Human mediotemporal EEG characteristics during propofol anesthesia

The impact of body posture on intrinsic brain activity: The role of beta power at rest

Tying the hands behind the back has detrimental effects on sensorimotor perceptual tasks. Here we provide evidence that beta band oscillatory activity in a resting state condition might play a crucial role in such detrimental effects. EEG activity at rest was measured from thirty young participants (mean age = 24.03) in two different body posture conditions. In one condition participants were required to keep their hands freely resting on the table. In the other condition, participants' hands were tied behind their back. Increased beta power was observed in the left inferior frontal gyrus during the tied hands condition compared to the free hands condition. A control experiment ruled out alternative explanations for observed change in beta power, including muscle tension. Our findings provide new insights on how body postural manipulations impact on perceptual tasks and brain activity.

Spectral and phase-amplitude coupling signatures in human deep brain oscillations during propofol-induced anaesthesia

BACKGROUND

Both the cerebral cortex and subcortical structures play important roles in consciousness. Some evidence points to general anaesthesia-induced unconsciousness being associated with distinct patterns of superficial cortical electrophysiological oscillations, but how general anaesthetics influence deep brain neural oscillations and interactions between oscillations in humans is poorly understood.

METHODS

Local field potentials were recorded in discrete deep brain regions, including anterior cingulate cortex, sensory thalamus, and periaqueductal grey, in humans with implanted deep brain electrodes during induction of unconsciousness with propofol. Power-frequency spectra, phase-amplitude coupling, coherence, and directed functional connectivity analysis were used to characterise local field potentials in the awake and unconscious states.

RESULTS

An increase in alpha (7-13 Hz) power and decrease in gamma (30-90 Hz) power were observed in both deep cortical (ACC, anterior cingulate cortex) and subcortical (sensory thalamus, periaqueductal grey) areas during propofol-induced unconsciousness. Robust alpha-low gamma (30-60 Hz) phase-amplitude coupling induced by general anaesthesia was observed in the anterior cingulate cortex but not in other regions studied. Moreover, alpha oscillations during unconsciousness were highly coherent within the anterior cingulate cortex, and this rhythm exhibited a bidirectional information flow between left and right anterior cingulate cortex but stronger left-to-right flow.

CONCLUSION

Propofol increases alpha oscillations and attenuates gamma oscillations in both cortical and subcortical areas. The alpha-gamma phase-amplitude coupling and the functional connectivity of alpha oscillations in the anterior cingulate cortex could be specific markers for loss of consciousness.

The sensory thalamus and cerebral motor cortex are affected concurrently during induction of anesthesia with propofol: a case series with intracranial electroencephalogram recordings

PURPOSE

Brain imaging studies suggest that loss of consciousness induced by general anesthetics is associated with impairment of thalamic function. There is, however, limited information on the time course of these changes. We recently obtained intracranial electroencephalogram (EEG) recordings from the ventroposterolateral (VPL) nucleus of the thalamus and from the motor cortex during induction of anesthesia in three patients to study the time course of the alterations of cortical and thalamic function.

CLINICAL FEATURES

The patients were American Society of Anesthesiologists physical status I-II males aged 33-57 yr with intractable central pain caused by brachial plexus injury (patient 1 and 2) or insular infarct (patient 3). Anesthesia was induced with propofol (2.5-3.1 mg·kg(-1) over 30-45 sec) followed, after loss of consciousness, by rocuronium for tracheal intubation. The data retained for analysis are from one minute before the start of propofol to 110 sec later during ventilation of the patients' lungs before tracheal intubation. Spectral analysis was used to measure absolute EEG power. Propofol caused significant increases of cortical and thalamic power in the delta to beta frequency bands (1-30 Hz). These increases of cortical and thalamic power occurred either concomitantly or within seconds of each other. Propofol also caused a decrease in cortical and thalamic high-gamma (62-200 Hz) power that also followed a similar time course.

CONCLUSION

We conclude that induction of anesthesia with propofol in these patients was associated with concurrent alterations of cortical and sensory thalamic activity.

Differential effects of isoflurane on high-frequency and low-frequency γ oscillations in the cerebral cortex and hippocampus in freely moving rats

BACKGROUND

Cortical γ oscillations are thought to play a role in conscious cognitive functions. Suppression of 40-Hz γ activity was implicated in the loss of consciousness during general anesthesia. However, several experimental studies found that γ oscillations were preserved in anesthesia. The authors investigated the concentration-dependent effect of isoflurane on spontaneous γ oscillations in two frequency bands and three distinct brain regions in the rat.

METHODS

Adult Sprague-Dawley rats were chronically implanted with epidural and coaxial depth electrodes to record cortical field potentials in frontal cortex, visual cortex, and hippocampus in waking and at steady-state isoflurane concentrations of 0.4, 0.8, and 1.2%. The γ power was calculated for the frequency bands 30-50 and 70-140 Hz. Temporal variation and interregional synchrony of γ activity were analyzed using wavelet transform. Loss of consciousness was indexed by the loss of righting reflex.

RESULTS

Rats lost their righting reflex at 0.8 ± 0.1% isoflurane. High-frequency γ power was decreased by isoflurane in a concentration-dependent manner (P < 0.001, 50% decrease at 0.8% isoflurane) in all brain regions. Low-frequency γ power was unaffected by isoflurane. The duration and interregional synchrony of high-frequency γ bursts was also reduced (P l < 0.001, 40% decrease at 0.8% isoflurane).

CONCLUSIONS

Distinction between high- and low-frequency γ bands is important when evaluating the effect of general anesthetics on brain electrical activity. Spontaneous 40-Hz γ power does not indicate the state of consciousness. The attenuation and interregional desynchronization of high-frequency γ oscillations appear to correlate with the loss of consciousness.

