1
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Zhang D, Wei Y. Distinct Neural Mechanisms Between Anesthesia Induction and Emergence: A Narrative Review. Anesth Analg 2024:00000539-990000000-00840. [PMID: 38861419 DOI: 10.1213/ane.0000000000007114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Anesthesia induction and emergence are critical periods for perioperative safety in the clinic. Traditionally, the emergence from general anesthesia has been recognized as a simple inverse process of induction resulting from the elimination of general anesthetics from the central nervous system. However, accumulated evidence has indicated that anesthesia induction and emergence are not mirror-image processes because of the occurrence of hysteresis/neural inertia in both animals and humans. An increasing number of studies have highlighted the critical role of orexinergic neurons and their involved circuits in the selective regulation of emergence but not the induction of general anesthesia. Moreover, additional brain regions have also been implicated in distinct neural mechanisms for anesthesia induction and emergence, which extends the concept that anesthetic induction and emergence are not antiparallel processes. Here, we reviewed the current literature and summarized the evidence regarding the differential mechanism of neural modulation in anesthesia induction and emergence, which will facilitate the understanding of the underlying neural mechanism for emergence from general anesthesia.
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Affiliation(s)
- Donghang Zhang
- From the Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Yiyong Wei
- Department of Anesthesiology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, China
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2
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Chis-Ciure R, Melloni L, Northoff G. A measure centrality index for systematic empirical comparison of consciousness theories. Neurosci Biobehav Rev 2024; 161:105670. [PMID: 38615851 DOI: 10.1016/j.neubiorev.2024.105670] [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: 02/03/2024] [Revised: 03/15/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
Consciousness science is marred by disparate constructs and methodologies, making it challenging to systematically compare theories. This foundational crisis casts doubts on the scientific character of the field itself. Addressing it, we propose a framework for systematically comparing consciousness theories by introducing a novel inter-theory classification interface, the Measure Centrality Index (MCI). Recognizing its gradient distribution, the MCI assesses the degree of importance a specific empirical measure has for a given consciousness theory. We apply the MCI to probe how the empirical measures of the Global Neuronal Workspace Theory (GNW), Integrated Information Theory (IIT), and Temporospatial Theory of Consciousness (TTC) would fare within the context of the other two. We demonstrate that direct comparison of IIT, GNW, and TTC is meaningful and valid for some measures like Lempel-Ziv Complexity (LZC), Autocorrelation Window (ACW), and possibly Mutual Information (MI). In contrast, it is problematic for others like the anatomical and physiological neural correlates of consciousness (NCC) due to their MCI-based differential weightings within the structure of the theories. In sum, we introduce and provide proof-of-principle of a novel systematic method for direct inter-theory empirical comparisons, thereby addressing isolated evolution of theories and confirmatory bias issues in the state-of-the-art neuroscience of consciousness.
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Affiliation(s)
- Robert Chis-Ciure
- New York University (NYU), New York, USA; International Center for Neuroscience and Ethics (CINET), Tatiana Foundation, Madrid, Spain; Wolfram Physics Project, USA.
| | - Lucia Melloni
- Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Georg Northoff
- University of Ottawa, Institute of Mental Health Research at the Royal Ottawa Hospital, Ottawa, Canada
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3
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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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4
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Jang H, Mashour GA, Hudetz AG, Huang Z. Measuring the dynamic balance of integration and segregation underlying consciousness, anesthesia, and sleep. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.12.589265. [PMID: 38659759 PMCID: PMC11042232 DOI: 10.1101/2024.04.12.589265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Consciousness requires a dynamic balance of integration and segregation in functional brain networks. An optimal integration-segregation balance depends on two key aspects of functional connectivity: global efficiency (i.e., integration) and clustering (i.e., segregation). We developed a new fMRI-based measure, termed the integration-segregation difference (ISD), which captures both aspects. We used this metric to quantify changes in brain state from conscious wakefulness to loss of responsiveness induced by the anesthetic propofol. The observed changes in ISD suggest a profound shift to segregation in both whole brain and all brain subnetworks during anesthesia. Moreover, brain networks displayed similar sequences of disintegration and subsequent reintegration during, respectively, loss and return of responsiveness. Random forest machine learning models, trained with the integration and segregation of brain networks, identified the awake vs. unresponsive states and their transitions with accuracy up to 93%. We found that metastability (i.e., the dynamic recurrence of non-equilibrium transient states) is more effectively explained by integration, while complexity (i.e., diversity and intricacy of neural activity) is more closely linked with segregation. The analysis of a sleep dataset revealed similar findings. Our results demonstrate that the integration-segregation balance is a useful index that can differentiate among various conscious and unconscious states.
