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Siddiqi AZ, Froese L, Gomez A, Sainbhi AS, Stein K, Park K, Vakitbilir N, Zeiler FA. The effect of burst suppression on cerebral blood flow and autoregulation: a scoping review of the human and animal literature. Front Physiol 2023; 14:1204874. [PMID: 37351255 PMCID: PMC10282505 DOI: 10.3389/fphys.2023.1204874] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
Background: Burst suppression (BS) is an electroencephalography (EEG) pattern in which there are isoelectric periods interspersed with bursts of cortical activity. Targeting BS through anaesthetic administration is used as a tool in the neuro-intensive care unit but its relationship with cerebral blood flow (CBF) and cerebral autoregulation (CA) is unclear. We performed a systematic scoping review investigating the effect of BS on CBF and CA in animals and humans. Methods: We searched MEDLINE, BIOSIS, EMBASE, SCOPUS and Cochrane library from inception to August 2022. The data that were collected included study population, methods to induce and measure BS, and the effect on CBF and CA. Results: Overall, there were 66 studies that were included in the final results, 41 of which examined animals, 24 of which examined humans, and 1 of which examined both. In almost all the studies, BS was induced using an anaesthetic. In most of the animal and human studies, BS was associated with a decrease in CBF and cerebral metabolism, even if the mean arterial pressure remained constant. The effect on CA during periods of stress (hypercapnia, hypothermia, etc.) was variable. Discussion: BS is associated with a reduction in cerebral metabolic demand and CBF, which may explain its usefulness in patients with brain injury. More evidence is needed to elucidate the connection between BS and CA.
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Affiliation(s)
- A. Zohaib Siddiqi
- Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Logan Froese
- Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Alwyn Gomez
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Amanjyot Singh Sainbhi
- Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Kevin Stein
- Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Kangyun Park
- Undergraduate Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Nuray Vakitbilir
- Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Frederick A. Zeiler
- Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Division of Anaesthesia, Department of Medicine, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
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Shin TJ, Kim PJ, Choi B. How general anesthetics work: from the perspective of reorganized connections within the brain. Korean J Anesthesiol 2022; 75:124-138. [PMID: 35130674 PMCID: PMC8980288 DOI: 10.4097/kja.22078] [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: 02/03/2022] [Accepted: 02/06/2022] [Indexed: 11/24/2022] Open
Abstract
General anesthesia is critical for various procedures and surgeries. Despite the widespread use of anesthetics, their precise mechanisms remain poorly understood. Anesthetics inevitably act on the brain, primarily through the modulation of target receptors. Even if the action is specific to an individual neuron, however, long-range effects can occur due to the tremendous interconnectedness of neuronal activity. The strength of this connectivity can be understood using mathematical models that allow for the study of neuronal connectivity dynamics. These models also allow researchers to develop hypotheses on the candidate mechanisms of action of different types of anesthesia. This review highlights the theoretical background associated with the study of the mechanisms of action of anesthetics. We propose a candidate framework that describes how anesthetics act on the brain and consciousness in general.
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Jeong H, Lee HS, Seong M, Baek J, Park K, Kim JG. Changes of Apomorphine-Induced Vaginal Hemodynamics in an Ovariectomized Rat Model Using Near-Infrared Spectroscopic Probe. J Sex Med 2021; 18:1328-1336. [PMID: 37057459 DOI: 10.1016/j.jsxm.2021.05.012] [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: 10/29/2020] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Female sexual arousal disorder (FSAD) can be caused by the change in vaginal structure due to the decline of estrogen and one of the main symptoms is vaginal dryness. FSAD is a prevalent problem afflicting women all over the world and thus the interest is growing on the matter, but related studies of monitoring FSAD using a non-invasive optical method barely have been carried out. AIM This study aims to investigate the longitudinal changes in female sexual arousal response induced by apomorphine (APO) administration in the ovariectomized rat using near-infrared spectroscopy (NIRS) probe. METHODS To elicit sexual arousal, APO was administered subcutaneously to animals (n = 6) before and after ovariectomy, and the changes in oxyhemoglobin (OHb), deoxyhemoglobin (RHb), total hemoglobin (THb) concentration, and temperature on the vaginal wall after APO administration were monitored bi-weekly for 8 weeks. Furthermore, estradiol hormone, vaginal secretion, and body weight have been measured for comparison with the results from vaginal hemodynamics. RESULTS APO administration caused the increase of vaginal OHb and RHb concentration but a decrease in temperature. The amplitude of OHb, RHb, and THb increase induced by APO gradually decreased over 8 weeks after ovariectomy while the decrease in vaginal temperature became profound. The level of estradiol and vaginal secretions also decreased over 8 weeks after ovariectomy, but bodyweight showed an increasing trend. CONCLUSIONS A comparison between the parameters measured from the NIRS probe and the others (estradiol level, amount of vaginal secretion, and body weight) proved that the NIRS has the potential as a monitoring tool to evaluate female sexual arousal response. Jeong H, Lee HS, Seong M, et al. Changes of Apomorphine-Induced Vaginal Hemodynamics in an Ovariectomized Rat Model Using Near-Infrared Spectroscopic Probe. J Sex Med 2021;18:1328-1336.
