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Ditz C, Leppert J, Küchler J. In Response: Volatile Sedation with Sevoflurane After Aneurysmal Subarachnoid Hemorrhage Using the Sedaconda Anesthetic Conserving Device: Is It Safe? Neurocrit Care 2024; 41:312-313. [PMID: 38902583 DOI: 10.1007/s12028-024-02034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]
Affiliation(s)
- Claudia Ditz
- Department of Neurosurgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, Germany.
| | - Jan Leppert
- Department of Neurosurgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, Germany
| | - Jan Küchler
- Department of Neurosurgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, Germany
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2
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Chen Y, Zhang J. How Energy Supports Our Brain to Yield Consciousness: Insights From Neuroimaging Based on the Neuroenergetics Hypothesis. Front Syst Neurosci 2021; 15:648860. [PMID: 34295226 PMCID: PMC8291083 DOI: 10.3389/fnsys.2021.648860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
Consciousness is considered a result of specific neuronal processes and mechanisms in the brain. Various suggested neuronal mechanisms, including the information integration theory (IIT), global neuronal workspace theory (GNWS), and neuronal construction of time and space as in the context of the temporospatial theory of consciousness (TTC), have been laid forth. However, despite their focus on different neuronal mechanisms, these theories neglect the energetic-metabolic basis of the neuronal mechanisms that are supposed to yield consciousness. Based on the findings of physiology-induced (sleep), pharmacology-induced (general anesthesia), and pathology-induced [vegetative state/unresponsive wakeful syndrome (VS/UWS)] loss of consciousness in both human subjects and animals, we, in this study, suggest that the energetic-metabolic processes focusing on ATP, glucose, and γ-aminobutyrate/glutamate are indispensable for functional connectivity (FC) of normal brain networks that renders consciousness possible. Therefore, we describe the energetic-metabolic predispositions of consciousness (EPC) that complement the current theories focused on the neural correlates of consciousness (NCC).
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Affiliation(s)
- Yali Chen
- Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jun Zhang
- Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical college, Fudan University, Shanghai, China
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3
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Yamamoto AK, Magerkurth J, Mancini L, White MJ, Miserocchi A, McEvoy AW, Appleby I, Micallef C, Thornton JS, Price CJ, Weiskopf N, Yousry TA. Acquisition of sensorimotor fMRI under general anaesthesia: Assessment of feasibility, the BOLD response and clinical utility. NEUROIMAGE-CLINICAL 2019; 23:101923. [PMID: 31491826 PMCID: PMC6699415 DOI: 10.1016/j.nicl.2019.101923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/28/2019] [Accepted: 06/30/2019] [Indexed: 11/17/2022]
Abstract
We evaluated whether task-related fMRI (functional magnetic resonance imaging) BOLD (blood oxygenation level dependent) activation could be acquired under conventional anaesthesia at a depth enabling neurosurgery in five patients with supratentorial gliomas. Within a 1.5 T MRI operating room immediately prior to neurosurgery, a passive finger flexion sensorimotor paradigm was performed on each hand with the patients awake, and then immediately after the induction and maintenance of combined sevoflurane and propofol general anaesthesia. The depth of surgical anaesthesia was measured and confirmed with an EEG-derived technique, the Bispectral Index (BIS). The magnitude of the task-related BOLD response and BOLD sensitivity under anaesthesia were determined. The fMRI data were assessed by three fMRI expert observers who rated each activation map for somatotopy and usefulness for radiological neurosurgical guidance. The mean magnitudes of the task-related BOLD response under a BIS measured depth of surgical general anaesthesia were 25% (tumour affected hemisphere) and 22% (tumour free hemisphere) of the respective awake values. BOLD sensitivity under anaesthesia ranged from 7% to 83% compared to the awake state. Despite these reductions, somatotopic BOLD activation was observed in the sensorimotor cortex in all ten data acquisitions surpassing statistical thresholds of at least p < 0.001uncorr. All ten fMRI activation datasets were scored to be useful for radiological neurosurgical guidance. Passive task-related sensorimotor fMRI acquired in neurosurgical patients under multi-pharmacological general anaesthesia is reproducible and yields clinically useful activation maps. These results demonstrate the feasibility of the technique and its potential value if applied intra-operatively. Additionally these methods may enable fMRI investigations in patients unable to perform or lie still for awake paradigms, such as young children, claustrophobic patients and those with movement disorders.
