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咪达唑仑镇静期间皮质脑电图频谱变化的时空模式。

Spatial-temporal patterns of electrocorticographic spectral changes during midazolam sedation.

作者信息

Nishida Masaaki, Zestos Maria M, Asano Eishi

机构信息

Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit Medical Center, Detroit, MI 48201, USA; Department of Anesthesiology, Hanyu General Hospital, Hanyu City, Saitama 348-8505, Japan.

Department of Anesthesiology, Children's Hospital of Michigan, Wayne State University, Detroit Medical Center, Detroit, MI 48201, USA.

出版信息

Clin Neurophysiol. 2016 Feb;127(2):1223-1232. doi: 10.1016/j.clinph.2015.10.044. Epub 2015 Nov 9.

Abstract

OBJECTIVE

To better understand 'when' and 'where' wideband electrophysiological signals are altered by sedation.

METHODS

We generated animation movies showing electrocorticography (ECoG) amplitudes at eight spectral frequency bands across 1.0-116 Hz, every 0.1s, on three-dimensional surface images of 10 children who underwent epilepsy surgery. We measured the onset, intensity, and variance of each band amplitude change at given nonepileptic regions separately from those at affected regions. We also determined the presence of differential ECoG changes depending on the brain anatomy.

RESULTS

Within 20s following injection of midazolam, beta (16-31.5 Hz) and sigma (12-15.5 Hz) activities began to be multifocally augmented with increased variance in amplitude at each site. Beta-sigma augmentation was most prominent within the association neocortex. Augmentation of low-delta activity (1.0-1.5 Hz) was relatively modest and confined to the somatosensory-motor region. Conversely, injection of midazolam induced attenuation of theta (4.0-7.5 Hz) and high-gamma (64-116 Hz) activities.

CONCLUSIONS

Our observations support the notion that augmentation beta-sigma and delta activities reflects cortical deactivation or inactivation, whereas theta and high-gamma activities contribute to maintenance of consciousness. The effects of midazolam on the dynamics of cortical oscillations differed across regions.

SIGNIFICANCE

Sedation, at least partially, reflects a multi-local phenomenon at the cortical level rather than global brain alteration homogeneously driven by the common central control structure.

摘要

目的

为了更好地理解镇静作用下宽带电生理信号在“何时”以及“何处”发生改变。

方法

我们制作了动画电影,展示了10名接受癫痫手术的儿童的三维表面图像上,每隔0.1秒在1.0 - 116赫兹的八个频谱频段的皮质脑电图(ECoG)振幅。我们分别测量了给定非癫痫区域与受影响区域每个频段振幅变化的起始、强度和方差。我们还根据脑解剖结构确定了ECoG差异变化的存在情况。

结果

在注射咪达唑仑后的20秒内,β(16 - 31.5赫兹)和σ(12 - 15.5赫兹)活动开始多灶性增强,每个部位的振幅方差增加。β - σ增强在联合新皮质内最为显著。低δ活动(1.0 - 1.5赫兹)的增强相对较小,且局限于体感运动区域。相反,注射咪达唑仑会导致θ(4.0 - 7.5赫兹)和高γ(64 - 116赫兹)活动减弱。

结论

我们的观察结果支持这样一种观点,即β - σ和δ活动的增强反映了皮质失活或去激活,而θ和高γ活动有助于维持意识。咪达唑仑对皮质振荡动力学的影响在不同区域有所不同。

意义

镇静作用至少部分反映了皮质水平的多部位现象,而非由共同的中央控制结构均匀驱动的全脑改变。

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