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Affiliation(s)
- Hyunwoo Jang
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - George A. Mashour
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Michigan Psychedelic Center, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Anthony G. Hudetz
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Michigan Psychedelic Center, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Zirui Huang
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Michigan Psychedelic Center, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
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5
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Huang Z, Mashour GA, Hudetz AG. Propofol Disrupts the Functional Core-Matrix Architecture of the Thalamus in Humans. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.23.576934. [PMID: 38328136 PMCID: PMC10849566 DOI: 10.1101/2024.01.23.576934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Research into the role of thalamocortical circuits in anesthesia-induced unconsciousness is difficult due to anatomical and functional complexity. Prior neuroimaging studies have examined either the thalamus as a whole or focused on specific subregions, overlooking the distinct neuronal subtypes like core and matrix cells. We conducted a study of heathy volunteers and functional magnetic resonance imaging during conscious baseline, deep sedation, and recovery. We advanced the functional gradient mapping technique to delineate the functional geometry of thalamocortical circuits, within a framework of the unimodal-transmodal functional axis of the cortex. We observed a significant shift in this geometry during unconsciousness, marked by the dominance of unimodal over transmodal geometry. This alteration was closely linked to the spatial variations in the density of matrix cells within the thalamus. This research bridges cellular and systems-level understanding, highlighting the crucial role of thalamic core-matrix functional architecture in understanding the neural mechanisms of states of consciousness.
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Affiliation(s)
- Zirui Huang
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Michigan Psychedelic Center, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - George A Mashour
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Michigan Psychedelic Center, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Anthony G Hudetz
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Michigan Psychedelic Center, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
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6
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Han J, Xie Q, Wu X, Huang Z, Tanabe S, Fogel S, Hudetz AG, Wu H, Northoff G, Mao Y, He S, Qin P. The neural correlates of arousal: Ventral posterolateral nucleus-global transient co-activation. Cell Rep 2024; 43:113633. [PMID: 38159279 DOI: 10.1016/j.celrep.2023.113633] [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: 01/10/2023] [Revised: 11/21/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024] Open
Abstract
Arousal and awareness are two components of consciousness whose neural mechanisms remain unclear. Spontaneous peaks of global (brain-wide) blood-oxygenation-level-dependent (BOLD) signal have been found to be sensitive to changes in arousal. By contrasting BOLD signals at different arousal levels, we find decreased activation of the ventral posterolateral nucleus (VPL) during transient peaks in the global signal in low arousal and awareness states (non-rapid eye movement sleep and anesthesia) compared to wakefulness and in eyes-closed compared to eyes-open conditions in healthy awake individuals. Intriguingly, VPL-global co-activation remains high in patients with unresponsive wakefulness syndrome (UWS), who exhibit high arousal without awareness, while it reduces in rapid eye movement sleep, a state characterized by low arousal but high awareness. Furthermore, lower co-activation is found in individuals during N3 sleep compared to patients with UWS. These results demonstrate that co-activation of VPL and global activity is critical to arousal but not to awareness.
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Affiliation(s)
- Junrong Han
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Qiuyou Xie
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China; Joint Research Centre for Disorders of Consciousness, Guangzhou, Guangdong, China
| | - Xuehai Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zirui Huang
- Department of Anesthesiology, Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA
| | - Sean Tanabe
- Department of Anesthesiology, Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA
| | - Stuart Fogel
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Anthony G Hudetz
- Department of Anesthesiology, Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA
| | - Hang Wu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, Guangdong, China
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada; Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Sheng He
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.
| | - Pengmin Qin
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou 510631, Guangdong, China; Pazhou Lab, Guangzhou 510335, China.