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Affiliation(s)
- Adam Kenji Yamamoto
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Joerg Magerkurth
- UCL Psychology and Language Sciences, Birkbeck-UCL Centre for Neuroimaging, London, United Kingdom.
| | - Laura Mancini
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Mark J White
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Medical Physics and Biomedical Engineering, University College London Hospital, London, United Kingdom.
| | - Anna Miserocchi
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Andrew W McEvoy
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Ian Appleby
- Department of Neuroanaesthesia, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Caroline Micallef
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - John S Thornton
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Nikolaus Weiskopf
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Tarek A Yousry
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
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4
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Palanca BJA, Avidan MS, Mashour GA. Human neural correlates of sevoflurane-induced unconsciousness. Br J Anaesth 2019; 119:573-582. [PMID: 29121298 DOI: 10.1093/bja/aex244] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2017] [Indexed: 01/01/2023] Open
Abstract
Sevoflurane, a volatile anaesthetic agent well-tolerated for inhalation induction, provides a useful opportunity to elucidate the processes whereby halogenated ethers disrupt consciousness and cognition. Multiple molecular targets of sevoflurane have been identified, complementing imaging and electrophysiologic markers for the mechanistically obscure progression from wakefulness to unconsciousness. Recent investigations have more precisely detailed scalp EEG activity during this transition, with practical clinical implications. The relative timing of scalp potentials in frontal and parietal EEG signals suggests that sevoflurane might perturb the propagation of neural information between underlying cortical regions. Spatially distributed brain activity during general anaesthesia has been further investigated with positron emission tomography (PET) and resting-state functional magnetic resonance imaging (fMRI). Combined EEG and PET investigations have identified changes in cerebral blood flow and metabolic activity in frontal, parietal, and thalamic regions during sevoflurane-induced loss of consciousness. More recent fMRI investigations have revealed that sevoflurane weakens the signal correlations among brain regions that share functionality and specialization during wakefulness. In particular, two such resting-state networks have shown progressive breakdown in intracortical and thalamocortical connectivity with increasing anaesthetic concentrations: the Default Mode Network (introspection and episodic memory) and the Ventral Attention Network (orienting of attention to salient feature of the external world). These data support the hypotheses that perturbations in temporally correlated activity across brain regions contribute to the transition between states of sevoflurane sedation and general anaesthesia.
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Affiliation(s)
- B J A Palanca
- Division of Biology and Biomedical Sciences.,Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - M S Avidan
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.,Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - G A Mashour
- Department of Anesthesiology, Center for Consciousness Science and Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI, USA
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5
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Golkowski D, Ranft A, Kiel T, Riedl V, Kohl P, Rohrer G, Pientka J, Berger S, Preibisch C, Zimmer C, Mashour GA, Schneider G, Kochs EF, Ilg R, Jordan D. Coherence of BOLD signal and electrical activity in the human brain during deep sevoflurane anesthesia. Brain Behav 2017; 7:e00679. [PMID: 28729926 PMCID: PMC5516594 DOI: 10.1002/brb3.679] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 12/23/2016] [Accepted: 02/16/2017] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Changes in neural activity induce changes in functional magnetic resonance (fMRI) blood oxygenation level dependent (BOLD) signal. Commonly, increases in BOLD signal are ascribed to cellular excitation. OBJECTIVE The relationship between electrical activity and BOLD signal in the human brain was probed on the basis of burst suppression EEG. This condition includes two distinct states of high and low electrical activity. METHODS Resting-state simultaneous EEG and BOLD measurements were acquired during deep sevoflurane anesthesia with burst suppression EEG in nineteen healthy volunteers. Afterwards, fMRI volumes were assigned to one of the two states (burst or suppression) as defined by the EEG. RESULTS In the frontal, parietal and temporal lobes as well as in the basal ganglia, BOLD signal increased after burst onset in the EEG and decreased after onset of EEG suppression. In contrast, BOLD signal in the occipital lobe was anticorrelated to electrical activity. This finding was obtained consistently in a general linear model and in raw data. CONCLUSIONS In human brains exhibiting burst suppression EEG induced by sevoflurane, the positive correlation between BOLD signal and electrical brain activity could be confirmed in most gray matter. The exceptional behavior of the occipital lobe with an anticorrelation of BOLD signal and electrical activity might be due to specific neurovascular coupling mechanisms that are pronounced in the deeply anesthetized brain.