Effects of the anesthetic agent propofol on neural populations

The neuronal mechanisms of general anesthesia are still poorly understood. Besides several characteristic features of anesthesia observed in experiments, a prominent effect is the bi-phasic change of power in the observed electroencephalogram (EEG), i.e. the initial increase and subsequent decrease of the EEG-power in several frequency bands while increasing the concentration of the anaesthetic agent. The present work aims to derive analytical conditions for this bi-phasic spectral behavior by the study of a neural population model. This model describes mathematically the effective membrane potential and involves excitatory and inhibitory synapses, excitatory and inhibitory cells, nonlocal spatial interactions and a finite axonal conduction speed. The work derives conditions for synaptic time constants based on experimental results and gives conditions on the resting state stability. Further the power spectrum of Local Field Potentials and EEG generated by the neural activity is derived analytically and allow for the detailed study of bi-spectral power changes. We find bi-phasic power changes both in monostable and bistable system regime, affirming the omnipresence of bi-spectral power changes in anesthesia. Further the work gives conditions for the strong increase of power in the δ-frequency band for large propofol concentrations as observed in experiments.

Potential network mechanisms mediating electroencephalographic beta rhythm changes during propofol-induced paradoxical excitation

Propofol, like most general anesthetic drugs, can induce both behavioral and electroencephalographic (EEG) manifestations of excitation, rather than sedation, at low doses. Neuronal excitation is unexpected in the presence of this GABA(A)-potentiating drug. We construct a series of network models to understand this paradox. Individual neurons have ion channel conductances with Hodgkin-Huxley-type formulations. Propofol increases the maximal conductance and time constant of decay of the synaptic GABA(A) current. Networks range in size from 2 to 230 neurons. Population output is measured as a function of pyramidal cell activity, with the electroencephalogram approximated by the sum of population AMPA activity between pyramidal cells. These model networks suggest propofol-induced paradoxical excitation may result from a membrane level interaction between the GABA(A) current and an intrinsic membrane slow potassium current (M-current). This membrane level interaction has consequences at the level of multicellular networks enabling a switch from baseline interneuron synchrony to propofol-induced interneuron antisynchrony. Large network models reproduce the clinical EEG changes characteristic of propofol-induced paradoxical excitation. The EEG changes coincide with the emergence of antisynchronous interneuron clusters in the model networks. Our findings suggest interneuron antisynchrony as a potential network mechanism underlying the generation of propofol-induced paradoxical excitation. As correlates of behavioral phenomenology, these networks may refine our understanding of the specific behavioral states associated with general anesthesia.

Power analysis of gamma frequencies (30 - 47Hz), adjusting for muscle activity (80 - 97Hz), in anesthesia: a comparison between young adults, middle-aged and the elderly

This study looks at the role of EEG gamma activity, and the influence of facial EMG (80-97 Hz), in predicting consciousness during anesthesia. It also studies the association between the conventional depth of anesthesia index, BIS (Aspect Medical Systems), and EEG gamma and EMG activity. Data has been collected from 21 adult patients and grouped into young adults (18 - 39 yrs, n=3), middle-aged (40 - 64 yrs, n=10) and the elderly (65+ yrs, n=8). The power of the EEG gamma activity was recorded from Fpz - Mastoid and the power of the EMG was recorded from Fpz - Mastoid and Masseter - Mastoid. It has been found that when considered alone, EEG gamma power is associated with both BIS index and consciousness versus unconsciousness, showing a decrease in power as consciousness is lost. When the effect of EEG gamma power is adjusted for EMG, it is found that generally these associations can be explained by the EMG power alone. There are two exceptions to this. In the young adults group there is a stronger association between BIS index and EEG gamma than there is between BIS index and EMG. In the elderly group, the state of consciousness is equally associated with EEG gamma and EMG recorded from the Masseter, but not with the EMG recorded from Fpz.

Suppression of the human spinal H-reflex by propofol: a quantitative analysis

BACKGROUND

The spinal cord is an important site of anaesthetic action because it mediates surgical immobility. During anaesthesia with volatile anaesthetics, it has been shown that the suppression of the spinal H-reflex correlates with surgical immobility. To evaluate whether the H-reflex could also be a possible candidate for monitoring immobility during propofol anaesthesia, this study assessed the concentration-dependent suppression of the H-reflex by propofol. To discriminate different effect sites, the individual concentration response-curves and the t(1/2ke0) of the H-reflex have been compared with those of two EEG parameters.

METHODS

In 18 patients, anaesthesia was induced and maintained with propofol infused using a target-controlled infusion pump at stepwise increasing and decreasing plasma concentrations between 0.5 and 4.5 mg/l. The H-reflex of the soleus muscle was recorded at a frequency of 0.1 Hz. Calculated propofol concentrations and H-reflex amplitude were analysed in terms of a pharmacokinetic-pharmacodynamic (PKPD) model with a sigmoid concentration-response function.

RESULTS

For slowly increasing propofol concentrations, computer fits of the PKPD model for H-reflex suppression by propofol yielded the following median parameters: EC50 1.1 (0.8-1.7) mg/l, slope parameter 2.4 (2.0-3.7), and a t(1/2ke0) of 6.7 (2.8-7.5, 25-75% quantiles) min. For the bispectral index, the t(1/2ke0) was 2.2 (1.8-3.1) min and for the spectral edge frequency at the 95th percentile of the power spectrum 2.8 (1.9-3.2) min.

CONCLUSIONS

Propofol, unlike sevoflurane, suppresses the spinal H-reflex at concentrations far lower than the C50 skin incision. The differences in t(1/2ke0)-values indicate the presence of different effect compartments for effects on the H-reflex and the EEG.