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7
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Krause BM, Campbell DI, Kovach CK, Mueller RN, Kawasaki H, Nourski KV, Banks MI. Analogous cortical reorganization accompanies entry into states of reduced consciousness during anesthesia and sleep. Cereb Cortex 2023; 33:9850-9866. [PMID: 37434363 PMCID: PMC10472497 DOI: 10.1093/cercor/bhad249] [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: 05/10/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 07/13/2023] Open
Abstract
Theories of consciousness suggest that brain mechanisms underlying transitions into and out of unconsciousness are conserved no matter the context or precipitating conditions. We compared signatures of these mechanisms using intracranial electroencephalography in neurosurgical patients during propofol anesthesia and overnight sleep and found strikingly similar reorganization of human cortical networks. We computed the "effective dimensionality" of the normalized resting state functional connectivity matrix to quantify network complexity. Effective dimensionality decreased during stages of reduced consciousness (anesthesia unresponsiveness, N2 and N3 sleep). These changes were not region-specific, suggesting global network reorganization. When connectivity data were embedded into a low-dimensional space in which proximity represents functional similarity, we observed greater distances between brain regions during stages of reduced consciousness, and individual recording sites became closer to their nearest neighbors. These changes corresponded to decreased differentiation and functional integration and correlated with decreases in effective dimensionality. This network reorganization constitutes a neural signature of states of reduced consciousness that is common to anesthesia and sleep. These results establish a framework for understanding the neural correlates of consciousness and for practical evaluation of loss and recovery of consciousness.
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Affiliation(s)
- Bryan M Krause
- Department of Anesthesiology, University of Wisconsin, Madison, WI, United States
| | - Declan I Campbell
- Department of Anesthesiology, University of Wisconsin, Madison, WI, United States
| | - Christopher K Kovach
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States
| | - Rashmi N Mueller
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States
- Department of Anesthesia, The University of Iowa, Iowa City, IA 52242, United States
| | - Hiroto Kawasaki
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States
| | - Kirill V Nourski
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA 52242, United States
| | - Matthew I Banks
- Department of Anesthesiology, University of Wisconsin, Madison, WI, United States
- Department of Neuroscience, University of Wisconsin, Madison, WI 53706, United States
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8
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Banks MI, Krause BM, Berger DG, Campbell DI, Boes AD, Bruss JE, Kovach CK, Kawasaki H, Steinschneider M, Nourski KV. Functional geometry of auditory cortical resting state networks derived from intracranial electrophysiology. PLoS Biol 2023; 21:e3002239. [PMID: 37651504 PMCID: PMC10499207 DOI: 10.1371/journal.pbio.3002239] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 09/13/2023] [Accepted: 07/07/2023] [Indexed: 09/02/2023] Open
Abstract
Understanding central auditory processing critically depends on defining underlying auditory cortical networks and their relationship to the rest of the brain. We addressed these questions using resting state functional connectivity derived from human intracranial electroencephalography. Mapping recording sites into a low-dimensional space where proximity represents functional similarity revealed a hierarchical organization. At a fine scale, a group of auditory cortical regions excluded several higher-order auditory areas and segregated maximally from the prefrontal cortex. On mesoscale, the proximity of limbic structures to the auditory cortex suggested a limbic stream that parallels the classically described ventral and dorsal auditory processing streams. Identities of global hubs in anterior temporal and cingulate cortex depended on frequency band, consistent with diverse roles in semantic and cognitive processing. On a macroscale, observed hemispheric asymmetries were not specific for speech and language networks. This approach can be applied to multivariate brain data with respect to development, behavior, and disorders.