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Affiliation(s)
- Daniel Golkowski
- Department of Neurology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Andreas Ranft
- Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Tobias Kiel
- Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Valentin Riedl
- Department of Neuroradiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Philipp Kohl
- Department of Neurology Klinikum rechts der Isar der Technischen Universität München München Germany.,Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Guido Rohrer
- Department of Neurology Klinikum rechts der Isar der Technischen Universität München München Germany.,Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Joachim Pientka
- Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Sebastian Berger
- Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Christine Preibisch
- Department of Neuroradiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Claus Zimmer
- Department of Neuroradiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - George A Mashour
- Department of Anesthesiology University of Michigan Medical School Ann Arbor MI USA
| | - Gerhard Schneider
- Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Eberhard F Kochs
- Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
| | - Rüdiger Ilg
- Department of Neurology Klinikum rechts der Isar der Technischen Universität München München Germany.,Department of Neurology Asklepios Kliniken Bad Tölz Germany
| | - Denis Jordan
- Department of Anesthesiology Klinikum rechts der Isar der Technischen Universität München München Germany
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6
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Cao W, Chang YV, Englund EK, Song HK, Barhoum S, Rodgers ZB, Langham MC, Wehrli FW. High-speed whole-brain oximetry by golden-angle radial MRI. Magn Reson Med 2017; 79:217-223. [PMID: 28342212 DOI: 10.1002/mrm.26666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 01/18/2017] [Accepted: 02/11/2017] [Indexed: 11/08/2022]
Abstract
PURPOSE To determine whole-brain cerebral metabolic rate of oxygen (CMRO2 ), an improved imaging approach, based on radial encoding, termed radial OxFlow (rOxFlow), was developed to simultaneously quantify draining vein venous oxygen saturation (SvO2 ) and total cerebral blood flow (tCBF). METHODS To evaluate the efficiency and precision of the rOxFlow sequence, 10 subjects were studied during a paradigm of repeated breath-holds with both rOxFlow and Cartesian OxFlow (cOxFlow) sequences. CMRO2 was calculated at baseline from OxFlow-measured data assuming an arterial O2 saturation of 97%, and the SvO2 and tCBF breath-hold responses were quantified. RESULTS Average neurometabolic-vascular parameters across the 10 subjects for cOxFlow and rOxFlow were, respectively: SvO2 (%) baseline: 64.6 ± 8.0 versus 64.2 ± 6.6; SvO2 peak: 70.5 ± 8.5 versus 72.6 ± 5.4; tCBF (mL/min/100 g) baseline: 39.2 ± 3.8 versus 40.6 ± 8.0; tCBF peak: 53.2 ± 5.1 versus 56.1 ± 11.7; CMRO2 (µmol O2 /min/100 g) baseline: 111.5 ± 26.8 versus 120.1 ± 19.6. The above measures were not significantly different between sequences (P > 0.05). CONCLUSION There was good agreement between the two methods in terms of the physiological responses measured. Comparing the two, rOxFlow provided higher temporal resolution and greater flexibility for reconstruction while maintaining high SNR. Magn Reson Med 79:217-223, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Wen Cao
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yulin V Chang
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Erin K Englund
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hee Kwon Song
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Suliman Barhoum
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Zachary B Rodgers
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael C Langham
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Felix W Wehrli
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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7
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Qiu M, Scheinost D, Ramani R, Constable RT. Multi-modal analysis of functional connectivity and cerebral blood flow reveals shared and unique effects of propofol in large-scale brain networks. Neuroimage 2017; 148:130-140. [PMID: 28069540 PMCID: PMC5410383 DOI: 10.1016/j.neuroimage.2016.12.080] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/13/2016] [Accepted: 12/28/2016] [Indexed: 01/17/2023] Open
Abstract
