Your browser doesn't support javascript.
loading
Constrained Functional Connectivity Dynamics in Pediatric Surgical Patients Undergoing General Anesthesia.
Puglia, Michael P; Vlisides, Phillip E; Kaplan, Chelsea M; Jewell, Elizabeth S; Therrian, Megan; Mashour, George A; Li, Duan.
Afiliación
  • Puglia MP; Department of Anesthesiology and Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, Michigan.
  • Vlisides PE; Department of Anesthesiology and Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, Michigan.
  • Kaplan CM; Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan.
  • Jewell ES; Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan.
  • Therrian M; Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan.
  • Mashour GA; Department of Anesthesiology, Center for Consciousness Science, and Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, Michigan.
  • Li D; Department of Anesthesiology and Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, Michigan.
Anesthesiology ; 137(1): 28-40, 2022 07 01.
Article en En | MEDLINE | ID: mdl-35363264
BACKGROUND: Functional connectivity in cortical networks is thought to be important for consciousness and can be disrupted during the anesthetized state. Recent work in adults has revealed dynamic connectivity patterns during stable general anesthesia, but whether similar connectivity state transitions occur in the developing brain remains undetermined. The hypothesis was that anesthetic-induced unconsciousness is associated with disruption of functional connectivity in the developing brain and that, as in adults, there are dynamic shifts in connectivity patterns during the stable maintenance phase of general anesthesia. METHODS: This was a preplanned analysis of a previously reported single-center, prospective, cross-sectional study of healthy (American Society of Anesthesiologists status I or II) children aged 8 to 16 yr undergoing surgery with general anesthesia (n = 50) at Michigan Medicine. Whole-scalp (16-channel), wireless electroencephalographic data were collected from the preoperative period through the recovery of consciousness. Functional connectivity was measured using a weighted phase lag index, and discrete connectivity states were classified using cluster analysis. RESULTS: Changes in functional connectivity were associated with anesthetic state transitions across multiple regions and frequency bands. An increase in prefrontal-frontal alpha (median [25th, 75th]; baseline, 0.070 [0.049, 0.101] vs. maintenance 0.474 [0.286, 0.606]; P < 0.001) and theta connectivity (0.038 [0.029, 0.048] vs. 0.399 [0.254, 0.488]; P < 0.001), and decrease in parietal-occipital alpha connectivity (0.171 [0.145, 0.243] vs. 0.089 [0.055, 0.132]; P < 0.001) were among those with the greatest effect size. Contrary to the hypothesis, connectivity patterns during the maintenance phase of general anesthesia were dominated by stable theta and alpha prefrontal-frontal and alpha frontal-parietal connectivity and exhibited high between-cluster similarity (r = 0.75 to 0.87). CONCLUSIONS: Changes in functional connectivity are associated with anesthetic state transitions but, unlike in adults, connectivity patterns are constrained during general anesthesia in late childhood and early adolescence.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corteza Cerebral / Anestesia General Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Humans Idioma: En Revista: Anesthesiology Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corteza Cerebral / Anestesia General Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Humans Idioma: En Revista: Anesthesiology Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos