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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
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