Anesthesia-induced changes in functional connectivity and cerebral blow flow (CBF) in large-scale brain networks have emerged as key markers of reduced consciousness. However, studies of functional connectivity disagree on which large-scale networks are altered or preserved during anesthesia, making it difficult to find a consensus amount studies. Additionally, pharmacological alterations in CBF could amplify or occlude changes in connectivity due to the shared variance between CBF and connectivity. Here, we used data-driven connectivity methods and multi-modal imaging to investigate shared and unique neural correlates of reduced consciousness for connectivity in large-scale brain networks. Rs-fMRI and CBF data were collected from the same subjects during an awake and deep sedation condition induced by propofol. We measured whole-brain connectivity using the intrinsic connectivity distribution (ICD), a method not reliant on pre-defined seed regions, networks of interest, or connectivity thresholds. The shared and unique variance between connectivity and CBF were investigated. Finally, to account for shared variance, we present a novel extension to ICD that incorporates cerebral blood flow (CBF) as a scaling factor in the calculation of global connectivity, labeled CBF-adjusted ICD). We observed altered connectivity in multiple large-scale brain networks including the default mode (DMN), salience, visual, and motor networks and reduced CBF in the DMN, frontoparietal network, and thalamus. Regional connectivity and CBF were significantly correlated during both the awake and propofol condition. Nevertheless changes in connectivity and CBF between the awake and deep sedation condition were only significantly correlated in a subsystem of the DMN, suggesting that, while there is significant shared variance between the modalities, changes due to propofol are relatively unique. Similar, but less significant, results were observed in the CBF-adjusted ICD analysis, providing additional evidence that connectivity differences were not fully explained by CBF. In conclusion, these results provide further evidence of alterations in large-scale brain networks are associated with reduced consciousness and suggest that different modalities capture unique aspects of these large scale changes.
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Affiliation(s)
- Maolin Qiu
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, USA
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, USA
| | | | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, USA; Neurosurgery, Yale School of Medicine, New Haven, CT 06520, USA
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8
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Khalili-Mahani N, Rombouts SARB, van Osch MJP, Duff EP, Carbonell F, Nickerson LD, Becerra L, Dahan A, Evans AC, Soucy JP, Wise R, Zijdenbos AP, van Gerven JM. Biomarkers, designs, and interpretations of resting-state fMRI in translational pharmacological research: A review of state-of-the-Art, challenges, and opportunities for studying brain chemistry. Hum Brain Mapp 2017; 38:2276-2325. [PMID: 28145075 DOI: 10.1002/hbm.23516] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 11/21/2016] [Accepted: 01/04/2017] [Indexed: 12/11/2022] Open
Abstract
A decade of research and development in resting-state functional MRI (RSfMRI) has opened new translational and clinical research frontiers. This review aims to bridge between technical and clinical researchers who seek reliable neuroimaging biomarkers for studying drug interactions with the brain. About 85 pharma-RSfMRI studies using BOLD signal (75% of all) or arterial spin labeling (ASL) were surveyed to investigate the acute effects of psychoactive drugs. Experimental designs and objectives include drug fingerprinting dose-response evaluation, biomarker validation and calibration, and translational studies. Common biomarkers in these studies include functional connectivity, graph metrics, cerebral blood flow and the amplitude and spectrum of BOLD fluctuations. Overall, RSfMRI-derived biomarkers seem to be sensitive to spatiotemporal dynamics of drug interactions with the brain. However, drugs cause both central and peripheral effects, thus exacerbate difficulties related to biological confounds, structured noise from motion and physiological confounds, as well as modeling and inference testing. Currently, these issues are not well explored, and heterogeneities in experimental design, data acquisition and preprocessing make comparative or meta-analysis of existing reports impossible. A unifying collaborative framework for data-sharing and data-mining is thus necessary for investigating the commonalities and differences in biomarker sensitivity and specificity, and establishing guidelines. Multimodal datasets including sham-placebo or active control sessions and repeated measurements of various psychometric, physiological, metabolic and neuroimaging phenotypes are essential for pharmacokinetic/pharmacodynamic modeling and interpretation of the findings. We provide a list of basic minimum and advanced options that can be considered in design and analyses of future pharma-RSfMRI studies. Hum Brain Mapp 38:2276-2325, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Najmeh Khalili-Mahani
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Institute of Psychology and Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | | | - Eugene P Duff
- Institute of Psychology and Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Oxford Centre for Functional MRI of the Brain, Oxford University, Oxford, United Kingdom
| | | | - Lisa D Nickerson
- McLean Hospital, Belmont, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School & Boston Children's Hospital, Boston, Massachusetts
| | - Albert Dahan
- Department of Anesthesiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Jean-Paul Soucy
- PERFORM Centre, Concordia University, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Richard Wise
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Alex P Zijdenbos
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada.,Biospective Inc, Montreal, Quebec, Canada
| | - Joop M van Gerven
- Centre for Human Drug Research, Leiden University Medical Centre, Leiden, The Netherlands
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9
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Hutchison RM, Hutchison M, Manning KY, Menon RS, Everling S. Isoflurane induces dose-dependent alterations in the cortical connectivity profiles and dynamic properties of the brain's functional architecture. Hum Brain Mapp 2014; 35:5754-75. [PMID: 25044934 DOI: 10.1002/hbm.22583] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 06/05/2014] [Accepted: 07/02/2014] [Indexed: 12/25/2022] Open
Abstract
Despite their widespread use, the effect of anesthetic agents on the brain's functional architecture remains poorly understood. This is particularly true of alterations that occur beyond the point of induced unconsciousness. Here, we examined the distributed intrinsic connectivity of macaques across six isoflurane levels using resting-state functional MRI (fMRI) following the loss of consciousness. The results from multiple analysis strategies showed stable functional connectivity (FC) patterns between 1.00% and 1.50% suggesting this as a suitable range for anesthetized nonhuman primate resting-state investigations. Dose-dependent effects were evident at moderate to high dosages showing substantial alteration of the functional topology and a decrease or complete loss of interhemispheric cortical FC strength including that of contralateral homologues. The assessment of dynamic FC patterns revealed that the functional repertoire of brain states is related to anesthesia depth and most strikingly, that the number of state transitions linearly decreases with increased isoflurane dosage. Taken together, the results indicate dose-specific spatial and temporal alterations of FC that occur beyond the typically defined endpoint of consciousness. Future work will be necessary to determine how these findings generalize across anesthetic types and extend to the transition between consciousness and unconsciousness.
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Affiliation(s)
- R Matthew Hutchison
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; Department of Psychology, Harvard University, Cambridge, Massachusetts; Center for Brain Science, Harvard University, Cambridge, Massachusetts
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10
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Gómez F, Phillips C, Soddu A, Boly M, Boveroux P, Vanhaudenhuyse A, Bruno MA, Gosseries O, Bonhomme V, Laureys S, Noirhomme Q. Changes in effective connectivity by propofol sedation. PLoS One 2013; 8:e71370. [PMID: 23977030 PMCID: PMC3747149 DOI: 10.1371/journal.pone.0071370] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 07/01/2013] [Indexed: 11/23/2022] Open
Abstract
Mechanisms of propofol-induced loss of consciousness remain poorly understood. Recent fMRI studies have shown decreases in functional connectivity during unconsciousness induced by this anesthetic agent. Functional connectivity does not provide information of directional changes in the dynamics observed during unconsciousness. The aim of the present study was to investigate, in healthy humans during an auditory task, the changes in effective connectivity resulting from propofol induced loss of consciousness. We used Dynamic Causal Modeling for fMRI (fMRI-DCM) to assess how causal connectivity is influenced by the anesthetic agent in the auditory system. Our results suggest that the dynamic observed in the auditory system during unconsciousness induced by propofol, can result in a mixture of two effects: a local inhibitory connectivity increase and a decrease in the effective connectivity in sensory cortices.
