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Brudzynski SM, Burgdorf JS, Moskal JR. From emotional arousal to executive action. Role of the prefrontal cortex. Brain Struct Funct 2024:10.1007/s00429-024-02837-w. [PMID: 39096390 DOI: 10.1007/s00429-024-02837-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 07/12/2024] [Indexed: 08/05/2024]
Abstract
Emotional arousal is caused by the activity of two parallel ascending systems targeting mostly the subcortical limbic regions and the prefrontal cortex. The aversive, negative arousal system is initiated by the activity of the mesolimbic cholinergic system and the hedonic, appetitive, arousal is initiated by the activity of the mesolimbic dopaminergic system. Both ascending projections have a diffused nature and arise from the rostral, tegmental part of the brain reticular activating system. The mesolimbic cholinergic system originates in the laterodorsal tegmental nucleus and the mesolimbic dopaminergic system in the ventral tegmental area. Cholinergic and dopaminergic arousal systems have converging input to the medial prefrontal cortex. The arousal system can modulate cortical EEG with alpha rhythms, which enhance synaptic strength as shown by an increase in long-term potentiation (LTP), whereas delta frequencies are associated with decreased arousal and a decrease in synaptic strength as shown by an increase in long-term depotentiation (LTD). It is postulated that the medial prefrontal cortex is an adaptable node with decision making capability and may control the switch between positive and negative affect and is responsible for modifying or changing emotional state and its expression.
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Affiliation(s)
| | - Jeffrey S Burgdorf
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Joseph R Moskal
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
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Luppi AI, Mediano PAM, Rosas FE, Allanson J, Pickard J, Carhart-Harris RL, Williams GB, Craig MM, Finoia P, Owen AM, Naci L, Menon DK, Bor D, Stamatakis EA. A synergistic workspace for human consciousness revealed by Integrated Information Decomposition. eLife 2024; 12:RP88173. [PMID: 39022924 PMCID: PMC11257694 DOI: 10.7554/elife.88173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
How is the information-processing architecture of the human brain organised, and how does its organisation support consciousness? Here, we combine network science and a rigorous information-theoretic notion of synergy to delineate a 'synergistic global workspace', comprising gateway regions that gather synergistic information from specialised modules across the human brain. This information is then integrated within the workspace and widely distributed via broadcaster regions. Through functional MRI analysis, we show that gateway regions of the synergistic workspace correspond to the human brain's default mode network, whereas broadcasters coincide with the executive control network. We find that loss of consciousness due to general anaesthesia or disorders of consciousness corresponds to diminished ability of the synergistic workspace to integrate information, which is restored upon recovery. Thus, loss of consciousness coincides with a breakdown of information integration within the synergistic workspace of the human brain. This work contributes to conceptual and empirical reconciliation between two prominent scientific theories of consciousness, the Global Neuronal Workspace and Integrated Information Theory, while also advancing our understanding of how the human brain supports consciousness through the synergistic integration of information.
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Affiliation(s)
- Andrea I Luppi
- Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
- University Division of Anaesthesia, School of Clinical Medicine, University of CambridgeCambridgeUnited Kingdom
| | - Pedro AM Mediano
- Department of Psychology, University of CambridgeCambridgeUnited Kingdom
| | - Fernando E Rosas
- Center for Psychedelic Research, Department of Brain Science, Imperial College LondonLondonUnited Kingdom
- Center for Complexity Science, Imperial College LondonLondonUnited Kingdom
- Data Science Institute, Imperial College LondonLondonUnited Kingdom
| | - Judith Allanson
- Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
- Department of Neurosciences, Cambridge University Hospitals NHS Foundation, Addenbrooke's HospitalCambridgeUnited Kingdom
| | - John Pickard
- Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
- Wolfson Brain Imaging Centre, University of CambridgeCambridgeUnited Kingdom
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Addenbrooke's HospitalCambridgeUnited Kingdom
| | - Robin L Carhart-Harris
- Center for Psychedelic Research, Department of Brain Science, Imperial College LondonLondonUnited Kingdom
- Psychedelics Division - Neuroscape, Department of Neurology, University of CaliforniaSan FranciscoUnited States
| | - Guy B Williams
- Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
- Wolfson Brain Imaging Centre, University of CambridgeCambridgeUnited Kingdom
| | - Michael M Craig
- Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
- University Division of Anaesthesia, School of Clinical Medicine, University of CambridgeCambridgeUnited Kingdom
| | - Paola Finoia
- Department of Clinical Neurosciences, University of CambridgeCambridgeUnited Kingdom
| | - Adrian M Owen
- Department of Psychology and Department of Physiology and Pharmacology, The Brain and Mind Institute, University of Western OntarioLondonCanada
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Lloyd Building, Trinity CollegeDublinIreland
| | - David K Menon
- University Division of Anaesthesia, School of Clinical Medicine, University of CambridgeCambridgeUnited Kingdom
- Wolfson Brain Imaging Centre, University of CambridgeCambridgeUnited Kingdom
| | - Daniel Bor
- Department of Psychology, University of CambridgeCambridgeUnited Kingdom
| | - Emmanuel A Stamatakis
- University Division of Anaesthesia, School of Clinical Medicine, University of CambridgeCambridgeUnited Kingdom
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Wang R, Zhang L, Wang X, Li W, Jian T, Yin P, Wang X, Chen Q, Chen X, Qin H. Electrophysiological activity pattern of mouse hippocampal CA1 and dentate gyrus under isoflurane anesthesia. Front Cell Neurosci 2024; 18:1392498. [PMID: 39104439 PMCID: PMC11299216 DOI: 10.3389/fncel.2024.1392498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/03/2024] [Indexed: 08/07/2024] Open
Abstract
General anesthesia can impact a patient's memory and cognition by influencing hippocampal function. The CA1 and dentate gyrus (DG), serving as the primary efferent and gateway of the hippocampal trisynaptic circuit facilitating cognitive learning and memory functions, exhibit significant differences in cellular composition, molecular makeup, and responses to various stimuli. However, the effects of isoflurane-induced general anesthesia on CA1 and DG neuronal activity in mice are not well understood. In this study, utilizing electrophysiological recordings, we examined neuronal population dynamics and single-unit activity (SUA) of CA1 and DG in freely behaving mice during natural sleep and general anesthesia. Our findings reveal that isoflurane anesthesia shifts local field potential (LFP) to delta frequency and reduces the firing rate of SUA in both CA1 and DG, compared to wakefulness. Additionally, the firing rates of DG neurons are significantly lower than CA1 neurons during isoflurane anesthesia, and the recovery of theta power is slower in DG than in CA1 during the transition from anesthesia to wakefulness, indicating a stronger and more prolonged impact of isoflurane anesthesia on DG. This work presents a suitable approach for studying brain activities during general anesthesia and provides evidence for distinct effects of isoflurane anesthesia on hippocampal subregions.
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Affiliation(s)
- Rui Wang
- Department of Anesthesiology, Shanxi Medical University and Second Hospital of Shanxi Medical University, Taiyuan, China
- Guangyang Bay Laboratory, Chongqing Institute for Brain and Intelligence, Chongqing, China
| | - Linzhong Zhang
- Department of Anesthesiology, Shanxi Medical University and Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xia Wang
- Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing, China
| | - Wen Li
- Brain Research Center and State Key Laboratory of Trauma and Chemical Poisoning, Third Military Medical University, Chongqing, China
| | - Tingliang Jian
- Brain Research Center and State Key Laboratory of Trauma and Chemical Poisoning, Third Military Medical University, Chongqing, China
| | - Pengcheng Yin
- Department of Anesthesiology, Shanxi Medical University and Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xinzhi Wang
- Department of Anesthesiology, Shanxi Medical University and Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Qianwei Chen
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Xiaowei Chen
- Guangyang Bay Laboratory, Chongqing Institute for Brain and Intelligence, Chongqing, China
- Brain Research Center and State Key Laboratory of Trauma and Chemical Poisoning, Third Military Medical University, Chongqing, China
| | - Han Qin
- Guangyang Bay Laboratory, Chongqing Institute for Brain and Intelligence, Chongqing, China
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Barra ME, Solt K, Yu X, Edlow BL. Restoring consciousness with pharmacologic therapy: Mechanisms, targets, and future directions. Neurotherapeutics 2024:e00374. [PMID: 39019729 DOI: 10.1016/j.neurot.2024.e00374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/16/2024] [Accepted: 05/03/2024] [Indexed: 07/19/2024] Open
Abstract
Severe brain injury impairs consciousness by disrupting a broad spectrum of neurotransmitter systems. Emerging evidence suggests that pharmacologic modulation of specific neurotransmitter systems, such as dopamine, promotes recovery of consciousness. Clinical guidelines now endorse the use of amantadine in individuals with traumatic disorders of consciousness (DoC) based on level 1 evidence, and multiple neurostimulants are used off-label in clinical practice, including methylphenidate, modafinil, bromocriptine, levodopa, and zolpidem. However, the relative contributions of monoaminergic, glutamatergic, cholinergic, GABAergic, and orexinergic neurotransmitter systems to recovery of consciousness after severe brain injury are unknown, and personalized approaches to targeted therapy have yet to be developed. This review summarizes the state-of-the-science in the neurochemistry and neurobiology of neurotransmitter systems involved in conscious behaviors, followed by a discussion of how pharmacologic therapies may be used to modulate these neurotransmitter systems and promote recovery of consciousness. We consider pharmacologic modulation of consciousness at the synapse, circuit, and network levels, with a focus on the mesocircuit model that has been proposed to explain the consciousness-promoting effects of various monoaminergic, glutamatergic, and paradoxically, GABAergic therapies. Though fundamental questions remain about neurotransmitter mechanisms, target engagement and optimal therapy selection for individual patients, we propose that pharmacologic therapies hold great promise to promote recovery and improve quality of life for patients with severe brain injuries.
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Affiliation(s)
- Megan E Barra
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA
| | - Ken Solt
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Xin Yu
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
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Yang L, Fang F, Wang WX, Xie Y, Cang J, Li SB. Substantia Innominata Glutamatergic Neurons Modulate Sevoflurane Anesthesia in Male Mice. Anesth Analg 2024:00000539-990000000-00862. [PMID: 39008422 DOI: 10.1213/ane.0000000000007092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
BACKGROUND Accumulated evidence suggests that brain regions that promote wakefulness also facilitate emergence from general anesthesia (GA). Glutamatergic neurons in the substantia innominata (SI) regulate motivation-related aversive, depressive, and aggressive behaviors relying on heightened arousal. Here, we hypothesize that glutamatergic neurons in the SI are also involved in the regulation of the effects of sevoflurane anesthesia. METHODS With a combination of fiber photometry, chemogenetic and optogenetic tools, behavioral tests, and cortical electroencephalogram recordings, we investigated whether and how SI glutamatergic neurons and their projections to the lateral hypothalamus (LH) regulate sevoflurane anesthesia in adult male mice. RESULTS Population activity of glutamatergic neurons in the SI gradually decreased upon sevoflurane-induced loss of consciousness (LOC) and slowly returned as soon as inhalation of sevoflurane discontinued before recovery of consciousness (ROC). Chemogenetic activation of SI glutamatergic neurons dampened the animals' sensitivity to sevoflurane exposure, prolonged induction time (mean ± standard deviation [SD]; 389 ± 67 seconds vs 458 ± 53 seconds; P = .047), and shortened emergence time (305 seconds, 95% confidence interval [CI], 242-369 seconds vs 207 seconds, 95% CI, 135-279 seconds; P = .004), whereas chemogenetic inhibition of these neurons facilitated sevoflurane anesthesia. Furthermore, optogenetic activation of SI glutamatergic neurons and their terminals in LH induced cortical activation and behavioral emergence from different depths of sevoflurane anesthesia. CONCLUSIONS Our study shows that SI glutamatergic neuronal activity facilitates emergence from sevoflurane anesthesia and provides evidence for the involvement of the SI-LH glutamatergic pathway in the regulation of consciousness during GA.