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Affiliation(s)
- Matthew I. Banks
- Department of Anesthesiology, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Neuroscience, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Bryan M. Krause
- Department of Anesthesiology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - D. Graham Berger
- Department of Anesthesiology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Declan I. Campbell
- Department of Anesthesiology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Aaron D. Boes
- Department of Neurology, The University of Iowa, Iowa City, Iowa, United States of America
| | - Joel E. Bruss
- Department of Neurology, The University of Iowa, Iowa City, Iowa, United States of America
| | - Christopher K. Kovach
- Department of Neurosurgery, The University of Iowa, Iowa City, Iowa, United States of America
| | - Hiroto Kawasaki
- Department of Neurosurgery, The University of Iowa, Iowa City, Iowa, United States of America
| | - Mitchell Steinschneider
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, United States of America
- Department of Neuroscience, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Kirill V. Nourski
- Department of Neurosurgery, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, Iowa, United States of America
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9
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Huang Z. Temporospatial Nestedness in Consciousness: An Updated Perspective on the Temporospatial Theory of Consciousness. ENTROPY (BASEL, SWITZERLAND) 2023; 25:1074. [PMID: 37510023 PMCID: PMC10378228 DOI: 10.3390/e25071074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
Time and space are fundamental elements that permeate the fabric of nature, and their significance in relation to neural activity and consciousness remains a compelling yet unexplored area of research. The Temporospatial Theory of Consciousness (TTC) provides a framework that links time, space, neural activity, and consciousness, shedding light on the intricate relationships among these dimensions. In this review, I revisit the fundamental concepts and mechanisms proposed by the TTC, with a particular focus on the central concept of temporospatial nestedness. I propose an extension of temporospatial nestedness by incorporating the nested relationship between the temporal circuit and functional geometry of the brain. To further unravel the complexities of temporospatial nestedness, future research directions should emphasize the characterization of functional geometry and the temporal circuit across multiple spatial and temporal scales. Investigating the links between these scales will yield a more comprehensive understanding of how spatial organization and temporal dynamics contribute to conscious states. This integrative approach holds the potential to uncover novel insights into the neural basis of consciousness and reshape our understanding of the world-brain dynamic.
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Affiliation(s)
- Zirui Huang
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA;
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
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10
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Sodré ME, Wießner I, Irfan M, Schenck CH, Mota-Rolim SA. Awake or Sleeping? Maybe Both… A Review of Sleep-Related Dissociative States. J Clin Med 2023; 12:3876. [PMID: 37373570 DOI: 10.3390/jcm12123876] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 06/29/2023] Open
Abstract
Recent studies have begun to understand sleep not only as a whole-brain process but also as a complex local phenomenon controlled by specific neurotransmitters that act in different neural networks, which is called "local sleep". Moreover, the basic states of human consciousness-wakefulness, sleep onset (N1), light sleep (N2), deep sleep (N3), and rapid eye movement (REM) sleep-can concurrently appear, which may result in different sleep-related dissociative states. In this article, we classify these sleep-related dissociative states into physiological, pathological, and altered states of consciousness. Physiological states are daydreaming, lucid dreaming, and false awakenings. Pathological states include sleep paralysis, sleepwalking, and REM sleep behavior disorder. Altered states are hypnosis, anesthesia, and psychedelics. We review the neurophysiology and phenomenology of these sleep-related dissociative states of consciousness and update them with recent studies. We conclude that these sleep-related dissociative states have a significant basic and clinical impact since their study contributes to the understanding of consciousness and the proper treatment of neuropsychiatric diseases.
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Affiliation(s)
| | - Isabel Wießner
- Brain Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Muna Irfan
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Carlos H Schenck
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sergio A Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
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11
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Wu H, Xie Q, Pan J, Liang Q, Lan Y, Guo Y, Han J, Xie M, Liu Y, Jiang L, Wu X, Li Y, Qin P. Identifying Patients with Cognitive Motor Dissociation Using Resting-state Temporal Stability. Neuroimage 2023; 272:120050. [PMID: 36963740 DOI: 10.1016/j.neuroimage.2023.120050] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/04/2023] [Accepted: 03/21/2023] [Indexed: 03/26/2023] Open
Abstract
Using task-dependent neuroimaging techniques, recent studies discovered a fraction of patients with disorders of consciousness (DOC) who had no command-following behaviors but showed a clear sign of awareness as healthy controls, which was defined as cognitive motor dissociation (CMD). However, existing task-dependent approaches might fail when CMD patients have cognitive function (e.g., attention, memory) impairments, in which patients with covert awareness cannot perform a specific task accurately and are thus wrongly considered unconscious, which leads to false-negative findings. Recent studies have suggested that sustaining a stable functional organization over time, i.e., high temporal stability, is crucial for supporting consciousness. Thus, temporal stability could be a powerful tool to detect the patient's cognitive functions (e.g., consciousness), while its alteration in the DOC and its capacity for identifying CMD were unclear. The resting-state fMRI (rs-fMRI) study included 119 participants from three independent research sites. A sliding-window approach was used to investigate global and regional temporal stability, which measured how stable the brain's functional architecture was across time. The temporal stability was compared in the first dataset (36/16 DOC/controls), and then a Support Vector Machine (SVM) classifier was built to discriminate DOC from controls. Furthermore, the generalizability of the SVM classifier was tested in the second independent dataset (35/21 DOC/controls). Finally, the SVM classifier was applied to the third independent dataset, where patients underwent rs-fMRI and brain-computer interface assessment (4/7 CMD/potential non-CMD), to test its performance in identifying CMD. Our results showed that global and regional temporal stability was impaired in DOC patients, especially in regions of the cingulo-opercular task control network, default-mode network, fronto-parietal task control network, and salience network. Using temporal stability as the feature, the SVM model not only showed good performance in the first dataset (accuracy = 90%), but also good generalizability in the second dataset (accuracy = 84%). Most importantly, the SVM model generalized well in identifying CMD in the third dataset (accuracy = 91%). Our preliminary findings suggested that temporal stability could be a potential tool to assist in diagnosing CMD. Furthermore, the temporal stability investigated in this study also contributed to a deeper understanding of the neural mechanism of consciousness.
