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Dynamic Cortical Connectivity during General Anesthesia in Surgical Patients
Open accessAbstract
Editor’s Perspective: What We Already Know about This Topic: What This Article Tells Us That Is New: Background: Functional connectivity across the cortex has been posited to be important for consciousness and anesthesia, but functional connectivity patterns during the course of surgery and general anesthesia are unknown. The authors tested the hypothesis that disrupted cortical connectivity patterns would correlate with surgical anesthesia. Methods: Surgical patients (n = 53) were recruited for study participation. Whole-scalp (16-channel) wireless electroencephalographic data were prospectively collected throughout the perioperative period. Functional connectivity was assessed using weighted phase lag index. During anesthetic maintenance, the temporal dynamics of connectivity states were characterized via Markov chain analysis, and state transition probabilities were quantified. Results: Compared to baseline (weighted phase lag index, 0.163, ± 0.091), alpha frontal–parietal connectivity was not significantly different across the remaining anesthetic and perioperative epochs, ranging from 0.100 (± 0.041) to 0.218 (± 0.136) (P > 0.05 for all time periods). In contrast, there were significant increases in alpha prefrontal–frontal connectivity (peak = 0.201 [0.154, 0.248]; P < 0.001), theta prefrontal–frontal connectivity (peak = 0.137 [0.091, 0.182]; P < 0.001), and theta frontal–parietal connectivity (peak = 0.128 [0.084, 0.173]; P < 0.001) during anesthetic maintenance. Additionally, shifts occurred between states of high prefrontal–frontal connectivity (alpha, beta) with suppressed frontal–parietal connectivity, and high frontal–parietal connectivity (alpha, theta) with reduced prefrontal–frontal connectivity. These shifts occurred in a nonrandom manner (P < 0.05 compared to random transitions), suggesting structured transitions of connectivity during general anesthesia. Conclusions: Functional connectivity patterns dynamically shift during surgery and general anesthesia but do so in a structured way. Thus, a single measure of functional connectivity will likely not be a reliable correlate of surgical anesthesia.
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“Still, it is important to note that the anesthetized brain is not just in a fixed state; recent observations found it to be more dynamic than previously considered, with metastable oscillations or connectivity patterns that appear to reflect intrinsic dynamics rather than pharmacokinetic instability or external stimuli (Hudson et al., 2014; Li et al., 2019; Vlisides et al., 2019).”
From Conscious Processing and the Global Neuronal Workspace Hypothesis (2020) · cites this paper as Vlisides et al., 2019
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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 [147]
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Electroencephalogram signatures of loss and recovery of consciousness from propofol
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Signature of consciousness in the dynamics of resting-state brain activity
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Prevention of Intraoperative Awareness in a High-Risk Surgical Population
Avidan, M. S., Jacobsohn, E., Glick, D. B., Burnside, B. A., Zhang, L., Villafranca, A., Karl, L. R., Kamal, S., Torres, B. A., O'Connor, M., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1100403 · Cited by 593
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Conscious Processing and the Global Neuronal Workspace Hypothesis
Mashour, G. A., Roelfsema, P., Changeux, J.-P., & Dehaene, S. (2020) · Neuron · doi:10.1016/j.neuron.2020.01.026 · Cited by 1,164
“Review with metastable oscillations or connectivity patterns that appear to reflect intrinsic dynamics rather than pharmacokinetic instability or external stimuli (Hudson et al., 2014; Li et al., 2019; Vli-sides et al., 2019).”
BackgroundSelf-citationTemporal circuit of macroscale dynamic brain activity supports human consciousness
Huang, Z., Zhang, J., Wu, J., Mashour, G. A., & Hudetz, A. G. (2020) · Science Advances · doi:10.1126/sciadv.aaz0087 · Cited by 217
Self-citationThe Biology of General Anesthesia from Paramecium to Primate
Kelz, M. B., & Mashour, G. A. (2019) · Current Biology · doi:10.1016/j.cub.2019.09.071 · Cited by 151
Self-citationAnesthesia and the neurobiology of consciousness
Mashour, G. A. (2024) · Neuron · doi:10.1016/j.neuron.2024.03.002 · Cited by 127
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Metadata
- Authors
- Vlisides, P. E., Li, D., Zierau, M., Lapointe, A. P., Ip, K. I., McKinney, A. M., & Mashour, G. A.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Li, Duan
- Venue
- Anesthesiology
- Published
- 2019-06
- Volume
- 130
- Issue
- 6
- Pages
- 885-897
- ISSN
- 0003-3022 (ISSN-L)
- PMC
- PMC6520139
- OpenAlex
- W2925881161
- Cited by
- 66
- References
- 48
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 10 · 2021: 14 · 2020: 10 · 2019: 10
- FWCI
- 15.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Anesthesiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of General Medical Sciences (R01GM098578, T32GM103730)
- 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, weighted phase lag index, Markov chain state transition, frontoparietal connectivity
- MeSH terms
- Adult, Aged, Anesthesia, General, Cerebral Cortex, Electroencephalography, Female, Humans, Male, Middle Aged, Nerve Net, Prospective Studies, Anesthetics, Inhalation, Anesthetics, Intravenous
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