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Affiliation(s)
- Li Yang
- From the Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Fang Fang
- From the Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wen-Xu Wang
- Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology, Frontiers Center for Brain Science of the Ministry of Education (MOE), Fudan University, Shanghai, China
| | - Yunli Xie
- Department of Anesthesiology, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Zhongshan Hospital, Fudan University, Shanghai, China and
| | - Jing Cang
- From the Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shi-Bin Li
- Department of Anesthesiology, Zhongshan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, MOE Innovative Center for New Drug Development of Immune Inflammatory Diseases, Fudan University, Shanghai, China
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6
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Leo DG, Keller SS, Proietti R. "Close your eyes and relax": the role of hypnosis in reducing anxiety, and its implications for the prevention of cardiovascular diseases. Front Psychol 2024; 15:1411835. [PMID: 39035095 PMCID: PMC11258040 DOI: 10.3389/fpsyg.2024.1411835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
Anxiety is the most common form of mental health disorder, affecting millions of people worldwide. Psychosocial interventions such as mindfulness and cognitive behavioral therapy (CBT) have been suggested as an effective treatment in the management of general anxiety and anxiety disorders, with emerging evidence also suggesting the effectiveness of hypnosis. Moreover, anxiety has shown to be linked to the onset and development of several cardiovascular diseases (CVD), which are the leading cause of global death. In this paper, we review the current literature to examine the role that anxiety has on the onset and development of CVD and summarize the current knowledge on the role that hypnosis and hypnotherapy have in reducing anxiety, also explaining how this can impact the cardiovascular system and the prevention of CVD. Review of the evidence suggests that hypnosis and hypnotherapy are effective in treating anxiety and may positively affect the heart and the cardiovascular system, reducing sympathetic activation and increasing parasympathetic tone, potentially preventing the onset of CVD related to increased sympathetic activation. However, further studies are required to further understand how hypnosis and hypnotherapy affect the cardiovascular system through investigation of the neurophysiological components of the hypnotic state and of the mind-body relationship. Healthcare systems should embed mental health screening in patients at risk of developing CVD as part of the clinical pathway and consider the role that hypnosis and hypnotherapy may play in the management of CVD.
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Affiliation(s)
- Donato Giuseppe Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Simon S. Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Riccardo Proietti
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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Fettiplace MR, Vincent KF, Cho A, Dillon E, Stapley BM, Stewart V, Solt K. Dopaminergic psychostimulants cause arousal from isoflurane-induced sedation without reversing memory impairment in rats. Br J Anaesth 2024:S0007-0912(24)00336-2. [PMID: 38965013 DOI: 10.1016/j.bja.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/30/2024] [Accepted: 05/04/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Dopaminergic psychostimulants can restore arousal in anaesthetised animals, and dopaminergic signalling contributes to hippocampal-dependent memory formation. We tested the hypothesis that dopaminergic psychostimulants can antagonise the amnestic effects of isoflurane on visuospatial working memory. METHODS Sixteen adult Sprague-Dawley rats were trained on a trial-unique nonmatching-to-location (TUNL) task which assessed the ability to identify a novel touchscreen location after a fixed delay. Once trained, the effects of low-dose isoflurane (0.3 vol%) on task performance and activity, assessed by infrared beam breaks, were assessed. We attempted to rescue deficits in performance and activity with a dopamine D1 receptor agonist (chloro-APB), a noradrenergic reuptake inhibitor (atomoxetine), and a mixed dopamine/norepinephrine releasing agent (dextroamphetamine). Anaesthetic induction, emergence, and recovery from anaesthesia were also investigated. RESULTS Low-dose isoflurane impaired working memory in a sex-independent and intra-trial delay-independent manner as assessed by task performance, and caused an overall reduction in activity. Administration of chloro-APB, atomoxetine, or dextroamphetamine did not restore visuospatial working memory, but chloro-APB and dextroamphetamine recovered arousal to levels observed in the baseline awake state. Performance did not differ between induction and emergence. Animals recovered to baseline performance within 15 min of discontinuing isoflurane. CONCLUSIONS Low-dose isoflurane impairs visuospatial working memory in a nondurable and delay-independent manner that potentially implicates non-hippocampal structures in isoflurane-induced memory deficits. Dopaminergic psychostimulants counteracted sedation but did not reverse memory impairments, suggesting that isoflurane-induced amnesia and isoflurane-induced sedation have distinct underlying mechanisms that can be antagonised independently.
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Affiliation(s)
- Michael R Fettiplace
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Anaesthesia, Harvard Medical School, Boston, MA, USA.
| | - Kathleen F Vincent
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
| | - Angel Cho
- Touro College of Osteopathic Medicine, New York, NY, USA
| | - Emmaline Dillon
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT, USA
| | - Brendan M Stapley
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT, USA
| | - Victoria Stewart
- University of California Irvine School of Medicine, Irvine, CA, USA
| | - Ken Solt
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
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Mao R, Cavelli ML, Findlay G, Driessen K, Peterson MJ, Marshall W, Tononi G, Cirelli C. Behavioral and cortical arousal from sleep, muscimol-induced coma, and anesthesia by direct optogenetic stimulation of cortical neurons. iScience 2024; 27:109919. [PMID: 38812551 PMCID: PMC11134913 DOI: 10.1016/j.isci.2024.109919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/28/2023] [Accepted: 05/03/2024] [Indexed: 05/31/2024] Open
Abstract
The cerebral cortex is widely considered part of the neural substrate of consciousness, but direct causal evidence is missing. Here, we tested in mice whether optogenetic activation of cortical neurons in posterior parietal cortex (PtA) or medial prefrontal cortex (mPFC) is sufficient for arousal from three behavioral states characterized by progressively deeper unresponsiveness: sleep, a coma-like state induced by muscimol injection in the midbrain, and deep sevoflurane-dexmedetomidine anesthesia. We find that cortical stimulation always awakens the mice from both NREM sleep and REM sleep, with PtA requiring weaker/shorter light pulses than mPFC. Moreover, in most cases light pulses produce both cortical activation (decrease in low frequencies) and behavioral arousal (recovery of the righting reflex) from brainstem coma, as well as cortical activation from anesthesia. These findings provide evidence that direct activation of cortical neurons is sufficient for behavioral and/or cortical arousal from sleep, brainstem coma, and anesthesia.
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Affiliation(s)
- Rong Mao
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53719, USA
| | - Matias Lorenzo Cavelli
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
- Departamento de Fisiología de Facultad de Medicina, Universidad de la República, Montevideo 11800, Uruguay
| | - Graham Findlay
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53719, USA
| | - Kort Driessen
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53719, USA
| | - Michael J. Peterson
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
| | - William Marshall
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
- Department of Mathematics and Statistics, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
| | - Chiara Cirelli
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, USA
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Cao T, He S, Wang L, Chai X, He Q, Liu D, Wang D, Wang N, He J, Wang S, Yang Y, Zhao J, Tan H. Clinical neuromodulatory effects of deep brain stimulation in disorder of consciousness: A literature review. CNS Neurosci Ther 2024; 30:e14559. [PMID: 38115730 PMCID: PMC11163193 DOI: 10.1111/cns.14559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/11/2023] [Accepted: 11/25/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The management of patients with disorders of consciousness (DOC) presents substantial challenges in clinical practice. Deep brain stimulation (DBS) has emerged as a potential therapeutic approach, but the lack of standardized regulatory parameters for DBS in DOC hinders definitive conclusions. OBJECTIVE This comprehensive review aims to provide a detailed summary of the current issues concerning patient selection, target setting, and modulation parameters in clinical studies investigating the application of DBS for DOC patients. METHODS A meticulous systematic analysis of the literatures was conducted, encompassing articles published from 1968 to April 2023, retrieved from reputable databases (PubMed, Embase, Medline, and Web of Science). RESULTS The systematic analysis of 21 eligible articles, involving 146 patients with DOC resulting from acquired brain injury or other disorders, revealed significant insights. The most frequently targeted regions were the Centromedian-parafascicular complex (CM-pf) nuclei and central thalamus (CT), both recognized for their role in regulating consciousness. However, other targets have also been explored in different studies. The stimulation frequency was predominantly set at 25 or 100 Hz, with pulse width of 120 μs, and voltages ranged from 0 to 4 V. These parameters were customized based on individual patient responses and evaluations. The overall clinical efficacy rate in all included studies was 39.7%, indicating a positive effect of DBS in a subset of DOC patients. Nonetheless, the assessment methods, follow-up durations, and outcome measures varied across studies, potentially contributing to the variability in reported efficacy rates. CONCLUSION Despite the challenges arising from the lack of standardized parameters, DBS shows promising potential as a therapeutic option for patients with DOC. However, there still remains the need for standardized protocols and assessment methods, which are crucial to deepen the understanding and optimizing the therapeutic potential of DBS in this specific patient population.
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Affiliation(s)
- Tianqing Cao
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Shenghong He
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Luchen Wang
- School of Information Science and TechnologyFudan UniversityShanghaiChina
| | - Xiaoke Chai
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Qiheng He
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Dongsheng Liu
- Department of NeurosurgeryAviation General HospitalBeijingChina
| | - Dong Wang
- Department of NeurosurgeryGanzhou People's HospitalGanzhouJiangxi ProvinceChina
| | - Nan Wang
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Jianghong He
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Shouyang Wang
- School of Information Science and TechnologyFudan UniversityShanghaiChina
| | - Yi Yang
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Chinese Institute for Brain ResearchBeijingChina
- Beijing Institute of Brain DisordersBeijingChina
| | - Jizong Zhao
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
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Panagiotaropoulos TI. An integrative view of the role of prefrontal cortex in consciousness. Neuron 2024; 112:1626-1641. [PMID: 38754374 DOI: 10.1016/j.neuron.2024.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/16/2024] [Accepted: 04/24/2024] [Indexed: 05/18/2024]
Abstract
The involvement of the prefrontal cortex (PFC) in consciousness is an ongoing focus of intense investigation. An important question is whether representations of conscious contents and experiences in the PFC are confounded by post-perceptual processes related to cognitive functions. Here, I review recent findings suggesting that neuronal representations of consciously perceived contents-in the absence of post-perceptual processes-can indeed be observed in the PFC. Slower ongoing fluctuations in the electrophysiological state of the PFC seem to control the stability and updates of these prefrontal representations of conscious awareness. In addition to conscious perception, the PFC has been shown to play a critical role in controlling the levels of consciousness as observed during anesthesia, while prefrontal lesions can result in severe loss of perceptual awareness. Together, the convergence of these processes in the PFC suggests its integrative role in consciousness and highlights the complex nature of consciousness itself.
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Mashour GA. Anesthesia and the neurobiology of consciousness. Neuron 2024; 112:1553-1567. [PMID: 38579714 PMCID: PMC11098701 DOI: 10.1016/j.neuron.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 04/07/2024]
Abstract
In the 19th century, the discovery of general anesthesia revolutionized medical care. In the 21st century, anesthetics have become indispensable tools to study consciousness. Here, I review key aspects of the relationship between anesthesia and the neurobiology of consciousness, including interfaces of sleep and anesthetic mechanisms, anesthesia and primary sensory processing, the effects of anesthetics on large-scale functional brain networks, and mechanisms of arousal from anesthesia. I discuss the implications of the data derived from the anesthetized state for the science of consciousness and then conclude with outstanding questions, reflections, and future directions.
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Affiliation(s)
- George A Mashour
- Center for Consciousness Science, Department of Anesthesiology, Department of Pharmacology, Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
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12
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Song XJ, Hu JJ. Neurobiological basis of emergence from anesthesia. Trends Neurosci 2024; 47:355-366. [PMID: 38490858 DOI: 10.1016/j.tins.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/25/2024] [Accepted: 02/19/2024] [Indexed: 03/17/2024]
Abstract
The suppression of consciousness by anesthetics and the emergence of the brain from anesthesia are complex and elusive processes. Anesthetics may exert their inhibitory effects by binding to specific protein targets or through membrane-mediated targets, disrupting neural activity and the integrity and function of neural circuits responsible for signal transmission and conscious perception/subjective experience. Emergence from anesthesia was generally thought to depend on the elimination of the anesthetic from the body. Recently, studies have suggested that emergence from anesthesia is a dynamic and active process that can be partially controlled and is independent of the specific molecular targets of anesthetics. This article summarizes the fundamentals of anesthetics' actions in the brain and the mechanisms of emergence from anesthesia that have been recently revealed in animal studies.