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Affiliation(s)
- Francisco Gómez
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
- * E-mail:
| | - Christophe Phillips
- Cyclotron Research Centre, University of Liège, Liège, Belgium
- Department of Electrical Engineering and Computer Science, University of Liège, Liège, Belgium
| | - Andrea Soddu
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Melanie Boly
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Pierre Boveroux
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
- Department of Anesthesiology and Reanimation, University Hospital of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Marie-Aurélie Bruno
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Vincent Bonhomme
- Department of Anesthesiology and Reanimation, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Quentin Noirhomme
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
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Thanos PK, Robison L, Nestler EJ, Kim R, Michaelides M, Lobo MK, Volkow ND. Mapping brain metabolic connectivity in awake rats with μPET and optogenetic stimulation. J Neurosci 2013; 33:6343-9. [PMID: 23575833 PMCID: PMC3666931 DOI: 10.1523/jneurosci.4997-12.2013] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 12/23/2012] [Accepted: 02/18/2013] [Indexed: 12/28/2022] Open
Abstract
Positron emission tomography (PET) with [(18)F]2-fluoro-2-deoxy-D-glucose was used to measure changes in regional brain glucose metabolism (BGluM) in response to optogenetic stimulation (using the excitatory channelrhodopsin-2) of the nucleus accumbens (NAc) in awake rats. We demonstrated not only increases in BGluM that correlated with c-Fos expression in the region of stimulation, but also BGluM increases in the ipsilateral striatum, periaqueductal gray, and somatosensory cortex, and in contralateral amygdala, ventral pallidum, globus pallidus, and hippocampus, as well as decreases in BGluM in regions of the default mode network (retrosplenial cortex and cingulate gyrus) and secondary motor cortex. Additional exploration of c-Fos expression in regions found to be activated by PET results found corroborating evidence, with increased c-Fos expression in the ipsilateral somatosensory cortex, contralateral amygdala and globus pallidus, and bilateral periaqueductal gray. These findings are consistent with optogenetic excitation of the area of stimulation (NAc), as well as with stimulatory and inhibitory effects on downstream regions. They also confirm the utility of PET imaging to monitor connectivity in the awake rodent brain.
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Affiliation(s)
- Panayotis K. Thanos
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Medical Department, Brookhaven National Laboratory, Upton, New York 11973
- Department of Psychology, Stony Brook University, Stony Brook New York 11794
| | - Lisa Robison
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852
- Department of Psychology, Stony Brook University, Stony Brook New York 11794
| | - Eric J. Nestler
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York 10029
| | - Ronald Kim
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Medical Department, Brookhaven National Laboratory, Upton, New York 11973
| | - Michael Michaelides
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York 10029
| | - Mary-Kay Lobo
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, Maryland 21201, and
| | - Nora D. Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852
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Khalili-Mahani N, van Osch MJ, de Rooij M, Beckmann CF, van Buchem MA, Dahan A, van Gerven JM, Rombouts SARB. Spatial heterogeneity of the relation between resting-state connectivity and blood flow: an important consideration for pharmacological studies. Hum Brain Mapp 2012; 35:929-42. [PMID: 23281174 DOI: 10.1002/hbm.22224] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 10/08/2012] [Accepted: 10/22/2012] [Indexed: 01/28/2023] Open
Abstract
Resting state fMRI (RSfMRI) and arterial spin labeling (ASL) provide the field of pharmacological Neuroimaging tool for investigating states of brain activity in terms of functional connectivity or cerebral blood flow (CBF). Functional connectivity reflects the degree of synchrony or correlation of spontaneous fluctuations--mostly in the blood oxygen level dependent (BOLD) signal--across brain networks; but CBF reflects mean delivery of arterial blood to the brain tissue over time. The BOLD and CBF signals are linked to common neurovascular and hemodynamic mechanisms that necessitate increased oxygen transportation to the site of neuronal activation; however, the scale and the sources of variation in static CBF and spatiotemporal BOLD correlations are likely different. We tested this hypothesis by examining the relation between CBF and resting-state-network consistency (RSNC)--representing average intranetwork connectivity, determined from dual regression analysis with eight standard networks of interest (NOIs)--in a crossover placebo-controlled study of morphine and alcohol. Overall, we observed spatially heterogeneous relations between RSNC and CBF, and between the experimental factors (drug-by-time, time, drug and physiological rates) and each of these metrics. The drug-by-time effects on CBF were significant in all networks, but significant RSNC changes were limited to the sensorimotor, the executive/salience and the working memory networks. The post-hoc voxel-wise statistics revealed similar dissociations, perhaps suggesting differential sensitivity of RSNC and CBF to neuronal and vascular endpoints of drug actions. The spatial heterogeneity of RSNC/CBF relations encourages further investigation into the role of neuroreceptor distribution and cerebrovascular anatomy in predicting spontaneous fluctuations under drugs.