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Affiliation(s)
- Hyeryun Jeong
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea; Department of Biomedical Engineering, National University of Singapore, Singpaore
| | - Hyun-Suk Lee
- Department of Urology, Chonnam National University Medical School, Gwangju, South Korea
| | - Myeongsu Seong
- Research center for Intelligent Information Technology, Nantong University, Nantong, China
| | - Jaewoo Baek
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, South Korea
| | - Jae Gwan Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea.
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Kim E, Anguluan E, Kum J, Sanchez-Casanova J, Park TY, Kim JG, Kim H. Wearable Transcranial Ultrasound System for Remote Stimulation of Freely Moving Animal. IEEE Trans Biomed Eng 2021; 68:2195-2202. [PMID: 33186099 DOI: 10.1109/tbme.2020.3038018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Transcranial focused ultrasound (tFUS) has drawn considerable attention in the neuroscience field as a noninvasive approach to modulate brain circuits. However, the conventional approach requires the use of anesthetized or immobilized animal models, which places considerable restrictions on behavior and affects treatment. Thus, this work presents a wireless, wearable system to achieve ultrasound brain stimulation in freely behaving animals. METHODS The wearable tFUS system was developed based on a microcontroller and amplifier circuit. Brain activity induced by tFUS was monitored through cerebral hemodynamic changes using near-infrared spectroscopy. The system was also applied to stroke rehabilitation after temporal middle cerebral artery occlusion (tMCAO) in rats. Temperature calculations and histological results showed the safety of the application even with prolonged 40 min sonication. RESULTS The output ultrasonic wave produced from a custom PZT transducer had a central frequency of 457 kHz and peak to peak pressure of 426 kPa. The device weight was 20 g, allowing a full range of motion. The stimulation was found to induce hemodynamic changes in the sonicated area, while open-field tests showed that ultrasound applied to the ipsilateral hemisphere for 5 consecutive days after the stroke facilitated recovery. CONCLUSION The wearable tFUS system has been designed and implemented on moving rats. The results showed the ability of device to cause both short- and long lasting effects. SIGNIFICANCE The proposed device provides a more natural environment to investigate the effects of tFUS for behavioral and long-term studies.
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Jeong H, Seong M, Lee HS, Park K, Moon S, Kim JG. Design of an Optical Probe to Monitor Vaginal Hemodynamics during Sexual Arousal. SENSORS 2019; 19:s19092129. [PMID: 31071987 PMCID: PMC6540249 DOI: 10.3390/s19092129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/02/2019] [Accepted: 05/05/2019] [Indexed: 11/16/2022]
Abstract
An optical probe was developed to measure the change of oxy-hemoglobin (OHb), deoxy- hemoglobin (RHb), and total hemoglobin (THb) along with temperature from the vaginal wall of female rats. Apomorphine (APO, 80 μg/kg) was administered to elicit sexual arousal in female Sprague Dawley rats (SD, 180–200 g). The behavior changes caused by APO administration were checked before monitoring vaginal responses. The changes of oxy-, deoxy-, and total hemoglobin concentration and the temperature from the vaginal wall were monitored before, during, and after APO administration. Animals were under anesthesia during the measurement. After APO administration, the concentration of OHb (55 ± 29 μM/DPF), RHb (33 ± 25 μM/DPF), and THb (83 ± 59 μM/DPF) in the vaginal wall increased in a few min, while saline administration did not cause any significant change. In case of the vaginal temperature change, APO decreased the temperature slightly in the vaginal wall while saline administration did not show any temperature change in the vaginal wall. As the outcomes demonstrated, the developed probe can detect hemodynamic and temperature variation in the vaginal wall. The hemodynamic information acquired by the probe can be utilized to establish an objective and accurate standard of female sexual disorders.
