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Dynamic Cortical Connectivity during General Anesthesia in Healthy Volunteers
Abstract
Editor’s Perspective: What We Already Know about This Topic: What This Article Tells Us That Is New: Background: Recent studies of anesthetic-induced unconsciousness in healthy volunteers have focused on functional brain connectivity patterns, but the protocols rarely parallel the depth and duration of surgical anesthesia. Furthermore, it is unknown whether there is a single functional connectivity pattern that correlates with general anesthesia for the duration of prolonged anesthetic exposure. Methods: The authors analyzed electroencephalographic data in 30 healthy participants who underwent induction of anesthesia with propofol followed by 3 h of isoflurane anesthesia at age-adjusted 1.3 minimum alveolar concentration. Functional connectivity was assessed by frequency-resolved weighted phase lag index between frontal and parietal channels and between prefrontal and frontal channels, which were classified into a discrete set of states through k-means cluster analysis. Temporal dynamics were evaluated by the occurrence rate and dwell time distribution for each state as well as the transition probabilities between states. Results: Burst suppression was present, with mean suppression ratio reducing from 44.8 ± 32.3% to 14.0 ± 20.2% (mean ± SD) during isoflurane anesthesia ( P < 0.001). Aside from burst suppression, eight connectivity states were classified by optimizing the reproducibility of clustering solutions, with each characterized by distinct properties. The temporal progression of dominant states revealed a successive shifting trajectory from the state associated with alpha frontal-parietal connectivity to those associated with delta and alpha prefrontal-frontal connectivity during induction, which was reversed during emergence. Cortical connectivity was dynamic during maintenance period, and it was more probable to remain in the same state (82.0 ± 8.3%) than to switch to a different state ( P < 0.001). However, transitions to other states were structured, i.e. , occurred more frequently than expected by chance. Conclusions: Anesthesia-induced alterations of functional connectivity are dynamic despite the stable and prolonged administration of isoflurane, in the absence of any noxious stimuli. Changes in connectivity over time will likely yield more information as a marker or mechanism of surgical anesthesia than any single pattern.
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“recent studies have demonstrated that corticocortical functional connectivity shifts dynamically during exposure to volatile anesthetics, even when controlling for pharmacokinetic stability and surgical stimulus [147, 148].”
From The Biology of General Anesthesia from Paramecium to Primate (2019) · cites this paper as [148]
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Metadata
- Authors
- Li, D., Vlisides, P. E., Kelz, M. B., Avidan, M. S., Mashour, G. A., & for the ReCCognition Study Group
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Li, Duan
- Venue
- Anesthesiology
- Published
- 2019-06
- Volume
- 130
- Issue
- 6
- Pages
- 870-884
- ISSN
- 0003-3022 (ISSN-L)
- OpenAlex
- W2925812302
- Cited by
- 69
- References
- 45
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 7 · 2021: 16 · 2020: 14 · 2019: 11
- FWCI
- 17.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anesthesiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of General Medical Sciences (R01GM124023)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural dynamics and brain function
- Keywords
- general anesthesia, cortical functional connectivity, dynamic connectivity, isoflurane, propofol, burst suppression, weighted phase lag index, state transitions, level of consciousness, emergence from anesthesia
- MeSH terms
- Adult, Anesthesia, General, Cerebral Cortex, Electroencephalography, Female, Humans, Isoflurane, Male, Nerve Net, Propofol, Anesthetics, Inhalation, Anesthetics, Intravenous, Young Adult, Healthy Volunteers
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