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Affiliation(s)
- Xue-Jun Song
- Department of Medical Neuroscience and SUSTech Center for Pain Medicine, Southern University of Science and Technology School of Medicine, Shenzhen, China.
| | - Jiang-Jian Hu
- Department of Medical Neuroscience and SUSTech Center for Pain Medicine, Southern University of Science and Technology School of Medicine, Shenzhen, China
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13
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Mckilliam A. A mechanistic alternative to minimal sufficiency as the guiding principle for NCC research. Neurosci Conscious 2024; 2024:niae014. [PMID: 38618486 PMCID: PMC11013376 DOI: 10.1093/nc/niae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 04/16/2024] Open
Abstract
A central project for the neuroscience of consciousness is to reveal the neural basis of consciousness. For the past 20-odd years, this project has been conceptualized in terms of minimal sufficiency. Recently, a number of authors have suggested that the project is better conceived in mechanistic terms as the search for difference-makers. In this paper, I (i) motivate this mechanistic alternative to minimal sufficiency, (ii) develop it further by clarifying debates about the prospects of leveraging mutual manipulability to distinguish constitutive difference-makers from those that are merely causal, and (iii) explore the implications this has for recent debates concerning the status of the prefrontal cortex. I argue that adopting a mechanistic approach to the neuroscience of consciousness suggests that the prefrontal cortex is part of the neural mechanisms underlying consciousness even if it is not strictly speaking a necessary part.
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Affiliation(s)
- Andy Mckilliam
- Cognition and Philosophy Lab, Monash Centre for Consciousness and Contemplative Studies, Department of Philosophy, Monash University, Room 429, 29 Ancora Imparo Way, Melbourne, VIC 3800, Australia
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14
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Luppi AI, Uhrig L, Tasserie J, Signorelli CM, Stamatakis EA, Destexhe A, Jarraya B, Cofre R. Local orchestration of distributed functional patterns supporting loss and restoration of consciousness in the primate brain. Nat Commun 2024; 15:2171. [PMID: 38462641 PMCID: PMC10925605 DOI: 10.1038/s41467-024-46382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/26/2024] [Indexed: 03/12/2024] Open
Abstract
A central challenge of neuroscience is to elucidate how brain function supports consciousness. Here, we combine the specificity of focal deep brain stimulation with fMRI coverage of the entire cortex, in awake and anaesthetised non-human primates. During propofol, sevoflurane, or ketamine anaesthesia, and subsequent restoration of responsiveness by electrical stimulation of the central thalamus, we investigate how loss of consciousness impacts distributed patterns of structure-function organisation across scales. We report that distributed brain activity under anaesthesia is increasingly constrained by brain structure across scales, coinciding with anaesthetic-induced collapse of multiple dimensions of hierarchical cortical organisation. These distributed signatures are observed across different anaesthetics, and they are reversed by electrical stimulation of the central thalamus, coinciding with recovery of behavioural markers of arousal. No such effects were observed upon stimulating the ventral lateral thalamus, demonstrating specificity. Overall, we identify consistent distributed signatures of consciousness that are orchestrated by specific thalamic nuclei.
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Affiliation(s)
- Andrea I Luppi
- Division of Anaesthesia and Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
| | - Lynn Uhrig
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191, Gif-sur-Yvette, France
- Department of Anesthesiology and Critical Care, Necker Hospital, AP-HP, Université de Paris Cité, Paris, France
| | - Jordy Tasserie
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191, Gif-sur-Yvette, France
- Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Camilo M Signorelli
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191, Gif-sur-Yvette, France
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, 1070, Brussels, Belgium
- Department of Computer Science, University of Oxford, Oxford, 7 Parks Rd, Oxford, OX1 3QG, UK
| | - Emmanuel A Stamatakis
- Division of Anaesthesia and Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Alain Destexhe
- Institute of Neuroscience (NeuroPSI), Paris-Saclay University, Centre National de la Recherche Scientifique (CNRS), Gif-sur-Yvette, France
| | - Bechir Jarraya
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191, Gif-sur-Yvette, France
- Department of Neurology, Hopital Foch, 92150, Suresnes, France
| | - Rodrigo Cofre
- Institute of Neuroscience (NeuroPSI), Paris-Saclay University, Centre National de la Recherche Scientifique (CNRS), Gif-sur-Yvette, France.
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15
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Cylinder DM, van Zundert AA, Solt K, van Swinderen B. Time to Wake Up! The Ongoing Search for General Anesthetic Reversal Agents. Anesthesiology 2024; 140:610-627. [PMID: 38349760 PMCID: PMC10868874 DOI: 10.1097/aln.0000000000004846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
How general anesthetics work remains a topic of ongoing study. A parallel field of research has sought to identify methods to reverse general anesthesia. Reversal agents could shorten patients' recovery time and potentially reduce the risk of postoperative complications. An incomplete understanding of the mechanisms of general anesthesia has hampered the pursuit for reversal agents. Nevertheless, the search for reversal agents has furthered understanding of the mechanisms underlying general anesthesia. The study of potential reversal agents has highlighted the importance of rigorous criteria to assess recovery from general anesthesia in animal models, and has helped identify key arousal systems (e.g., cholinergic, dopaminergic, and orexinergic systems) relevant to emergence from general anesthesia. Furthermore, the effects of reversal agents have been found to be inconsistent across different general anesthetics, revealing differences in mechanisms among these drugs. The presynapse and glia probably also contribute to general anesthesia recovery alongside postsynaptic receptors. The next stage in the search for reversal agents will have to consider alternate mechanisms encompassing the tripartite synapse.
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Affiliation(s)
- Drew M. Cylinder
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - André A.J. van Zundert
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, The University of Queensland, Brisbane, QLD, Australia
| | - Ken Solt
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, U.S.A
- Department of Anaesthesia, Harvard Medical School, Boston, MA, U.S.A
| | - Bruno van Swinderen
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
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16
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Cao F, Guo Y, Guo S, Hao X, Yang L, Cao J, Zhou Z, Mi W, Tong L. Prelimbic cortical pyramidal neurons to ventral tegmental area projections promotes arousal from sevoflurane anesthesia. CNS Neurosci Ther 2024; 30:e14675. [PMID: 38488453 PMCID: PMC10941502 DOI: 10.1111/cns.14675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/27/2024] [Accepted: 02/28/2024] [Indexed: 03/18/2024] Open
Abstract
AIMS General anesthesia has been used in surgical procedures for approximately 180 years, yet the precise mechanism of anesthetic drugs remains elusive. There is significant anatomical connectivity between the ventral tegmental area (VTA) and the prelimbic cortex (PrL). Projections from VTA dopaminergic neurons (VTADA ) to the PrL play a role in the transition from sevoflurane anesthesia to arousal. It is still uncertain whether the prelimbic cortex pyramidal neuron (PrLPyr ) and its projections to VTA (PrLPyr -VTA) are involved in anesthesia-arousal regulation. METHODS We employed chemogenetics and optogenetics to selectively manipulate neuronal activity in the PrLPyr -VTA pathway. Electroencephalography spectra and burst-suppression ratios (BSR) were used to assess the depth of anesthesia. Furthermore, the loss or recovery of the righting reflex was monitored to indicate the induction or emergence time of general anesthesia. To elucidate the receptor mechanisms in the PrLPyr -VTA projection's impact on anesthesia and arousal, we microinjected NMDA receptor antagonists (MK-801) or AMPA receptor antagonists (NBQX) into the VTA. RESULTS Our findings show that chemogenetic or optogenetic activation of PrLPyr neurons prolonged anesthesia induction and promoted emergence. Additionally, chemogenetic activation of the PrLPyr -VTA neural pathway delayed anesthesia induction and promoted anesthesia emergence. Likewise, optogenetic activation of the PrLPyr -VTA projections extended the induction time and facilitated emergence from sevoflurane anesthesia. Moreover, antagonizing NMDA receptors in the VTA attenuates the delayed anesthesia induction and promotes emergence caused by activating the PrLPyr -VTA projections. CONCLUSION This study demonstrates that PrLPyr neurons and their projections to the VTA are involved in facilitating emergence from sevoflurane anesthesia, with the PrLPyr -VTA pathway exerting its effects through the activation of NMDA receptors within the VTA.
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Affiliation(s)
- Fuyang Cao
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
- Department of AnesthesiologyThe Sixth Medical Center of Chinese PLA General HospitalBeijingChina
- Chinese PLA Medical SchoolBeijingChina
| | - Yongxin Guo
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Shuting Guo
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
- Chinese PLA Medical SchoolBeijingChina
| | - Xinyu Hao
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
- Chinese PLA Medical SchoolBeijingChina
| | - Lujia Yang
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Jiangbei Cao
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Zhikang Zhou
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Weidong Mi
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
| | - Li Tong
- Department of AnesthesiologyThe First Medical Center of Chinese PLA General HospitalBeijingChina
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17
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McKinstry-Wu AR, Kelz MB. One node among many: sevoflurane-induced hypnosis and the challenge of an integrative network-level view of anaesthetic action. Br J Anaesth 2024; 132:220-223. [PMID: 38000931 DOI: 10.1016/j.bja.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
Building on their known ability to influence sleep and arousal, Li and colleagues show that modulating the activity of glutamatergic pedunculopontine tegmental neurones also alters sevoflurane-induced hypnosis. This finding adds support for the shared sleep-anaesthesia circuit hypothesis. However, the expanding recognition of many neuronal clusters capable of modulating anaesthetic hypnosis raises the question of how disparate and anatomically distant sites ultimately interact to coordinate global changes in the state of the brain. Understanding how these individual sites work in concert to disrupt cognition and behaviour is the next challenge for anaesthetic mechanisms research.
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Affiliation(s)
- Andrew R McKinstry-Wu
- Department of Anaesthesiology and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA; Center for Neuroscience of Unconsciousness and Reanimation Research Alliance, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Max B Kelz
- Department of Anaesthesiology and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA; Center for Neuroscience of Unconsciousness and Reanimation Research Alliance, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA; Mahoney Institute of Neuroscience, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
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18
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Li B, Ma C, Huang YA, Ding X, Silverman D, Chen C, Darmohray D, Lu L, Liu S, Montaldo G, Urban A, Dan Y. Circuit mechanism for suppression of frontal cortical ignition during NREM sleep. Cell 2023; 186:5739-5750.e17. [PMID: 38070510 DOI: 10.1016/j.cell.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 09/06/2023] [Accepted: 11/09/2023] [Indexed: 12/24/2023]
Abstract
Conscious perception is greatly diminished during sleep, but the underlying circuit mechanism is poorly understood. We show that cortical ignition-a brain process shown to be associated with conscious awareness in humans and non-human primates-is strongly suppressed during non-rapid-eye-movement (NREM) sleep in mice due to reduced cholinergic modulation and rapid inhibition of cortical responses. Brain-wide functional ultrasound imaging and cell-type-specific calcium imaging combined with optogenetics showed that activity propagation from visual to frontal cortex is markedly reduced during NREM sleep due to strong inhibition of frontal pyramidal neurons. Chemogenetic activation and inactivation of basal forebrain cholinergic neurons powerfully increased and decreased visual-to-frontal activity propagation, respectively. Furthermore, although multiple subtypes of dendrite-targeting GABAergic interneurons in the frontal cortex are more active during wakefulness, soma-targeting parvalbumin-expressing interneurons are more active during sleep. Chemogenetic manipulation of parvalbumin interneurons showed that sleep/wake-dependent cortical ignition is strongly modulated by perisomatic inhibition of pyramidal neurons.