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Affiliation(s)
- Hang Wu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong, 510631, China
| | - Qiuyou Xie
- Joint Center for disorders of consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510220, China; Centre for Hyperbaric Oxygen and Neurorehabilitation, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, 510010, China
| | - Jiahui Pan
- School of Software, South China Normal University, Foshan, 528225, China; Pazhou Lab, Guangzhou, 510330, China
| | - Qimei Liang
- Joint Center for disorders of consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510220, China
| | - Yue Lan
- Joint Center for disorders of consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510220, China
| | - Yequn Guo
- Centre for Hyperbaric Oxygen and Neurorehabilitation, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, 510010, China
| | - Junrong Han
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education, China; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China
| | - Musi Xie
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong, 510631, China
| | - Yueyao Liu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong, 510631, China
| | - Liubei Jiang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong, 510631, China
| | - Xuehai Wu
- Pazhou Lab, Guangzhou, 510330, China; Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200433, China; Neurosurgical Institute of Fudan University, Shanghai Clinical Medical Center of Neurosurgery, Shanghai Key laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200433, China; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200433, China.
| | - Yuanqing Li
- Pazhou Lab, Guangzhou, 510330, China; School of Automation Science and Engineering, South China University of Technology, Guangzhou 510640, China.
| | - Pengmin Qin
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong, 510631, China; Pazhou Lab, Guangzhou, 510330, China.
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12
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Huang Z, Mashour GA, Hudetz AG. Functional geometry of the cortex encodes dimensions of consciousness. Nat Commun 2023; 14:72. [PMID: 36604428 PMCID: PMC9814511 DOI: 10.1038/s41467-022-35764-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
Consciousness is a multidimensional phenomenon, but key dimensions such as awareness and wakefulness have been described conceptually rather than neurobiologically. We hypothesize that dimensions of consciousness are encoded in multiple neurofunctional dimensions of the brain. We analyze cortical gradients, which are continua of the brain's overarching functional geometry, to characterize these neurofunctional dimensions. We demonstrate that disruptions of human consciousness - due to pharmacological, neuropathological, or psychiatric causes - are associated with a degradation of one or more of the major cortical gradients depending on the state. Network-specific reconfigurations within the multidimensional cortical gradient space are associated with behavioral unresponsiveness of various etiologies, and these spatial reconfigurations correlate with a temporal disruption of structured transitions of dynamic brain states. In this work, we therefore provide a unifying neurofunctional framework for multiple dimensions of human consciousness in both health and disease.
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Affiliation(s)
- Zirui Huang
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA. .,Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
| | - George A Mashour
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Anthony G Hudetz
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, 48109, USA
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13
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Coppola P, Allanson J, Naci L, Adapa R, Finoia P, Williams GB, Pickard JD, Owen AM, Menon DK, Stamatakis EA. The complexity of the stream of consciousness. Commun Biol 2022; 5:1173. [PMID: 36329176 PMCID: PMC9633704 DOI: 10.1038/s42003-022-04109-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Typical consciousness can be defined as an individual-specific stream of experiences. Modern consciousness research on dynamic functional connectivity uses clustering techniques to create common bases on which to compare different individuals. We propose an alternative approach by combining modern theories of consciousness and insights arising from phenomenology and dynamical systems theory. This approach enables a representation of an individual's connectivity dynamics in an intrinsically-defined, individual-specific landscape. Given the wealth of evidence relating functional connectivity to experiential states, we assume this landscape is a proxy measure of an individual's stream of consciousness. By investigating the properties of this landscape in individuals in different states of consciousness, we show that consciousness is associated with short term transitions that are less predictable, quicker, but, on average, more constant. We also show that temporally-specific connectivity states are less easily describable by network patterns that are distant in time, suggesting a richer space of possible states. We show that the cortex, cerebellum and subcortex all display consciousness-relevant dynamics and discuss the implication of our results in forming a point of contact between dynamical systems interpretations and phenomenology.
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Affiliation(s)
- Peter Coppola
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Judith Allanson
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Department of Neurosciences, Cambridge University Hospitals NHS Foundation, Addenbrooke's Hospital, Cambridge, UK
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Lloyd Building, Trinity College Dublin, Dublin, Ireland
| | - Ram Adapa
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Paola Finoia
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Guy B Williams
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - John D Pickard
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Adrian M Owen
- The Brain and Mind Institute, Western Interdisciplinary Research Building, N6A 5B7 University of Western Ontario, London, ON, Canada
| | - David K Menon
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
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14
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Northoff G, Zilio F. Temporo-spatial Theory of Consciousness (TTC) - Bridging the gap of neuronal activity and phenomenal states. Behav Brain Res 2022; 424:113788. [PMID: 35149122 DOI: 10.1016/j.bbr.2022.113788] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 01/22/2023]
Abstract
Consciousness and its neural mechanisms remain a mystery. Current neuroscientific theories focus predominantly on the external input/stimulus and the associated stimulus-related activity during conscious contents. Despite all progress, we encounter two gaps: (i) a gap between spontaneous and stimulus-related activity; (ii) a gap between neuronal and phenomenal features. A novel, different, and unique approach, Temporo-spatial theory of consciousness (TTC) aims to bridge both gaps. The TTC focuses on the brain's spontaneous activity and how its spatial topography and temporal dynamic shape stimulus-related activity and resurface in the corresponding spatial and temporal features of consciousness, i.e., 'common currency'. The TTC introduces four temporo-spatial mechanisms: expansion, globalization, alignment, and nestedness. These are associated with distinct dimensions of consciousness including phenomenal content, access, form/structure, and level/state, respectively. Following up on the first introduction of the TTC in 2017, we review updates, further develop these temporo-spatial mechanisms, and postulate specific neurophenomenal hypotheses. We conclude that the TTC offers a viable approach for (i) linking spontaneous and stimulus-related activity in conscious states; (ii) determining specific neuronal and neurophenomenal mechanisms for the distinct dimensions of consciousness; (iii) an integrative and unifying framework of different neuroscientific theories of consciousness; and (iv) offers novel empirically grounded conceptual assumptions about the biological and ontological nature of consciousness and its relation to the brain.
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Affiliation(s)
- Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, The Royal Ottawa Mental Health Centre and University of Ottawa, Ottawa, Canada; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China; Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Federico Zilio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy.
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15
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Abstract
Background: The wakeful brain can easily access and coordinate a large repertoire of different states—dynamics suggestive of “criticality.” Anesthesia causes loss of criticality at the level of electroencephalogram waveforms, but the criticality of brain network connectivity is less well studied. The authors hypothesized that propofol anesthesia is associated with abrupt and divergent changes in brain network connectivity for different frequencies and time scales—characteristic of a phase transition, a signature of loss of criticality. Methods: As part of a previously reported study, 16 volunteers were given propofol in slowly increasing brain concentrations, and their behavioral responsiveness was assessed. The network dynamics from 31-channel electroencephalogram data were calculated from 1 to 20 Hz using four phase and envelope amplitude–based functional connectivity metrics that covered a wide range of time scales from milliseconds to minutes. The authors calculated network global efficiency, clustering coefficient, and statistical complexity (using the Jensen–Shannon divergence) for each functional connectivity metric and compared their findings with those from an in silico Kuramoto network model. Results: The transition to anesthesia was associated with critical slowing and then abrupt profound decreases in global network efficiency of 2 Hz power envelope metrics (from mean ± SD of 0.64 ± 0.15 to 0.29 ± 0.28 absolute value, P < 0.001, for medium; and from 0.47 ± 0.13 to 0.24 ± 0.21, P < 0.001, for long time scales) but with an increase in global network efficiency for 10 Hz weighted phase lag index (from 0.30 ± 0.20 to 0.72 ± 0.06, P < 0.001). Network complexity decreased for both the 10 Hz hypersynchronous (0.44 ± 0.13 to 0.23 ± 0.08, P < 0.001), and the 2 Hz asynchronous (0.73 ± 0.08 to 0.40 ± 0.13, P < 0.001) network states. These patterns of network coupling were consistent with those of the Kuramoto model of an order–disorder phase transition. Conclusions: Around loss of behavioral responsiveness, a small increase in propofol concentrations caused a collapse of long time scale power envelope connectivity and an increase in 10 Hz phase-based connectivity—suggestive of a brain network phase transition. Temporospatial electroencephalographic analysis of brain network dynamics over a wide range of frequencies and time scales in 16 volunteers receiving slowly increasing concentrations of propofol revealed that transition to unresponsiveness was associated with a sudden rise in alpha frequency network phase synchrony anteriorly, but also a transient surge and then loss of network coupling over long (tens of seconds) time scales. Deep anesthesia was characterized by alpha waveform hypersynchrony and slow-wave power envelope dissynchrony across the whole cortex. These observations suggest that propofol anesthesia is associated with a constellation of changes in network connectivity across frequencies and time scales that are signatures of sharp and sudden transitions in the behavior of networks.
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16
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Propofol Anesthesia: A Leap into the Void? Anesthesiology 2022; 136:405-407. [PMID: 35120194 DOI: 10.1097/aln.0000000000004110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Wasilczuk AZ, Meng QC, McKinstry-Wu AR. Electroencephalographic Evidence for Individual Neural Inertia in Mice That Decreases With Time. Front Syst Neurosci 2022; 15:787612. [PMID: 35095434 PMCID: PMC8794956 DOI: 10.3389/fnsys.2021.787612] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/14/2021] [Indexed: 12/02/2022] Open
Abstract
Previous studies have demonstrated that the brain has an intrinsic resistance to changes in arousal state. This resistance is most easily measured at the population level in the setting of general anesthesia and has been termed neural inertia. To date, no study has attempted to determine neural inertia in individuals. We hypothesize that individuals with markedly increased or decreased neural inertia might be at increased risk for complications related to state transitions, from awareness under anesthesia, to delayed emergence or confusion/impairment after emergence. Hence, an improved theoretical and practical understanding of neural inertia may have the potential to identify individuals at increased risk for these complications. This study was designed to explicitly measure neural inertia in individuals and empirically test the stochastic model of neural inertia using spectral analysis of the murine EEG. EEG was measured after induction of and emergence from isoflurane administered near the EC50 dose for loss of righting in genetically inbred mice on a timescale that minimizes pharmacokinetic confounds. Neural inertia was assessed by employing classifiers constructed using linear discriminant or supervised machine learning methods to determine if features of EEG spectra reliably demonstrate path dependence at steady-state anesthesia. We also report the existence of neural inertia at the individual level, as well as the population level, and that neural inertia decreases over time, providing direct empirical evidence supporting the predictions of the stochastic model of neural inertia.