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Affiliation(s)
- Najmeh Khalili-Mahani
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
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13
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Bernal B, Grossman S, Gonzalez R, Altman N. FMRI under sedation: what is the best choice in children? J Clin Med Res 2012; 4:363-70. [PMID: 23226168 PMCID: PMC3513417 DOI: 10.4021/jocmr1047w] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2012] [Indexed: 12/11/2022] Open
Abstract
Background Pediatric fMRI may require sedation. The aim of this study is to compare different sedation schemes to determine which medication yields least failures and the best activation. Methods A total of 100 children who had fMRI performed as part of the work up for epilepsy surgery, were divided into different medication groups (Pentobarbital, Propofol, Dexmedetomidine, Sevoflurane). Comparison was performed among the groups for number of failures, rank of activation, adverse effects, anesthesia time, and recovery time. The study was approved by the IRB and followed all HIPAA guidelines. BOLD sequences were utilized to perform two block-design paradigms (auditory and visual). The activation was ranked into 5 categories according to the presence and localization of the activation. Descriptive and parametric statistics (ANOVA) were utilized to look for significant differences. Results Pentobarbital yielded the least amount of failures, for the auditory task, followed by propofol, while sevoflurane yielded the highest number of failures for both tasks. In the visual task, propofol administered after dexmedetomidine resulted in the least number of failures. Brain activations were not statistical different (auditory: ANOVA, P = 0.42; F = 1.01; visual: ANOVA, P = 0.077; F = 2.1). The shortest recovery time was obtained with sevoflurane, followed by propofol. Agitation and cardiac complications were seen in 28% of cases in the pentobarbital group. Conclusion No statistically significant difference in brain activation was found utilizing different sedative medications in children with intractable epilepsy. A trend toward less failures was obtained with pentobarbital and propofol; however pentobarbital was more frequently associated with undesirable side effects.
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Affiliation(s)
- Byron Bernal
- Department of Radiology, Miami Children's Hospital, USA
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Liu X, Li R, Yang Z, Hudetz AG, Li SJ. Differential effect of isoflurane, medetomidine, and urethane on BOLD responses to acute levo-tetrahydropalmatine in the rat. Magn Reson Med 2011; 68:552-9. [PMID: 22213080 DOI: 10.1002/mrm.23243] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 08/02/2011] [Accepted: 09/12/2011] [Indexed: 11/08/2022]
Abstract
Levo-tetrahydropalmatine (l-THP) has shown significant promise in preclinical and clinical studies to treat drug addiction. Pharmacological MRI methods can elucidate the regional cerebral effects of l-THP, but there are potential confounds from the use of general anesthesia. To investigate the possible anesthetic-drug interactions for the pharmacological MRI result of acute l-THP, we examined acute blood oxygen level-dependent responses of both 5 and 20 mg/kg l-THP in naïve rats during general anesthesia achieved with three agents: isoflurane, medetomidine, and urethane. We found that with acute l-THP administration, isoflurane revealed the smallest blood oxygen level-dependent activation areas. In addition, urethane had the most activation areas; however, they were all negative. Medetomidine showed mixed positive and negative activations. Region-specific interactions were found between the l-THP-induced blood oxygen level-dependent responses and the anesthetic agents.
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Affiliation(s)
- Xiping Liu
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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15
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Pulsed arterial spin labeling perfusion imaging at 3 T: estimating the number of subjects required in common designs of clinical trials. Magn Reson Imaging 2011; 29:1382-9. [DOI: 10.1016/j.mri.2011.02.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 02/01/2011] [Accepted: 02/20/2011] [Indexed: 11/24/2022]
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Martuzzi R, Ramani R, Qiu M, Rajeevan N, Constable RT. Functional connectivity and alterations in baseline brain state in humans. Neuroimage 2009; 49:823-34. [PMID: 19631277 DOI: 10.1016/j.neuroimage.2009.07.028] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 07/10/2009] [Accepted: 07/15/2009] [Indexed: 11/18/2022] Open
Abstract
This work examines the influence of changes in baseline activity on the intrinsic functional connectivity fMRI (fc-fMRI) in humans. Baseline brain activity was altered by inducing anesthesia (sevoflurane end-tidal concentration 1%) in human volunteers and fc-fMRI maps between the pre-anesthetized and anesthetized conditions were compared across different brain networks. We particularly focused on low-level sensory areas (primary somatosensory, visual, and auditory cortices), the thalamus, and pain (insula), memory (hippocampus) circuits, and the default mode network (DMN), the latter three to examine higher-order brain regions. The results indicate that, while fc-fMRI patterns did not significantly differ (p<0.005; 20-voxel cluster threshold) in sensory cortex and in the DMN between the pre- and anesthetized conditions, fc-fMRI in high-order cognitive regions (i.e. memory and pain circuits) was significantly altered by anesthesia. These findings provide further evidence that fc-fMRI reflects intrinsic brain properties, while also demonstrating that 0.5 MAC sevoflurane anesthesia preferentially modulates higher-order connections.