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Affiliation(s)
- Bing Li
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Chenyan Ma
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Yun-An Huang
- Neuro-Electronics Research Flanders, VIB, Department of Neurosciences, KU Leuven, imec, Leuven, Belgium
| | - Xinlu Ding
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Daniel Silverman
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Changwan Chen
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Dana Darmohray
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Lihui Lu
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Siqi Liu
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Gabriel Montaldo
- Neuro-Electronics Research Flanders, VIB, Department of Neurosciences, KU Leuven, imec, Leuven, Belgium
| | - Alan Urban
- Neuro-Electronics Research Flanders, VIB, Department of Neurosciences, KU Leuven, imec, Leuven, Belgium
| | - Yang Dan
- Division of Neurobiology, Department of Molecular and Cell Biology, Helen Wills Neuroscience Institute, Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA.
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19
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Zhang Y, Wang Y, Cheng H, Yan F, Li D, Song D, Wang Q, Huang L. EEG spectral slope: A reliable indicator for continuous evaluation of consciousness levels during propofol anesthesia. Neuroimage 2023; 283:120426. [PMID: 37898378 DOI: 10.1016/j.neuroimage.2023.120426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023] Open
Abstract
The level of consciousness undergoes continuous alterations during anesthesia. Prior to the onset of propofol-induced complete unconsciousness, degraded levels of behavioral responsiveness can be observed. However, a reliable index to monitor altered consciousness levels during anesthesia has not been sufficiently investigated. In this study, we obtained 60-channel EEG data from 24 healthy participants during an ultra-slow propofol infusion protocol starting with an initial concentration of 1 μg/ml and a stepwise increase of 0.2 μg/ml in concentration. Consecutive auditory stimuli were delivered every 5 to 6 s, and the response time to the stimuli was used to assess the responsiveness levels. We calculated the spectral slope in a time-resolved manner by extracting 5-second EEG segments at each auditory stimulus and estimated their correlation with the corresponding response time. Our results demonstrated that during slow propofol infusion, the response time to external stimuli increased, while the EEG spectral slope, fitted at 15-45 Hz, became steeper, and a significant negative correlation was observed between them. Moreover, the spectral slope further steepened at deeper anesthetic levels and became flatter during anesthesia recovery. We verified these findings using an external dataset. Additionally, we found that the spectral slope of frontal electrodes over the prefrontal lobe had the best performance in predicting the response time. Overall, this study used a time-resolved analysis to suggest that the EEG spectral slope could reliably track continuously altered consciousness levels during propofol anesthesia. Furthermore, the frontal spectral slope may be a promising index for clinical monitoring of anesthesia depth.
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Affiliation(s)
- Yun Zhang
- School of Life Science and Technology, Xidian University, No.2 TaiBai South Road, Xi'an 710061, China
| | - Yubo Wang
- School of Life Science and Technology, Xidian University, No.2 TaiBai South Road, Xi'an 710061, China
| | - Huanhuan Cheng
- School of Life Science and Technology, Xidian University, No.2 TaiBai South Road, Xi'an 710061, China
| | - Fei Yan
- Department of Anesthesiology & Center for Brain Science, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China
| | - Dingning Li
- School of Life Science and Technology, Xidian University, No.2 TaiBai South Road, Xi'an 710061, China
| | - Dawei Song
- Department of Anesthesiology & Center for Brain Science, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China
| | - Qiang Wang
- Department of Anesthesiology & Center for Brain Science, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China.
| | - Liyu Huang
- School of Life Science and Technology, Xidian University, No.2 TaiBai South Road, Xi'an 710061, China.
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20
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Zelmann R, Paulk AC, Tian F, Balanza Villegas GA, Dezha Peralta J, Crocker B, Cosgrove GR, Richardson RM, Williams ZM, Dougherty DD, Purdon PL, Cash SS. Differential cortical network engagement during states of un/consciousness in humans. Neuron 2023; 111:3479-3495.e6. [PMID: 37659409 PMCID: PMC10843836 DOI: 10.1016/j.neuron.2023.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 06/13/2023] [Accepted: 08/08/2023] [Indexed: 09/04/2023]
Abstract
What happens in the human brain when we are unconscious? Despite substantial work, we are still unsure which brain regions are involved and how they are impacted when consciousness is disrupted. Using intracranial recordings and direct electrical stimulation, we mapped global, network, and regional involvement during wake vs. arousable unconsciousness (sleep) vs. non-arousable unconsciousness (propofol-induced general anesthesia). Information integration and complex processing we`re reduced, while variability increased in any type of unconscious state. These changes were more pronounced during anesthesia than sleep and involved different cortical engagement. During sleep, changes were mostly uniformly distributed across the brain, whereas during anesthesia, the prefrontal cortex was the most disrupted, suggesting that the lack of arousability during anesthesia results not from just altered overall physiology but from a disconnection between the prefrontal and other brain areas. These findings provide direct evidence for different neural dynamics during loss of consciousness compared with loss of arousability.
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Affiliation(s)
- Rina Zelmann
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA.
| | - Angelique C Paulk
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA
| | - Fangyun Tian
- Department of Anesthesia, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Britni Crocker
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Harvard-MIT Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - R Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Ziv M Williams
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick L Purdon
- Department of Anesthesia, Massachusetts General Hospital, Boston, MA, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA
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21
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Guo Y, Song Y, Cao F, Li A, Hao X, Shi W, Zhou Z, Cao J, Liu Y, Mi W, Tong L. Ventrolateral periaqueductal gray GABAergic neurons promote arousal of sevoflurane anesthesia through cortico-midbrain circuit. iScience 2023; 26:107486. [PMID: 37744409 PMCID: PMC10517397 DOI: 10.1016/j.isci.2023.107486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 05/24/2023] [Accepted: 07/24/2023] [Indexed: 09/26/2023] Open
Abstract
The mechanism of general anesthesia remains elusive. The ventrolateral periaqueductal gray (vlPAG) in the midbrain regulates sleep and awake states. However, the role of vlPAG and its circuits in anesthesia is unclear. We utilized opto/chemogenetics, righting reflex, and electroencephalographic recording to assess consciousness changes. We employed fiber photometry to measure the activity of neurons and neurotransmitters. As a result, photometry recording showed that the activity of GABA neurons in vlPAG decreased during sevoflurane anesthesia and was reactivated after anesthesia. Activating GABAergic neurons in vlPAG promoted arousal during anesthesia, while inhibiting them delayed this process. Furthermore, medial prefrontal cortex (mPFC) to vlPAG pyramidal neurons projections and vlPAG to ventral tegmental area (VTA) GABAergic projections played a prominent role in the anesthesia-awake transition. GABA neurotransmitter activity of VTA synchronized with mPFC-vlPAG pyramidal neuron projections. Therefore, the cortico-midbrain circuits centered on vlPAG GABAergic neurons exert an arousal-promoting effect during sevoflurane anesthesia.
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Affiliation(s)
- Yongxin Guo
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Yanping Song
- Department of Anaesthesiology, 922th Hospital of Joint Logistics Support Force, PLA, Hengyang, Hunan, China
| | - Fuyang Cao
- Department of Anaesthesiology, The Sixth Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Ao Li
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Xinyu Hao
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Wenzhu Shi
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Zhikang Zhou
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Jiangbei Cao
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Yanhong Liu
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Weidong Mi
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
| | - Li Tong
- Department of Anaesthesiology, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
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22
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Bao W, Ding J, Jiang S, Yao Z, Qu W, Li W, Huang Z, Han Y. Selective Activation of NAc D1R-VP/LH Circuits Promotes Reanimation From Sevoflurane Anesthesia in Mice. Anesth Analg 2023; 137:87-97. [PMID: 36944111 DOI: 10.1213/ane.0000000000006436] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Emerging evidence has uncovered a vital role of nucleus accumbens (NAc) neurons that express the dopamine D1 receptor (D1R) and its upstream neural circuit in general anesthesia (GA) regulation. However, the underlying downstream neural basis of the modulation of GA emergence by NAc D1R neurons remains unknown. In the present study, we explored the downstream neural mechanism of NAc D1R neurons in the modulation of emergence from sevoflurane GA. METHODS We traced the axonal projections of NAc D1R neurons using a cell type-specific anterograde tracing method and immunohistochemical techniques in D1R-Cre mice. Optogenetic stimulations combined with electroencephalogram/electromyogram recordings and behavioral tests were used to determine the effects of optogenetic activation of the axonal terminals of NAc D1R neurons on sevoflurane emergence during sevoflurane-induced continuous, steady-state general anesthesia (CSSGA) or burst-suppression oscillations. RESULTS Labeled efferent fibers of NAc D1R neurons were highly distributed in the ventral pallidum (VP), lateral hypothalamus (LH), and substantia nigra pars compacta. Optogenetic activation of the NAc D1R -VP circuit during CSSGA with sevoflurane induced cortical activation (mean ± standard deviation [SD]; delta power: prestimulation versus during stimulation, 48.7% ± 5.7% vs 35.1% ± 3.3%, P < .0001; beta power: 7.1% ± 2.7% vs 14.2% ± 3.3%, P = .0264) and behavioral emergence, and restored the righting reflex in 66.7% of ChR2 mice. Optogenetic stimulation of the NAc D1R -LH circuit also produced cortical activation (delta power: prestimulation versus during stimulation, 45.0% ± 6.5% vs 36.1% ± 4.6%, P = .0016) and behavioral emergence, and restored the righting reflex in 100% of the ChR2 mice during CSSGA with sevoflurane. Under a sevoflurane-induced burst-suppression state, NAc D1R -VP/LH circuit activation produced evidence of cortical activation (burst-suppression ratio [BSR]: NAc D1R -VP circuit, prestimulation versus during stimulation, 42.4% ± 4.0% vs 26.3% ± 6.0%, P = .0120; prestimulation versus poststimulation, 42.4% ± 4.0% vs 5.9% ± 5.6%, P = .0002; BSR: NAc D1R -LH circuit, prestimulation versus during stimulation, 33.3% ± 13.4% vs 5.1% ± 4.9%, P = .0177; prestimulation vs poststimulation, 33.3% ± 13.4% vs 3.2% ± 4.0%, P = .0105) and behavioral emergence. CONCLUSIONS Both NAc D1R -VP and NAc D1R -LH circuits are sufficient to promote reanimation from sevoflurane GA by simultaneously inducing cortical and behavioral emergence.
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Affiliation(s)
- Weiwei Bao
- From the Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiahui Ding
- From the Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Shan Jiang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhen Yao
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weimin Qu
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wenxian Li
- From the Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Zhili Huang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuan Han
- From the Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
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23
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Baron M, Devor M. From molecule to oblivion: dedicated brain circuitry underlies anesthetic loss of consciousness permitting pain-free surgery. Front Mol Neurosci 2023; 16:1197304. [PMID: 37305550 PMCID: PMC10248014 DOI: 10.3389/fnmol.2023.1197304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/04/2023] [Indexed: 06/13/2023] Open
Abstract
The canonical view of how general anesthetics induce loss-of-consciousness (LOC) permitting pain-free surgery posits that anesthetic molecules, distributed throughout the CNS, suppress neural activity globally to levels at which the cerebral cortex can no longer sustain conscious experience. We support an alternative view that LOC, in the context of GABAergic anesthesia at least, results from anesthetic exposure of a small number of neurons in a focal brainstem nucleus, the mesopontine tegmental anesthesia area (MPTA). The various sub-components of anesthesia, in turn, are effected in distant locations, driven by dedicated axonal pathways. This proposal is based on the observations that microinjection of infinitesimal amounts of GABAergic agents into the MPTA, and only there, rapidly induces LOC, and that lesioning the MPTA renders animals relatively insensitive to these agents delivered systemically. Recently, using chemogenetics, we identified a subpopulation of MPTA "effector-neurons" which, when excited (not inhibited), induce anesthesia. These neurons contribute to well-defined ascending and descending axonal pathways each of which accesses a target region associated with a key anesthetic endpoint: atonia, anti-nociception, amnesia and LOC (by electroencephalographic criteria). Interestingly, the effector-neurons do not themselves express GABAA-receptors. Rather, the target receptors reside on a separate sub-population of presumed inhibitory interneurons. These are thought to excite the effectors by disinhibition, thus triggering anesthetic LOC.
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Affiliation(s)
- Mark Baron
- Department of Cell and Developmental Biology, Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Marshall Devor
- Department of Cell and Developmental Biology, Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
- Center for Research on Pain, The Hebrew University of Jerusalem, Jerusalem, Israel
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24
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Lawn T, Martins D, O'Daly O, Williams S, Howard M, Dipasquale O. The effects of propofol anaesthesia on molecular-enriched networks during resting-state and naturalistic listening. Neuroimage 2023; 271:120018. [PMID: 36935083 PMCID: PMC10410200 DOI: 10.1016/j.neuroimage.2023.120018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
Placing a patient in a state of anaesthesia is crucial for modern surgical practice. However, the mechanisms by which anaesthetic drugs, such as propofol, impart their effects on consciousness remain poorly understood. Propofol potentiates GABAergic transmission, which purportedly has direct actions on cortex as well as indirect actions via ascending neuromodulatory systems. Functional imaging studies to date have been limited in their ability to unravel how these effects on neurotransmission impact the system-level dynamics of the brain. Here, we leveraged advances in multi-modal imaging, Receptor-Enriched Analysis of functional Connectivity by Targets (REACT), to investigate how different levels of propofol-induced sedation alter neurotransmission-related functional connectivity (FC), both at rest and when individuals are exposed to naturalistic auditory stimulation. Propofol increased GABA-A- and noradrenaline transporter-enriched FC within occipital and somatosensory regions respectively. Additionally, during auditory stimulation, the network related to the dopamine transporter showed reduced FC within bilateral regions of temporal and mid/posterior cingulate cortices, with the right temporal cluster showing an interaction between auditory stimulation and level of consciousness. In bringing together these micro- and macro-scale systems, we provide support for both direct GABAergic and indirect noradrenergic and dopaminergic-related network changes under propofol sedation. Further, we delineate a cognition-related reconfiguration of the dopaminergic network, highlighting the utility of REACT to explore the molecular substrates of consciousness and cognition.
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Affiliation(s)
- Timothy Lawn
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK.
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Steve Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Matthew Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
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25
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McKinstry-Wu AR, Wasilczuk AZ, Dailey WP, Eckenhoff RG, Kelz MB. In Vivo Photoadduction of Anesthetic Ligands in Mouse Brain Markedly Extends Sedation and Hypnosis. J Neurosci 2023; 43:2338-2348. [PMID: 36849414 PMCID: PMC10072292 DOI: 10.1523/jneurosci.1884-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/01/2023] Open
Abstract
Photoaffinity ligands are best known as tools used to identify the specific binding sites of drugs to their molecular targets. However, photoaffinity ligands have the potential to further define critical neuroanatomic targets of drug action. In the brains of WT male mice, we demonstrate the feasibility of using photoaffinity ligands in vivo to prolong anesthesia via targeted yet spatially restricted photoadduction of azi-m-propofol (aziPm), a photoreactive analog of the general anesthetic propofol. Systemic administration of aziPm with bilateral near-ultraviolet photoadduction in the rostral pons, at the border of the parabrachial nucleus and locus coeruleus, produced a 20-fold increase in the duration of sedative and hypnotic effects compared with control mice without UV illumination. Photoadduction that missed the parabrachial-coerulean complex also failed to extend the sedative or hypnotic actions of aziPm and was indistinguishable from nonadducted controls. Paralleling the prolonged behavioral and EEG consequences of on target in vivo photoadduction, we conducted electrophysiologic recordings in rostral pontine brain slices. Using neurons within the locus coeruleus to further highlight the cellular consequences of irreversible aziPm binding, we demonstrate transient slowing of spontaneous action potentials with a brief bath application of aziPm that becomes irreversible on photoadduction. Together, these findings suggest that photochemistry-based strategies are a viable new approach for probing CNS physiology and pathophysiology.SIGNIFICANCE STATEMENT Photoaffinity ligands are drugs capable of light-induced irreversible binding, which have unexploited potential to identify the neuroanatomic sites of drug action. We systemically administer a centrally acting anesthetic photoaffinity ligand in mice, conduct localized photoillumination within the brain to covalently adduct the drug at its in vivo sites of action, and successfully enrich irreversible drug binding within a restricted 250 µm radius. When photoadduction encompassed the pontine parabrachial-coerulean complex, anesthetic sedation and hypnosis was prolonged 20-fold, thus illustrating the power of in vivo photochemistry to help unravel neuronal mechanisms of drug action.
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Affiliation(s)
- Andrew R McKinstry-Wu
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia 19104
- Neuroscience of Unconsciousness and Reanimation Research Alliance, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Philadelphia 19104
| | - Andrzej Z Wasilczuk
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia 19104
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Philadelphia 19104
- Neuroscience of Unconsciousness and Reanimation Research Alliance, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Philadelphia 19104
| | - William P Dailey
- Department of Chemistry, University of Pennsylvania School of Arts and Sciences, Philadelphia, Pennsylvania 19104
| | - Roderic G Eckenhoff
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia 19104
| | - Max B Kelz
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia 19104
- Mahoney Institute for Neurosciences, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Philadelphia 19104
- Neuroscience of Unconsciousness and Reanimation Research Alliance, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Philadelphia 19104
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26
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Weiner VS, Zhou DW, Kahali P, Stephen EP, Peterfreund RA, Aglio LS, Szabo MD, Eskandar EN, Salazar-Gomez AF, Sampson AL, Cash SS, Brown EN, Purdon PL. Propofol disrupts alpha dynamics in functionally distinct thalamocortical networks during loss of consciousness. Proc Natl Acad Sci U S A 2023; 120:e2207831120. [PMID: 36897972 PMCID: PMC10089159 DOI: 10.1073/pnas.2207831120] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 01/14/2023] [Indexed: 03/12/2023] Open
Abstract
During propofol-induced general anesthesia, alpha rhythms measured using electroencephalography undergo a striking shift from posterior to anterior, termed anteriorization, where the ubiquitous waking alpha is lost and a frontal alpha emerges. The functional significance of alpha anteriorization and the precise brain regions contributing to the phenomenon are a mystery. While posterior alpha is thought to be generated by thalamocortical circuits connecting nuclei of the sensory thalamus with their cortical partners, the thalamic origins of the propofol-induced alpha remain poorly understood. Here, we used human intracranial recordings to identify regions in sensory cortices where propofol attenuates a coherent alpha network, distinct from those in the frontal cortex where it amplifies coherent alpha and beta activities. We then performed diffusion tractography between these identified regions and individual thalamic nuclei to show that the opposing dynamics of anteriorization occur within two distinct thalamocortical networks. We found that propofol disrupted a posterior alpha network structurally connected with nuclei in the sensory and sensory associational regions of the thalamus. At the same time, propofol induced a coherent alpha oscillation within prefrontal cortical areas that were connected with thalamic nuclei involved in cognition, such as the mediodorsal nucleus. The cortical and thalamic anatomy involved, as well as their known functional roles, suggests multiple means by which propofol dismantles sensory and cognitive processes to achieve loss of consciousness.
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Affiliation(s)
- Veronica S. Weiner
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
| | - David W. Zhou
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Center for Neurotechnology and Recovery, Department of Neurology, Massachusetts General Hospital, Boston, MA02114
| | - Pegah Kahali
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Emily P. Stephen
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
| | - Robert A. Peterfreund
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
| | - Linda S. Aglio
- Harvard Medical School, Boston, MA02115
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA02115
| | - Michele D. Szabo
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Emad N. Eskandar
- Harvard Medical School, Boston, MA02115
- Department of Neurological Surgery, Massachusetts General Hospital, Boston, MA02114
| | - Andrés F. Salazar-Gomez
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Aaron L. Sampson
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Sydney S. Cash
- Center for Neurotechnology and Recovery, Department of Neurology, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
| | - Emery N. Brown
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
- Division of Health Sciences and Technology, Harvard Medical School/Massachusetts Institute of Technology, Cambridge, MA02139
- Institute of Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
| | - Patrick L. Purdon
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
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27
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Choe M, Jin SH, Kim JS, Chung CK. Propofol anesthesia-induced spatiotemporal changes in cortical activity with loss of external and internal awareness: An electrocorticography study. Clin Neurophysiol 2023; 149:51-60. [PMID: 36898318 DOI: 10.1016/j.clinph.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/12/2023] [Accepted: 01/29/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To understand the underlying mechanism of consciousness, investigating spatiotemporal changes in the cortical activity during the induction phase of unconsciousness is important. Loss of consciousness induced by general anesthesia is not necessarily accompanied by a uniform inhibition of all cortical activities. We hypothesized that cortical regions involved in internal awareness would be suppressed after disruption of cortical regions involved in external awareness. Thus, we investigated temporal changes in cortex during induction of unconsciousness. METHODS We recorded electrocorticography data of 16 epilepsy patients and investigated power spectral changes during induction phase from awake state to unconsciousness. Temporal changes were assessed at 1) the start point and 2) the interval of normalized time between start and end of power change (Δ tnormalized). RESULTS We found that the power increased at frequencies < 46 Hz, and decreased in range of 62-150 Hz, in global channels. In temporal changes of power change, superior parietal lobule and dorsolateral prefrontal cortex started to change early, but the changes were completed over a prolonged interval, whereas angular gyrus and associative visual cortex showed a delayed change and rapid completion. CONCLUSIONS Loss of consciousness induced by general anesthesia results first from disrupted communication between self and external world, followed by disrupted communication within self, with decreased activities of superior parietal lobule and dorsolateral prefrontal cortex, and later, attenuated activities of angular gyrus. SIGNIFICANCE Our findings provided neurophysiological evidence for the temporal changes in consciousness components induced by general anesthesia.
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Affiliation(s)
- Mikyung Choe
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Seung-Hyun Jin
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - June Sic Kim
- The Research Institute of Basic Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Chun Kee Chung
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea; Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
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28
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Lyu J, Cai H, Chen Y, Chen G. Brain areas modulation in consciousness during sevoflurane anesthesia. Front Integr Neurosci 2022; 16:1031613. [PMID: 36619239 PMCID: PMC9811387 DOI: 10.3389/fnint.2022.1031613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Sevoflurane is presently one of the most used inhaled anesthetics worldwide. However, the mechanisms through which sevoflurane acts and the areas of the brain associated with changes in consciousness during anesthesia remain important and complex research questions. Sevoflurane is generally regarded as a volatile anesthetic that blindly targets neuronal (and sometimes astrocyte) GABAA receptors. This review focuses on the brain areas of sevoflurane action and their relation to changes in consciousness during anesthesia. We cover 20 years of history, from the bench to the bedside, and include perspectives on functional magnetic resonance, electroencephalogram, and pharmacological experiments. We review the interactions and neurotransmitters involved in brain circuits during sevoflurane anesthesia, improving the effectiveness and accuracy of sevoflurane's future application and shedding light on the mechanisms behind human consciousness.
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29
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Wang H, Zhang Y, Cheng H, Yan F, Song D, Wang Q, Cai S, Wang Y, Huang L. Selective corticocortical connectivity suppression during propofol-induced anesthesia in healthy volunteers. Cogn Neurodyn 2022; 16:1029-1043. [PMID: 36237410 PMCID: PMC9508318 DOI: 10.1007/s11571-021-09775-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/17/2021] [Accepted: 12/13/2021] [Indexed: 11/03/2022] Open
Abstract
We comprehensively studied directional feedback and feedforward connectivity to explore potential connectivity changes that underlie propofol-induced deep sedation. We further investigated the corticocortical connectivity patterns within and between hemispheres. Sixty-channel electroencephalographic data were collected from 19 healthy volunteers in a resting wakefulness state and propofol-induced deep unconsciousness state defined by a bispectral index value of 40. A source analysis was employed to locate cortical activity. The Desikan-Killiany atlas was used to partition cortices, and directional functional connectivity was assessed by normalized symbolic transfer entropy between higher-order (prefrontal and frontal) and lower-order (auditory, sensorimotor and visual) cortices and between hot-spot frontal and parietal cortices. We found that propofol significantly suppressed feedforward connectivity from the left parietal to right frontal cortex and bidirectional connectivity between the left frontal and left parietal cortex, between the frontal and auditory cortex, and between the frontal and sensorimotor cortex. However, there were no significant changes in either feedforward or feedback connectivity between the prefrontal and all the lower-order cortices and between the frontal and visual cortices or in feedback connectivity from the frontal to parietal cortex. Propofol anesthetic selectively decreased the unidirectional interaction between higher-order frontoparietal cortices and bidirectional interactions between the higher-order frontal cortex and lower-order auditory and sensorimotor cortices, which indicated that both feedback and feedforward connectivity were suppressed under propofol-induced deep sedation. Our findings provide critical insights into the connectivity changes underlying the top-down mechanism of propofol anesthesia at deep sedation. Supplementary Information The online version contains supplementary material available at 10.1007/s11571-021-09775-x.
