorgio; Walsh, J.; Harrell, P. Grace; Kwo, Jean; Deschler, Daniel G.; Barlow, Margaret A.; Merhar, Rebecca C.; Lamus, Camilo; Mullaly, Catherine M.; Sullivan, Mary Pat; Maginnis, Sharon; Skoniecki, Debra; Higgins, Helen-Anne; Brown, Emery N.

doi:10.1111/j.1749-6632.2008.04119.x

Cited by 44 publications

(39 citation statements)

References 48 publications

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“…It is clear that the neural processes involved in cognitive functions cannot be studied under deep general anaesthesia; human brain activations induced by noxious, auditory or visual stimulations decrease in a dose-dependent manner after analgesia by ketamine (Rogers et al 2004), and after sedation by propofol (Plourde et al 2006, Purdon et al 2009). In these studies, the authors described a decrease in BOLD in certain regions, but not in the primary cortical areas.…”

Section: Pratical Issues Anaesthesia and Immobilization Of Animalsmentioning

confidence: 99%

MRI Techniques and New Animal Models for Imaging the Brain

Chaillou¹,

Tillet²,

Andersson³

2012

When Things Go Wrong - Diseases and Disorders of the Human Brain

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Section: Pratical Issues Anaesthesia and Immobilization Of Animalsmentioning

confidence: 99%

MRI Techniques and New Animal Models for Imaging the Brain

Chaillou¹,

Tillet²,

Andersson³

2012

When Things Go Wrong - Diseases and Disorders of the Human Brain

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“…These recordings were collected as part of a larger study on the electrophysiological and behavioral effects of propofol general anesthesia (18). Fig.…”

Section: Additional Data and Constraintsmentioning

confidence: 99%

A neurophysiological–metabolic model for burst suppression

Ching

Purdon

Vijayan

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

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249

326

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Burst suppression is an electroencepholagram (EEG) pattern in which high-voltage activity alternates with isoelectric quiescence. It is characteristic of an inactivated brain and is commonly observed at deep levels of general anesthesia, hypothermia, and in pathological conditions such as coma and early infantile encephalopathy. We propose a unifying mechanism for burst suppression that accounts for all of these conditions. By constructing a biophysical computational model, we show how the prevailing features of burst suppression may arise through the interaction between neuronal dynamics and brain metabolism. In each condition, the model suggests that a decrease in cerebral metabolic rate, coupled with the stabilizing properties of ATP-gated potassium channels, leads to the characteristic epochs of suppression. Consequently, the model makes a number of specific predictions of experimental and clinical relevance.B urst suppression-an electroencephalogram (EEG) pattern in which high voltage activity (burst) and flatline (suppression) periods alternate systematically but quasiperiodically (almost periodic but with variations in inter-and intra-burst duration) (1)-is a state of profound brain inactivation. It is frequently observed in deep general anesthesia (2). It is also observed in a range of pathological conditions including hypothermia (3-5), hypoxic-ischemic trauma/coma (6), and the so-called Ohtahara syndrome (7,8), a type of early infantile encephalopathy. These etiologies indicate that the burst suppression pattern represents a low-order dynamic mechanism that persists in the absence of higher-level brain activity. Indeed, the fact that many different conditions produce similar brain activity suggests that there may be a common pathway to the state of brain inactivation and may indicate fundamental properties of the brain's arousal circuits (2).The basic features of the burst suppression phenomenon have been established through a variety of EEG studies that are reviewed in ref. 9. The two most notable of these features are the spatial homogeneity of bursts and the quasi-periodic nature of the suppression. Later research has been directed at describing the phenomenon in vivo and in the specific context of general anesthesia. In particular, the early work of Steriade et al. (10) helped establish the neural correlates of burst suppression, including the differential participation of cortical and subcortical cell types. More recent studies (11,12) have suggested that burst suppression is associated with enhanced excitability in cortical networks. These studies implicate extracellular calcium as a correlate for the switches between burst and suppression.Despite the findings of these studies, a unifying mechanism for burst suppression-one that explains its prevailing features and also accounts for its range of etiologies-has not been proposed. Indeed, the existing characterizations of burst suppression in pathological situations are highly limited. Computational models offer a means of synthesizing the availabl...

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“…Beyond the potentially highly phenotyped standardised preoperative workup, the serial sampling of tissue (including blood, 61 muscle, 62 wound 63,64 and indwelling catheters 65 ) coupled with advanced non-invasive imaging modalities 66,67 afford increasingly sophisticated readouts referenced to an individual's own control data.…”

Section: Timing Is Everything: Serial Accessibility Of Tissue and Phymentioning

confidence: 99%

Man is the new mouse: Elective surgery as a key translational model for multi-organ dysfunction and sepsis

Cain

Arroyo

Ackland

2015

Journal of the Intensive Care Society

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Translational research in critically ill human patients presents many methodological challenges. Diagnostic uncertainty, coupled with poorly defined comorbidities, make the identification of a suitable control population for case-control investigations an arguably insurmountable challenge. Healthy volunteer experiments using endotoxin infusion as an inflammatory model are methodologically robust, but fail to replicate the onset of, and diverse therapeutic interventions associated with, sepsis/trauma. Animal models are also limited by many of these issues. Major elective surgery addresses many of these shortfalls and offers a key model for exploring the human biology underlying the sepsis syndrome. Surgery triggers highly conserved features of the human inflammatory response that are common to both tissue damage and infection. Surgical patients sustain a predictable and relatively high incidence of sepsis, particularly within the 'higher risk' group. The collection of preoperative samples enables each patient to act as their own control. Thus, the surgical model offers unique and elegant experimental design features that provide an important translational bridge between the basic biological understanding afforded by animal laboratory models and the de novo presentation of human sepsis.

show abstract

Simultaneous Electroencephalography and Functional Magnetic Resonance Imaging of General Anesthesia

Cited by 44 publications

References 48 publications

MRI Techniques and New Animal Models for Imaging the Brain

MRI Techniques and New Animal Models for Imaging the Brain

A neurophysiological–metabolic model for burst suppression

Man is the new mouse: Elective surgery as a key translational model for multi-organ dysfunction and sepsis

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