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Affiliation(s)
- Andrzej Z. Wasilczuk
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Qing Cheng Meng
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, United States
| | - Andrew R. McKinstry-Wu
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, United States
- *Correspondence: Andrew Rich McKinstry-Wu
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Nir T, Raizman R, Meningher I, Jacob Y, Huang KH, Schwartz AE, Brallier JW, Ahn H, Kundu P, Tang CY, Delman BN, McCormick PJ, Scarpa J, Sano M, Deiner SG, Livny A, Baxter MG, Mincer JS. Lateralisation of subcortical functional connectivity during and after general anaesthesia. Br J Anaesth 2022; 128:65-76. [PMID: 34802696 PMCID: PMC8787782 DOI: 10.1016/j.bja.2021.08.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/03/2021] [Accepted: 08/21/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Arousal and awareness are two important components of consciousness states. Functional neuroimaging has furthered our understanding of cortical and thalamocortical mechanisms of awareness. Investigating the relationship between subcortical functional connectivity and arousal has been challenging owing to the relatively small size of brainstem structures and thalamic nuclei, and their depth in the brain. METHODS Resting state functional MRI scans of 72 healthy volunteers were acquired before, during, 1 h after, and 1 day after sevoflurane general anaesthesia. Functional connectivity of subcortical regions of interest vs whole brain and homotopic functional connectivity for assessment of left-right symmetry analyses of both cortical and subcortical regions of interest were performed. Both analyses used high resolution atlases generated from deep brain stimulation applications. RESULTS Functional connectivity in subcortical loci within the thalamus and of the ascending reticular activating system was sharply restricted under anaesthesia, featuring a general lateralisation of connectivity. Similarly, left-right homology was sharply reduced under anaesthesia. Subcortical bilateral functional connectivity was not fully restored after emergence from anaesthesia, although greater restoration was seen between ascending reticular activating system loci and specific thalamic nuclei thought to be involved in promoting and maintaining arousal. Functional connectivity was fully restored to baseline by the following day. CONCLUSIONS Functional connectivity in the subcortex is sharply restricted and lateralised under general anaesthesia. This restriction may play a part in loss and return of consciousness. CLINICAL TRIAL REGISTRATION NCT02275026.
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Affiliation(s)
- Tommer Nir
- Department of Anesthesiology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Reut Raizman
- Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Inbar Meningher
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Yael Jacob
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kuang-Han Huang
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arthur E Schwartz
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jess W Brallier
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Helen Ahn
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Prantik Kundu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Hyperfine Research, Guilford, CT, USA
| | - Cheuk Y Tang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bradley N Delman
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patrick J McCormick
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Julia Scarpa
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Mary Sano
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stacie G Deiner
- Department of Anesthesiology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Mark G Baxter
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua S Mincer
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
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19
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Nourski KV, Steinschneider M, Rhone AE, Krause BM, Mueller RN, Kawasaki H, Banks MI. Cortical Responses to Vowel Sequences in Awake and Anesthetized States: A Human Intracranial Electrophysiology Study. Cereb Cortex 2021; 31:5435-5448. [PMID: 34117741 PMCID: PMC8568007 DOI: 10.1093/cercor/bhab168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/22/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023] Open
Abstract
Elucidating neural signatures of sensory processing across consciousness states is a major focus in neuroscience. Noninvasive human studies using the general anesthetic propofol reveal differential effects on auditory cortical activity, with a greater impact on nonprimary and auditory-related areas than primary auditory cortex. This study used intracranial electroencephalography to examine cortical responses to vowel sequences during induction of general anesthesia with propofol. Subjects were adult neurosurgical patients with intracranial electrodes placed to identify epileptic foci. Data were collected before electrode removal surgery. Stimuli were vowel sequences presented in a target detection task during awake, sedated, and unresponsive states. Averaged evoked potentials (AEPs) and high gamma (70-150 Hz) power were measured in auditory, auditory-related, and prefrontal cortex. In the awake state, AEPs were found throughout studied brain areas; high gamma activity was limited to canonical auditory cortex. Sedation led to a decrease in AEP magnitude. Upon LOC, there was a decrease in the superior temporal gyrus and adjacent auditory-related cortex and a further decrease in AEP magnitude in core auditory cortex, changes in the temporal structure and increased trial-to-trial variability of responses. The findings identify putative biomarkers of LOC and serve as a foundation for future investigations of altered sensory processing.
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Affiliation(s)
- Kirill V Nourski
- Address correspondence to Kirill V. Nourski, MD, PhD, Department of Neurosurgery, The University of Iowa, 200 Hawkins Dr. 1815 JCP, Iowa City, IA 52242, USA.
| | - Mitchell Steinschneider
- Department of Neurology and Neuroscience, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Ariane E Rhone
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, USA
| | - Bryan M Krause
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Rashmi N Mueller
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, USA,Department of Anesthesia, The University of Iowa, Iowa City, IA 52242, USA
| | - Hiroto Kawasaki
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, USA
| | - Matthew I Banks
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA,Department of Neuroscience, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
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