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Affiliation(s)
- Roberto Martuzzi
- Department of Diagnostic Radiology, Yale University School of Medicine, The Anlyan Center, 300 Cedar Street, New Haven, CT 06520-8042, USA.
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Influence of selecting EPI readout-encoding bandwidths on arterial spin labeling perfusion MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2009; 22:287-95. [PMID: 19578915 DOI: 10.1007/s10334-009-0174-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 06/10/2009] [Accepted: 06/11/2009] [Indexed: 10/20/2022]
Abstract
OBJECT The objective of this study was to investigate effects of varying readout bandwidths on the arterial spin labeling (ASL)-perfusion MRI measurements at a high magnetic field MRI system. MATERIALS AND METHODS Brain perfusion studies were performed on nine volunteers (four males, five females) using flow sensitive alternating inversion recovery (FAIR) ASL single-shot echo-planar imaging (EPI)-MRI. To investigate EPI bandwidth effects on the time-series perfusion-weighted imaging (PWI) data, two regions-of-interest (ROI) were placed outside the brain to determine the level of noise and another ROI inside the brain to determine the level of signal. Coefficients of variations (CoV) were calculated for the time-series PWI data. One-way analysis of variance (ANOVA) was used to investigate voxel-wise differences in the time-series PWI data between two different bandwidth values. RESULTS At the level of ROI, there was no significant effect of changing EPI bandwidths on the time-series PWI data in any of the volunteers (P > 0.031). In contrast, CoV values over the dynamic PWI data varied with depending on selecting EPI bandwidths and voxel-based tests showed that N2 ghosting, modulated by EPI bandwidth, can appear in some brain regions, especially in areas that overlap with the spatial distribution of N2 ghosting artifacts. CONCLUSIONS Although N2 ghosting can be reduced by adjusting the bandwidth of EPI on the time-series of PWI data, the effects cannot be entirely eliminated. In particular, N2 ghosting can bias CBF quantification if EPI control scans to determine the equilibrium-state signal are confounded by N2 ghosting. Therefore, careful tuning of the bandwidth of EPI is necessary to avoid artifacts in the ASL signal from N2-ghosting.
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Larson-Prior LJ, Zempel JM, Nolan TS, Prior FW, Snyder AZ, Raichle ME. Cortical network functional connectivity in the descent to sleep. Proc Natl Acad Sci U S A 2009; 106:4489-94. [PMID: 19255447 PMCID: PMC2657465 DOI: 10.1073/pnas.0900924106] [Citation(s) in RCA: 339] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Indexed: 11/18/2022] Open
Abstract
Descent into sleep is accompanied by disengagement of the conscious brain from the external world. It follows that this process should be associated with reduced neural activity in regions of the brain known to mediate interaction with the environment. We examined blood oxygen dependent (BOLD) signal functional connectivity using conventional seed-based analyses in 3 primary sensory and 3 association networks as normal young adults transitioned from wakefulness to light sleep while lying immobile in the bore of a magnetic resonance imaging scanner. Functional connectivity was maintained in each network throughout all examined states of arousal. Indeed, correlations within the dorsal attention network modestly but significantly increased during light sleep compared to wakefulness. Moreover, our data suggest that neuronally mediated BOLD signal variance generally increases in light sleep. These results do not support the view that ongoing BOLD fluctuations primarily reflect unconstrained cognition. Rather, accumulating evidence supports the hypothesis that spontaneous BOLD fluctuations reflect processes that maintain the integrity of functional systems in the brain.
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Affiliation(s)
- Linda J. Larson-Prior
- Department of Radiology, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO 63110
| | - John M. Zempel
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Tracy S. Nolan
- Department of Radiology, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO 63110
| | - Fred W. Prior
- Department of Radiology, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO 63110
| | - Abraham Z. Snyder
- Department of Radiology, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO 63110
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Marcus E. Raichle
- Department of Radiology, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO 63110
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110; and
- Department of Biomedical Engineering, Washington University School of Engineering, St. Louis, MO 63130
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