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Affiliation(s)
- Hyeryun Jeong
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Korea.
| | - Myeongsu Seong
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Korea.
| | - Hyun-Suk Lee
- Department of Urology, Chonnam National University Medical School, Gwangju 61186, Korea.
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju 61186, Korea.
| | - Sucbei Moon
- Department of Physics, Kookmin University, Seoul 02707, Korea.
| | - Jae Gwan Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju 61005, Korea.
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Kim E, Anguluan E, Youn S, Kim J, Hwang JY, Kim JG. Non-invasive measurement of hemodynamic change during 8 MHz transcranial focused ultrasound stimulation using near-infrared spectroscopy. BMC Neurosci 2019; 20:12. [PMID: 30885121 PMCID: PMC6423784 DOI: 10.1186/s12868-019-0493-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/12/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Transcranial focused ultrasound (tFUS) attracts wide attention in neuroscience as an effective noninvasive approach to modulate brain circuits. In spite of this, the effects of tFUS on the brain is still unclear, and further investigation is needed. The present study proposes to use near-infrared spectroscopy (NIRS) to observe cerebral hemodynamic change caused by tFUS in a noninvasive manner. RESULTS The results show a transient increase of oxyhemoglobin and decrease of deoxyhemoglobin concentration in the mouse model induced by ultrasound stimulation of the somatosensory cortex with a frequency of 8 MHz but not in sham. In addition, the amplitude of hemodynamics change can be related to the peak intensity of the acoustic wave. CONCLUSION High frequency 8 MHz ultrasound was shown to induce hemodynamic changes measured using NIRS through the intact mouse head. The implementation of NIRS offers the possibility of investigating brain response noninvasively for different tFUS parameters through cerebral hemodynamic change.
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Affiliation(s)
- Evgenii Kim
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju, 61005 Republic of Korea
| | - Eloise Anguluan
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005 Republic of Korea
| | - Sangyeon Youn
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, 42988 Republic of Korea
| | - Jihun Kim
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, 42988 Republic of Korea
| | - Jae Youn Hwang
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, 42988 Republic of Korea
| | - Jae Gwan Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005 Republic of Korea
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Bae J, Shin TJ, Kim S, Choi DH, Cho D, Ham J, Manca M, Jeong S, Lee B, Kim JG. The changes of cerebral hemodynamics during ketamine induced anesthesia in a rat model. JOURNAL OF BIOPHOTONICS 2018; 11:e201800081. [PMID: 29799675 DOI: 10.1002/jbio.201800081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/24/2018] [Indexed: 06/08/2023]
Abstract
Current electroencephalogram (EEG) based-consciousness monitoring technique is vulnerable to specific clinical conditions (eg, epilepsy and dementia). However, hemodynamics is the most fundamental and well-preserved parameter to evaluate, even under severe clinical situations. In this study, we applied near-infrared spectroscopy (NIRS) system to monitor hemodynamic change during ketamine-induced anesthesia to find its correlation with the level of consciousness. Oxy-hemoglobin (OHb) and deoxy-hemoglobin concentration levels were continuously acquired throughout the experiment, and the reflectance ratio between 730 and 850 nm was calculated to quantify the hemodynamic changes. The results showed double peaks of OHb concentration change during ketamine anesthesia, which seems to be closely related to the consciousness state of the rat. This finding suggests the possibility of NIRS based-hemodynamic monitoring as a supplementary parameter for consciousness monitoring, compensating drawbacks of EEG signal based monitoring.
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Affiliation(s)
- Jayyoung Bae
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Teo J Shin
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Seonghyun Kim
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Dong-Hyuk Choi
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Dongrae Cho
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Jinsil Ham
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Marco Manca
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Seongwook Jeong
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Boreom Lee
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
| | - Jae G Kim
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea
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