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Affiliation(s)
- Haidong Wang
- School of Life Science and Technology, Xidian University, No. 2 South Taibai Road, Xi’an, 710071 China
| | - Yun Zhang
- School of Life Science and Technology, Xidian University, No. 2 South Taibai Road, Xi’an, 710071 China
| | - Huanhuan Cheng
- School of Life Science and Technology, Xidian University, No. 2 South Taibai Road, Xi’an, 710071 China
| | - Fei Yan
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an, 710061 China
| | - Dawei Song
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an, 710061 China
| | - Qiang Wang
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an, 710061 China
| | - Suping Cai
- School of Life Science and Technology, Xidian University, No. 2 South Taibai Road, Xi’an, 710071 China
| | - Yubo Wang
- School of Life Science and Technology, Xidian University, No. 2 South Taibai Road, Xi’an, 710071 China
| | - Liyu Huang
- School of Life Science and Technology, Xidian University, No. 2 South Taibai Road, Xi’an, 710071 China
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30
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Mashour GA, Pal D, Brown EN. Prefrontal cortex as a key node in arousal circuitry. Trends Neurosci 2022; 45:722-732. [PMID: 35995629 PMCID: PMC9492635 DOI: 10.1016/j.tins.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/02/2022] [Accepted: 07/31/2022] [Indexed: 10/15/2022]
Abstract
The role of the prefrontal cortex (PFC) in the mechanism of consciousness is a matter of active debate. Most theoretical and empirical investigations have focused on whether the PFC is critical for the content of consciousness (i.e., the qualitative aspects of conscious experience). However, there is emerging evidence that, in addition to its well-established roles in cognition, the PFC is a key regulator of the level of consciousness (i.e., the global state of arousal). In this opinion article we review recent data supporting the hypothesis that the medial PFC is a critical node in arousal-promoting networks.
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Affiliation(s)
- George A Mashour
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA; Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA; Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA; Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA; Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA.
| | - Dinesh Pal
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA; Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA; Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA; Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Emery N Brown
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA; Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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31
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Glovak ZT, Baghdoyan HA, Lydic R. Fentanyl and neostigmine delivered to mouse prefrontal cortex differentially alter breathing. Respir Physiol Neurobiol 2022; 303:103924. [PMID: 35662641 DOI: 10.1016/j.resp.2022.103924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/13/2022] [Accepted: 05/29/2022] [Indexed: 11/17/2022]
Abstract
Opioids impair many functions modulated by the prefrontal cortex (PFC), including wakefulness, cognition, and breathing. In contrast, cholinergic activity in the PFC increases wakefulness. This study tested the hypothesis that microinjecting the opioid fentanyl and the acetylcholinesterase inhibitor neostigmine into the PFC of awake C57BL/6J male mice (n = 27) alters breathing. The lateral and medial PFC were unilaterally microinjected with saline (control) and fentanyl. The medial PFC received additional microinjections of neostigmine. The results show that fentanyl caused site-specific changes in breathing. Fentanyl delivered to the lateral PFC significantly decreased minute ventilation variability, whereas fentanyl delivered to the medial PFC significantly increased tidal volume and duty cycle. Neostigmine microinjected into the medial PFC significantly increased respiratory rate, tidal volume, and minute ventilation. A final series of experiments revealed that decreased minute ventilation caused by systemic fentanyl administration was mitigated by PFC microinjection of neostigmine.
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Affiliation(s)
- Zachary T Glovak
- Department of Psychology, University of Tennessee, Knoxville TN 37996, USA
| | - Helen A Baghdoyan
- Department of Psychology, University of Tennessee, Knoxville TN 37996, USA; Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - Ralph Lydic
- Department of Psychology, University of Tennessee, Knoxville TN 37996, USA; Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA.
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Altered functional and directed connectivity in propofol-induced loss of consciousness: A source-space resting-state EEG study. Clin Neurophysiol 2022; 142:209-219. [DOI: 10.1016/j.clinph.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2022]
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Almeida VN, Radanovic M. Semantic processing and neurobiology in Alzheimer's disease and Mild Cognitive Impairment. Neuropsychologia 2022; 174:108337. [DOI: 10.1016/j.neuropsychologia.2022.108337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/17/2022] [Accepted: 07/17/2022] [Indexed: 11/28/2022]
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Cheng Y, Liu S, Zhang L, Jiang H. Identification of Prefrontal Cortex and Amygdala Expressed Genes Associated With Sevoflurane Anesthesia on Non-human Primate. Front Integr Neurosci 2022; 16:857349. [PMID: 35845920 PMCID: PMC9286018 DOI: 10.3389/fnint.2022.857349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022] Open
Abstract
Clinical trials and animal studies have indicated that long-term use or multiple administrations of anesthesia may lead to fine motor impairment in the developing brain. Most studies on anesthesia-induced neurotoxicity have focused on the hippocampus and prefrontal cortex (PFC); however, the role of other vital encephalic regions, such as the amygdala, is still unclear. Herein, we focused on sevoflurane, the most commonly used volatile anesthetic in infants, and performed a transcriptional analysis of the PFC and amygdala of macaques after multiple exposures to the anesthetic by RNA sequencing. The overall, overlapping, and encephalic region-specific transcriptional patterns were separately analyzed to reveal their functions and differentially expressed gene sets that were influenced by sevoflurane. Specifically, functional, protein–protein interaction, neighbor gene network, and gene set enrichment analyses were performed. Further, we built the basic molecular feature of the amygdala by comparing it to the PFC. In comparison with the amygdala’s changing pattern following sevoflurane exposure, functional annotations of the PFC were more enriched in glial cell-related biological functions than in neuron and synapsis development. Taken together, transcriptional studies and bioinformatics analyses allow for an improved understanding of the primate PFC and amygdala.
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Zhang K, Pan J, Yu Y. Regulation of Neural Circuitry under General Anesthesia: New Methods and Findings. Biomolecules 2022; 12:biom12070898. [PMID: 35883456 PMCID: PMC9312763 DOI: 10.3390/biom12070898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 02/01/2023] Open
Abstract
General anesthesia has been widely utilized since the 1840s, but its underlying neural circuits remain to be completely understood. Since both general anesthesia and sleep are reversible losses of consciousness, studies on the neural-circuit mechanisms affected by general anesthesia have mainly focused on the neural nuclei or the pathways known to regulate sleep. Three advanced technologies commonly used in neuroscience, in vivo calcium imaging, chemogenetics, and optogenetics, are used to record and modulate the activity of specific neurons or neural circuits in the brain areas of interest. Recently, they have successfully been used to study the neural nuclei and pathways of general anesthesia. This article reviews these three techniques and their applications in the brain nuclei or pathways affected by general anesthesia, to serve as a reference for further and more accurate exploration of other neural circuits under general anesthesia and to contribute to other research fields in the future.
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Affiliation(s)
- Kai Zhang
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin 300052, China; (K.Z.); (J.P.)
- Tianjin Institute of Anesthesiology, Tianjin 300052, China
| | - Jiacheng Pan
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin 300052, China; (K.Z.); (J.P.)
- Tianjin Institute of Anesthesiology, Tianjin 300052, China
| | - Yonghao Yu
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin 300052, China; (K.Z.); (J.P.)
- Tianjin Institute of Anesthesiology, Tianjin 300052, China
- Correspondence:
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Eniwaye BP, Booth V, Hudetz AG, Zochowski M. Modeling cortical synaptic effects of anesthesia and their cholinergic reversal. PLoS Comput Biol 2022; 18:e1009743. [PMID: 35737717 PMCID: PMC9258872 DOI: 10.1371/journal.pcbi.1009743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 07/06/2022] [Accepted: 05/31/2022] [Indexed: 01/07/2023] Open
Abstract
General anesthetics work through a variety of molecular mechanisms while resulting in the common end point of sedation and loss of consciousness. Generally, the administration of common anesthetics induces reduction in synaptic excitation while promoting synaptic inhibition. Exogenous modulation of the anesthetics' synaptic effects can help determine the neuronal pathways involved in anesthesia. For example, both animal and human studies have shown that exogenously induced increases in acetylcholine in the brain can elicit wakeful-like behavior despite the continued presence of the anesthetic. However, the underlying mechanisms of anesthesia reversal at the cellular level have not been investigated. Here we apply a computational model of a network of excitatory and inhibitory neurons to simulate the network-wide effects of anesthesia, due to changes in synaptic inhibition and excitation, and their reversal by cholinergic activation through muscarinic receptors. We use a differential evolution algorithm to fit model parameters to match measures of spiking activity, neuronal connectivity, and network dynamics recorded in the visual cortex of rodents during anesthesia with desflurane in vivo. We find that facilitating muscarinic receptor effects of acetylcholine on top of anesthetic-induced synaptic changes predicts the reversal of anesthetic suppression of neurons' spiking activity, functional connectivity, as well as pairwise and population interactions. Thus, our model predicts a specific neuronal mechanism for the cholinergic reversal of anesthesia consistent with experimental behavioral observations.
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Affiliation(s)
- Bolaji P. Eniwaye
- Department of Applied Physics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Victoria Booth
- Department of Mathematics and Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail: (VB); (AGH); (MZ)
| | - Anthony G. Hudetz
- Department of Applied Physics, University of Michigan, Ann Arbor, Michigan, United States of America
- Center for Consciousness Science, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail: (VB); (AGH); (MZ)
| | - Michal Zochowski
- Department of Applied Physics, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Physics and Biophysics Program, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail: (VB); (AGH); (MZ)
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Pal D, Mashour GA. General anesthesia and the cortical stranglehold on consciousness. Neuron 2022; 110:1891-1893. [PMID: 35709695 DOI: 10.1016/j.neuron.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this issue of Neuron, Bharioke et al. (2022) demonstrate that diverse general anesthetic regimens all reversibly and selectively synchronize spontaneous activity of pyramidal neurons in layer 5 of mouse cortex. We discuss the implications of these findings for the mechanism of consciousness and anesthetic-induced unconsciousness.
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Affiliation(s)
- Dinesh Pal
- Department of Anesthesiology, Center for Consciousness Science, Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - George A Mashour
- Department of Anesthesiology, Center for Consciousness Science, Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pharmacology, University of Michigan, Ann Arbor, MI 48109, USA.
