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Toward a Unified Theory of Narcosis: Brain Imaging Evidence for a Thalamocortical Switch as the Neurophysiologic Basis of Anesthetic-Induced Unconsciousness
Abstract
A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness.
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“The thalamus has long been considered a critical neuroanatomical target of general anesthetics in mammals and has been proposed as a “switch” for anesthetic state transitions [126].”
From The Biology of General Anesthesia from Paramecium to Primate (2019) · cites this paper as [126]
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Metadata
- Authors
- Alkire, M. T., Haier, R. J., & Fallon, J. H.
- Affiliations
- University of California, Irvine (US)
- Corresponding author
- Alkire, M.T.
- Venue
- Consciousness and Cognition
- Publisher
- Elsevier BV
- Published
- 2000-09
- Volume
- 9
- Issue
- 3
- Pages
- 370-386
- ISSN
- 1053-8100 (ISSN-L)
- OpenAlex
- W1990752984
- Cited by
- 391
- References
- 54
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 12 · 2020: 16 · 2019: 11 · 2018: 16 · 2017: 20 · 2016: 17 · 2015: 25 · 2014: 23 · 2013: 14 · 2012: 19
- FWCI
- 14.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Consciousness and Cognition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Life Sciences › Neuroscience › Developmental Neuroscience › Anesthesia and Neurotoxicity Research
- Keywords
- general anesthesia, anesthetic-induced unconsciousness, narcosis, thalamocortical neurons, thalamus, midbrain reticular formation, consciousness, sleep, volatile anesthetics
- MeSH terms
- Adolescent, Adult, Anesthesia, General, Cerebral Cortex, Energy Metabolism, Female, Halothane, Humans, Isoflurane, Male, Mesencephalon, Neural Pathways, Reticular Formation, Thalamus, Tomography, Emission-Computed, Unconsciousness, Anesthetics, Inhalation, Fluorodeoxyglucose F18
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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