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从头皮和丘脑底核电极记录到的丙泊酚麻醉期间的爆发抑制:三例报告

Burst suppression during propofol anaesthesia recorded from scalp and subthalamic electrodes: report of three cases.

作者信息

Sonkajärvi E, Puumala P, Erola T, Baer G A, Karvonen E, Suominen K, Jäntti V

机构信息

Department of Anaesthesiology, Oulu University Hospital, Oulu, Finland.

出版信息

Acta Anaesthesiol Scand. 2008 Feb;52(2):274-9. doi: 10.1111/j.1399-6576.2007.01501.x. Epub 2007 Nov 8.

Abstract

BACKGROUND

Measurement of slow EEG activity and burst suppression are the main tasks in monitoring the effects of anaesthestics with EEG, which is often done with commercial univariate indexes such as BIS. The aim of this study was to describe the characteristics of burst suppression EEG during propofol anaesthesia using scalp electrodes and depth electrodes in the subthalamic nucleus. Specifically, we describe the electrical fields of the three EEG patterns we have previously described: the sharp wave, the burst and the spindle.

METHODS

We recorded the EEG of three Parkinson patients during propofol anaesthesia from the scalp electrodes and the depth electrode implanted in the subthalamic nucleus for treating parkinsonism.

RESULTS

(1) The slow waves of bursts recorded from all surface electrodes on scalp or neck with depth electrode reference are positive and have the highest amplitude in frontal electrodes, suggesting synchronous generation in the whole cerebral cortex. (2) The sharp wave and spindles have the highest amplitude at vertex. They are opposite in polarity in vertex and depth electrodes when referred to the neck electrode, suggesting generation in the sensorimotor cortex.

CONCLUSIONS

Recording simultaneously EEG from the depth and scalp electrodes shows that bursts and their slow wave oscillations are synchronous in the whole cortex while spindles and sharp waves are produced by the sensorimotor cortex. The amplitude of slow waves recorded with surface electrodes is equal to the difference of the wave at two electrodes and therefore only a small part of that generated by the cortex.

摘要

背景

测量脑电图(EEG)的慢波活动和爆发抑制是通过EEG监测麻醉药物效果的主要任务,这通常使用诸如脑电双频指数(BIS)等商业单变量指标来完成。本研究的目的是描述在丙泊酚麻醉期间,使用头皮电极和丘脑底核深度电极时爆发抑制脑电图的特征。具体而言,我们描述了我们之前所描述的三种脑电图模式的电场:尖波、爆发和纺锤波。

方法

我们记录了三名帕金森病患者在丙泊酚麻醉期间的脑电图,记录电极包括头皮电极和为治疗帕金森病而植入丘脑底核的深度电极。

结果

(1)以深度电极作为参考,从头皮或颈部所有表面电极记录到的爆发慢波为正向,且在额电极处振幅最高,提示在整个大脑皮层同步产生。(2)尖波和纺锤波在头顶处振幅最高。当以颈部电极作为参考时,它们在头顶电极和深度电极处的极性相反,提示在感觉运动皮层产生。

结论

同时从深度电极和头皮电极记录脑电图表明,爆发及其慢波振荡在整个皮层是同步的,而纺锤波和尖波是由感觉运动皮层产生的。用表面电极记录的慢波振幅等于两个电极处波幅的差值,因此仅为皮层产生的慢波的一小部分。

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