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Jiang J, Zhao Y, Liu J, Yang Y, Liang P, Huang H, Wu Y, Kang Y, Zhu T, Zhou C. Signatures of Thalamocortical Alpha Oscillations and Synchronization With Increased Anesthetic Depths Under Isoflurane. Front Pharmacol 2022; 13:887981. [PMID: 35721144 PMCID: PMC9204038 DOI: 10.3389/fphar.2022.887981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Electroencephalography (EEG) recordings under propofol exhibit an increase in slow and alpha oscillation power and dose-dependent phase–amplitude coupling (PAC), which underlie GABAA potentiation and the central role of thalamocortical entrainment. However, the exact EEG signatures elicited by volatile anesthetics and the possible neurophysiological mechanisms remain unclear.Methods: Cortical EEG signals and thalamic local field potential (LFP) were recorded in a mouse model to detect EEG signatures induced by 0.9%, 1.5%, and 2.0% isoflurane. Then, the power of the EEG spectrum, thalamocortical coherence, and slow–alpha phase–amplitude coupling were analyzed. A computational model based on the thalamic network was used to determine the primary neurophysiological mechanisms of alpha spiking of thalamocortical neurons under isoflurane anesthesia.Results: Isoflurane at 0.9% (light anesthesia) increased the power of slow and delta oscillations both in cortical EEG and in thalamic LFP. Isoflurane at 1.5% (surgery anesthesia) increased the power of alpha oscillations both in cortical EEG and in thalamic LFP. Isoflurane at 2% (deep anesthesia) further increased the power of cortical alpha oscillations, while thalamic alpha oscillations were unchanged. Thalamocortical coherence of alpha oscillation only exhibited a significant increase under 1.5% isoflurane. Isoflurane-induced PAC modulation remained unchanged throughout under various concentrations of isoflurane. By adjusting the parameters in the computational model, isoflurane-induced alpha spiking in thalamocortical neurons was simulated, which revealed the potential molecular targets and the thalamic network involved in isoflurane-induced alpha spiking in thalamocortical neurons.Conclusion: The EEG changes in the cortical alpha oscillation, thalamocortical coherence, and slow–alpha PAC may provide neurophysiological signatures for monitoring isoflurane anesthesia at various depths.
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Affiliation(s)
- Jingyao Jiang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Zhao
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jin Liu
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yaoxin Yang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Peng Liang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Han Huang
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Chengdu, China
| | - Yongkang Wu
- Intelligent Manufacturing Institute, Chengdu Jincheng College, Chengdu, China
| | - Yi Kang
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Tao Zhu
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Tao Zhu, ; Cheng Zhou,
| | - Cheng Zhou
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Tao Zhu, ; Cheng Zhou,
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Brito MA, Li D, Fields CW, Rybicki-Kler C, Dean JG, Liu T, Mashour GA, Pal D. Cortical Acetylcholine Levels Correlate With Neurophysiologic Complexity During Subanesthetic Ketamine and Nitrous Oxide Exposure in Rats. Anesth Analg 2022; 134:1126-1139. [PMID: 34928887 PMCID: PMC9093725 DOI: 10.1213/ane.0000000000005835] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurophysiologic complexity has been shown to decrease during states characterized by a depressed level of consciousness, such as sleep or anesthesia. Conversely, neurophysiologic complexity is increased during exposure to serotonergic psychedelics or subanesthetic doses of dissociative anesthetics. However, the neurochemical substrates underlying changes in neurophysiologic complexity are poorly characterized. Cortical acetylcholine appears to relate to cortical activation and changes in states of consciousness, but the relationship between cortical acetylcholine and complexity has not been formally studied. We addressed this gap by analyzing simultaneous changes in cortical acetylcholine (prefrontal and parietal) and neurophysiologic complexity before, during, and after subanesthetic ketamine (10 mg/kg/h) or 50% nitrous oxide. METHODS Under isoflurane anesthesia, adult Sprague Dawley rats (n = 24, 12 male and 12 female) were implanted with stainless-steel electrodes across the cortex to record monopolar electroencephalogram (0.5-175 Hz; 30 channels) and guide canulae in prefrontal and parietal cortices for local microdialysis quantification of acetylcholine levels. One subgroup of these rats was instrumented with a chronic catheter in jugular vein for ketamine infusion (n = 12, 6 male and 6 female). The electroencephalographic data were analyzed to determine subanesthetic ketamine or nitrous oxide-induced changes in Lempel-Ziv complexity and directed frontoparietal connectivity. Changes in complexity and connectivity were analyzed for correlation with concurrent changes in prefrontal and parietal acetylcholine. RESULTS Subanesthetic ketamine produced sustained increases in normalized Lempel-Ziv complexity (0.5-175 Hz; P < .001) and high gamma frontoparietal connectivity (125-175 Hz; P < .001). This was accompanied by progressive increases in prefrontal (104%; P < .001) and parietal (159%; P < .001) acetylcholine levels that peaked after 50 minutes of infusion. Nitrous oxide induction produced a transient increase in complexity (P < .05) and high gamma connectivity (P < .001), which was accompanied by increases (P < .001) in prefrontal (56%) and parietal (43%) acetylcholine levels. In contrast, the final 50 minutes of nitrous oxide administration were characterized by a decrease in prefrontal (38%; P < .001) and parietal (45%; P < .001) acetylcholine levels, reduced complexity (P < .001), and comparatively weaker frontoparietal high gamma connectivity (P < .001). Cortical acetylcholine and complexity were correlated with both subanesthetic ketamine (prefrontal: cluster-weighted marginal correlation [CW r] [144] = 0.42, P < .001; parietal: CW r[144] = 0.42, P < .001) and nitrous oxide (prefrontal: CW r[156] = 0.46, P < .001; parietal: CW r[156] = 0.56, P < .001) cohorts. CONCLUSIONS These data bridge changes in cortical acetylcholine with concurrent changes in neurophysiologic complexity, frontoparietal connectivity, and the level of consciousness.
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Affiliation(s)
- Michael A. Brito
- From the Department of Anesthesiology
- Neuroscience Graduate Program
- Center for Consciousness Science
| | - Duan Li
- From the Department of Anesthesiology
- Center for Consciousness Science
| | | | | | - Jon G. Dean
- From the Department of Anesthesiology
- Center for Consciousness Science
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan
| | | | - George A. Mashour
- From the Department of Anesthesiology
- Neuroscience Graduate Program
- Center for Consciousness Science
| | - Dinesh Pal
- From the Department of Anesthesiology
- Neuroscience Graduate Program
- Center for Consciousness Science
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan
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40
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Affiliation(s)
- George A. Mashour
- From the Departments of Anesthesiology and Pharmacology, Center for Consciousness Science, Michigan Neuroscience Institute, Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan
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41
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Dean JG, Fields CW, Brito MA, Silverstein BH, Rybicki-Kler C, Fryzel AM, Groenhout T, Liu T, Mashour GA, Pal D. Inactivation of Prefrontal Cortex Attenuates Behavioral Arousal Induced by Stimulation of Basal Forebrain During Sevoflurane Anesthesia. Anesth Analg 2022; 134:1140-1152. [PMID: 35436248 PMCID: PMC9093733 DOI: 10.1213/ane.0000000000006011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Cholinergic stimulation of prefrontal cortex (PFC) can reverse anesthesia. Conversely, inactivation of PFC can delay emergence from anesthesia. PFC receives cholinergic projections from basal forebrain, which contains wake-promoting neurons. However, the role of basal forebrain cholinergic neurons in arousal from the anesthetized state requires refinement, and it is currently unknown whether the arousal-promoting effect of basal forebrain is mediated through PFC. To address these gaps in knowledge, we implemented a novel approach to the use of chemogenetic stimulation and tested the role of basal forebrain cholinergic neurons in behavioral arousal during sevoflurane anesthesia. Next, we investigated the effect of tetrodotoxin-mediated inactivation of PFC on behavioral arousal produced by electrical stimulation of basal forebrain during sevoflurane anesthesia.
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Affiliation(s)
- Jon G Dean
- From the Departments of Anesthesiology.,Molecular and Integrative Physiology.,Center for Consciousness Science
| | | | - Michael A Brito
- From the Departments of Anesthesiology.,Center for Consciousness Science.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan
| | | | | | | | | | | | - George A Mashour
- From the Departments of Anesthesiology.,Center for Consciousness Science.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan
| | - Dinesh Pal
- From the Departments of Anesthesiology.,Molecular and Integrative Physiology.,Center for Consciousness Science.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan
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Kelz MB. Consciousness Rebound: The Second-Century Challenge for Anesthesiology and Neuroscience. Anesth Analg 2022; 134:1114-1117. [PMID: 35595687 DOI: 10.1213/ane.0000000000006049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Max B Kelz
- From the Department of Anesthesiology and Critical Care, Mahoney Institute for Neurological Sciences, Chronobiology and Sleep Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Wang Z, Zhang F, Yue L, Hu L, Li X, Xu B, Liang Z. Cortical Complexity and Connectivity during Isoflurane-induced General Anesthesia: A Rat Study. J Neural Eng 2022; 19. [PMID: 35472693 DOI: 10.1088/1741-2552/ac6a7b] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 04/25/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The investigation of neurophysiologic mechanisms of anesthetic drug-induced loss of consciousness (LOC) by using the entropy, complexity, and information integration theories at the mesoscopic level has been a hot topic in recent years. However, systematic research is still lacking. APPROACH We analyzed electrocorticography (ECoG) data recorded from nine rats during isoflurane-induced unconsciousness. To characterize the complexity and connectivity changes, we investigated ECoG power, symbolic dynamic-based entropy (i.e., permutation entropy (PE)), complexity (i.e., permutation Lempel-Ziv complexity (PLZC)), information integration (i.e., permutation cross mutual information (PCMI)), and PCMI-based cortical brain networks in the frontal, parietal, and occipital cortical regions. MAIN RESULTS Firstly, LOC was accompanied by a raised power in the ECoG beta (12-30 Hz) but a decreased power in the high gamma (55-95 Hz) frequency band in all three brain regions. Secondly, PE and PLZC showed similar change trends in the lower frequency band (0.1-45 Hz), declining after LOC (p<0.05) and increasing after recovery of consciousness (p<0.001). Thirdly, intra-frontal and inter-frontal-parietal PCMI declined after LOC, in both lower (0.1-45Hz) and higher frequency bands (55-95Hz) (p<0.001). Finally, the local network parameters of the nodal clustering coefficient and nodal efficiency in the frontal region decreased after LOC, in both the lower and higher frequency bands (p<0.05). Moreover, global network parameters of the normalized average clustering coefficient and small world index increased slightly after LOC in the lower frequency band. However, this increase was not statistically significant. SIGNIFICANCE The PE, PLZC, PCMI and PCMI-based brain networks are effective metrics for qualifying the effects of isoflurane.
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Affiliation(s)
- Zhijie Wang
- Yanshan University, Yanshan University, Qinhuangdao 066004, China., Qinhuangdao, 066004, CHINA
| | - Fengrui Zhang
- Department of Psychology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Beijing 100049, China., Beijing, 100049, CHINA
| | - Lupeng Yue
- Department of Psychology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Beijing 100049, China., Beijing, 100049, CHINA
| | - Li Hu
- Department of Psychology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Beijing 100049, China, Beijing, 100049, CHINA
| | - Xiaoli Li
- Department of Psychology, Beijing Normal University, Beijing Normal University, Beijing 100875, China., Beijing, Beijing, 100875, CHINA
| | - Bo Xu
- PLA General Hospital of Southern Theatre Command, Guangzhou 510010, China., Guangzhou, Guangdong, 510010, CHINA
| | - Zhenhu Liang
- Institute of Electrical Engineering, Yanshan University, Yanshan University, Qinhuangdao 066004, China., Qinhuangdao, 066004, CHINA
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Bharioke A, Munz M, Brignall A, Kosche G, Eizinger MF, Ledergerber N, Hillier D, Gross-Scherf B, Conzelmann KK, Macé E, Roska B. General anesthesia globally synchronizes activity selectively in layer 5 cortical pyramidal neurons. Neuron 2022; 110:2024-2040.e10. [PMID: 35452606 PMCID: PMC9235854 DOI: 10.1016/j.neuron.2022.03.032] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 10/30/2021] [Accepted: 03/28/2022] [Indexed: 12/27/2022]
Abstract
General anesthetics induce loss of consciousness, a global change in behavior. However, a corresponding global change in activity in the context of defined cortical cell types has not been identified. Here, we show that spontaneous activity of mouse layer 5 pyramidal neurons, but of no other cortical cell type, becomes consistently synchronized in vivo by different general anesthetics. This heightened neuronal synchrony is aperiodic, present across large distances, and absent in cortical neurons presynaptic to layer 5 pyramidal neurons. During the transition to and from anesthesia, changes in synchrony in layer 5 coincide with the loss and recovery of consciousness. Activity within both apical and basal dendrites is synchronous, but only basal dendrites’ activity is temporally locked to somatic activity. Given that layer 5 is a major cortical output, our results suggest that brain-wide synchrony in layer 5 pyramidal neurons may contribute to the loss of consciousness during general anesthesia. Activity of layer 5 PNs synchronizes globally in different anesthetics Other mouse cortical cell types show no consistent increase in synchrony Changes in layer 5 synchrony coincide with the loss and recovery of consciousness Basal, but not apical, layer 5 dendrites are in synchrony with somas
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Affiliation(s)
- Arjun Bharioke
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland; Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Martin Munz
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland; Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Alexandra Brignall
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Georg Kosche
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland; Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Max Ferdinand Eizinger
- Max von Pettenkofer-Institute, Virology, Medical Faculty and Gene Center, Ludwig Maximilians University, Munich, Germany
| | - Nicole Ledergerber
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland; Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Daniel Hillier
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland; Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland; Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Brigitte Gross-Scherf
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland; Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Karl-Klaus Conzelmann
- Max von Pettenkofer-Institute, Virology, Medical Faculty and Gene Center, Ludwig Maximilians University, Munich, Germany
| | - Emilie Macé
- Brain-Wide Circuits for Behavior Research Group, Max Planck Institute of Neurobiology, Martinsried, Germany
| | - Botond Roska
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland; Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland.
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Ma Z, Zheng JC, Li T, Xie Z, Kang L. Janus Kinase Mediates Faster Recovery From Sevoflurane Anesthesia Than Isoflurane Anesthesia in the Migratory Locusts. Front Physiol 2022; 13:806746. [PMID: 35431999 PMCID: PMC9006988 DOI: 10.3389/fphys.2022.806746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/24/2022] [Indexed: 12/03/2022] Open
Abstract
Inhalation anesthetics isoflurane and sevoflurane have been widely used in clinical practice for anesthesia. However, the molecular mechanisms underlying the faster recovery from sevoflurane anesthesia than isoflurane anesthesia remain largely undetermined. Herein, we use RNA-seq, RNA interference, quantitative real-time PCR and western blotting to explore the mechanisms of recovery from isoflurane and sevoflurane anesthesia in the migratory locusts. Although the migratory locusts show similar anesthetic responses to these two chemicals in corresponding half-maximal effective concentrations (EC50s), the recovery from sevoflurane anesthesia is significantly faster than that for isoflurane anesthesia after 30 min of anesthetic exposure. Transcriptome analysis shows that those transcripts involved in cytoskeletal components, Janus kinase (JAK) pathway and cuticle protein are differentially expressed in locust brains in response to isoflurane and sevoflurane. RNAi knockdown confirms that Actin, Myosin-like protein 84B (Mlp84B), JAK and cuticle protein NCP56 do not affect anesthetic response of the locusts to these two chemical anesthetics. Moreover, actin, Mlp84B and NCP56 do not affect differential recovery from isoflurane and sevoflurane anesthesia, whereas RNAi knockdown of JAK and its partner STAT5B does not affect anesthetic recovery from isoflurane but elongates recovery duration from sevoflurane anesthesia. Thus, JAK may mediate faster recovery from sevoflurane anesthesia than from isoflurane anesthesia in the migratory locust. This finding provides novel insights into the molecular mechanism underlying faster recovery from sevoflurane anesthesia than isoflurane anesthesia.
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Affiliation(s)
- Zongyuan Ma
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China
| | - Jialin C. Zheng
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tianzuo Li
- Department of Anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Zhongcong Xie
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- *Correspondence: Zhongcong Xie,
| | - Le Kang
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China
- Le Kang,
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Tasserie J, Uhrig L, Sitt JD, Manasova D, Dupont M, Dehaene S, Jarraya B. Deep brain stimulation of the thalamus restores signatures of consciousness in a nonhuman primate model. SCIENCE ADVANCES 2022; 8:eabl5547. [PMID: 35302854 PMCID: PMC8932660 DOI: 10.1126/sciadv.abl5547] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/26/2022] [Indexed: 05/27/2023]
Abstract
Loss of consciousness is associated with the disruption of long-range thalamocortical and corticocortical brain communication. We tested the hypothesis that deep brain stimulation (DBS) of central thalamus might restore both arousal and awareness following consciousness loss. We applied anesthesia to suppress consciousness in nonhuman primates. During anesthesia, central thalamic stimulation induced arousal in an on-off manner and increased functional magnetic resonance imaging activity in prefrontal, parietal, and cingulate cortices. Moreover, DBS restored a broad dynamic repertoire of spontaneous resting-state activity, previously described as a signature of consciousness. None of these effects were obtained during the stimulation of a control site in the ventrolateral thalamus. Last, DBS restored a broad hierarchical response to auditory violations that was disrupted under anesthesia. Thus, DBS restored the two dimensions of consciousness, arousal and conscious access, following consciousness loss, paving the way to its therapeutical translation in patients with disorders of consciousness.
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Affiliation(s)
- Jordy Tasserie
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France
| | - Lynn Uhrig
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France
- Department of Anesthesiology and Critical Care, Necker Hospital, AP-HP, Université de Paris, Paris, France
| | - Jacobo D. Sitt
- Sorbonne Université, Institut du Cerveau–Paris Brain Institute–ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Dragana Manasova
- Sorbonne Université, Institut du Cerveau–Paris Brain Institute–ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Paris, France
- Université de Paris, Paris, France
| | - Morgan Dupont
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France
| | - Stanislas Dehaene
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France
- Collège de France, Université Paris-Sciences-Lettres (PSL), Paris, France
| | - Béchir Jarraya
- Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France
- University of Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, Versailles, France
- Foch Hospital, Suresnes, France
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47
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Almeida VN. The neural hierarchy of consciousness. Neuropsychologia 2022; 169:108202. [PMID: 35271856 DOI: 10.1016/j.neuropsychologia.2022.108202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 01/08/2023]
Abstract
The chief undertaking in the studies of consciousness is that of unravelling "the minimal set of neural processes that are together sufficient for the conscious experience of a particular content - the neural correlates of consciousness". To this day, this crusade remains at an impasse, with a clash of two main theories: consciousness may arise either in a graded and cortically-localised fashion, or in an all-or-none and widespread one. In spite of the long-lasting theoretical debates, neurophysiological theories of consciousness have been mostly dissociated from them. Herein, a theoretical review will be put forth with the aim to change that. In its first half, we will cover the hard available evidence on the neurophysiology of consciousness, whereas in its second half we will weave a series of considerations on both theories and substantiate a novel take on conscious awareness: the levels of processing approach, partitioning the conscious architecture into lower- and higher-order, graded and nonlinear.
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Affiliation(s)
- Victor N Almeida
- Faculdade de Letras, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil.
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48
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Arena A, Juel BE, Comolatti R, Thon S, Storm JF. Capacity for consciousness under ketamine anaesthesia is selectively associated with activity in posteromedial cortex in rats. Neurosci Conscious 2022; 2022:niac004. [PMID: 35261778 PMCID: PMC8896332 DOI: 10.1093/nc/niac004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 12/09/2021] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
It remains unclear how specific cortical regions contribute to the brain’s overall capacity for consciousness. Clarifying this could help distinguish between theories of consciousness. Here, we investigate the association between markers of regionally specific (de)activation and the brain’s overall capacity for consciousness. We recorded electroencephalographic responses to cortical electrical stimulation in six rats and computed Perturbational Complexity Index state-transition (PCIST), which has been extensively validated as an index of the capacity for consciousness in humans. We also estimated the balance between activation and inhibition of specific cortical areas with the ratio between high and low frequency power from spontaneous electroencephalographic activity at each electrode. We repeated these measurements during wakefulness, and during two levels of ketamine anaesthesia: with the minimal dose needed to induce behavioural unresponsiveness and twice this dose. We found that PCIST was only slightly reduced from wakefulness to light ketamine anaesthesia, but dropped significantly with deeper anaesthesia. The high-dose effect was selectively associated with reduced high frequency/low frequency ratio in the posteromedial cortex, which strongly correlated with PCIST. Conversely, behavioural unresponsiveness induced by light ketamine anaesthesia was associated with similar spectral changes in frontal, but not posterior cortical regions. Thus, activity in the posteromedial cortex correlates with the capacity for consciousness, as assessed by PCIST, during different depths of ketamine anaesthesia, in rats, independently of behaviour. These results are discussed in relation to different theories of consciousness.
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Affiliation(s)
- A Arena
- Brain Signalling Group, Department of Molecular Medicine, University of Oslo, Sognsvannsveien 9, Oslo 0372, Norway
| | - B E Juel
- Brain Signalling Group, Department of Molecular Medicine, University of Oslo, Sognsvannsveien 9, Oslo 0372, Norway
- Center for Sleep and Consciousness, University of Wisconsin, 6001 Research Park Blvd, Madison, WI 53719, USA
| | - R Comolatti
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Via Giovanni Battista Grassi 74, Milano 20157, Italy
| | - S Thon
- Brain Signalling Group, Department of Molecular Medicine, University of Oslo, Sognsvannsveien 9, Oslo 0372, Norway
| | - J F Storm
- Brain Signalling Group, Department of Molecular Medicine, University of Oslo, Sognsvannsveien 9, Oslo 0372, Norway
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Pazienti A, Galluzzi A, Dasilva M, Sanchez-Vives MV, Mattia M. Slow waves form expanding, memory-rich mesostates steered by local excitability in fading anesthesia. iScience 2022; 25:103918. [PMID: 35265807 PMCID: PMC8899414 DOI: 10.1016/j.isci.2022.103918] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/17/2021] [Accepted: 02/09/2022] [Indexed: 11/27/2022] Open
Abstract
In the arousal process, the brain restores its integrative activity from the synchronized state of slow wave activity (SWA). The mechanisms underpinning this state transition remain, however, to be elucidated. Here we simultaneously probed neuronal assemblies throughout the whole cortex with micro-electrocorticographic recordings in mice. We investigated the progressive shaping of propagating SWA at different levels of isoflurane. We found a form of memory of the wavefront shapes at deep anesthesia, tightly alternating posterior-anterior-posterior patterns. At low isoflurane, metastable patterns propagated in more directions, reflecting an increased complexity. The wandering across these mesostates progressively increased its randomness, as predicted by simulations of a network of spiking neurons, and confirmed in our experimental data. The complexity increase is explained by the elevated excitability of local assemblies with no modifications of the network connectivity. These results shed new light on the functional reorganization of the cortical network as anesthesia fades out. Complexity of isoflurane-induced slow waves reliably determines anesthesia level In deep anesthesia, the propagation strictly alternates between front-back-front patterns In light anesthesia, there is a continuum of directions and faster propagation Local excitability underpins the cortical reorganization in fading anesthesia
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Bachmann T. Representational 'touch' and modulatory 'retouch'-two necessary neurobiological processes in thalamocortical interaction for conscious experience. Neurosci Conscious 2021; 2021:niab045. [PMID: 34925911 PMCID: PMC8672242 DOI: 10.1093/nc/niab045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 11/16/2021] [Accepted: 11/30/2021] [Indexed: 12/01/2022] Open
Abstract
Theories of consciousness using neurobiological data or being influenced by these data have been focused either on states of consciousness or contents of consciousness. These theories have occasionally used evidence from psychophysical phenomena where conscious experience is a dependent experimental variable. However, systematic catalog of many such relevant phenomena has not been offered in terms of these theories. In the perceptual retouch theory of thalamocortical interaction, recently developed to become a blend with the dendritic integration theory, consciousness states and contents of consciousness are explained by the same mechanism. This general-purpose mechanism has modulation of the cortical layer-5 pyramidal neurons that represent contents of consciousness as its core. As a surplus, many experimental psychophysical phenomena of conscious perception can be explained by the workings of this mechanism. Historical origins and current views inherent in this theory are presented and reviewed.
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Affiliation(s)
- Talis Bachmann
- Department of Penal Law, Laboratory of Cognitive Neuroscience, School of Law, University of Tartu (Tallinn Branch), Kaarli puiestee 3, Tallinn 10119, Estonia
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