Li Duan, Puglia Mike P, Lapointe Andrew P, Ip Ka I, Zierau Mackenzie, McKinney Amy, Vlisides Phillip E
Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, United States.
Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI, United States.
Front Aging Neurosci. 2020 Jan 10;11:371. doi: 10.3389/fnagi.2019.00371. eCollection 2019.
An advanced understanding of the neurophysiologic changes that occur with aging may help improve care for older, vulnerable surgical patients. The objective of this study was to determine age-related changes in cortical connectivity patterns during surgical anesthesia. This was a substudy analysis of a prospective, observational study characterizing cortical connectivity during surgical anesthesia in adult patients ( = 45) whole-scalp (16-channel) electroencephalography. Functional connectivity was estimated using a weighted phase lag index (wPLI), which was classified into a discrete set of states through k-means analysis. Temporal dynamics were quantified by occurrence rate and state transition probabilities. The mean global connectivity state transition probability [13.4% (±8.1)] was not correlated with age ( = 0.100, = 0.513). Increasing age was inversely correlated with prefrontal-frontal alpha-beta connectivity ( = -0.446, = 0.002) and positively correlated with frontal-parietal theta connectivity ( = 0.414, = 0.005). After adjusting for anesthetic-related confounders, prefrontal-frontal alpha-beta connectivity remained significantly associated with age ( = -0.625, 95% CI -0.99 to -0.26; = 0.001), while frontal-parietal theta connectivity was no longer significant ( = 0.436, 95% CI -0.03 to 0.90; = 0.066). Specific transition states were also examined. Between frontal-parietal connectivity states, transitioning from theta-alpha to theta-dominated connectivity positively correlated with age ( = 0.545, = 0.001). Dynamic connectivity states during surgical anesthesia, particularly involving alpha and theta bandwidths, maybe an informative measure to assess neurophysiologic changes that occur with aging.
对衰老过程中发生的神经生理变化有更深入的了解，可能有助于改善对老年脆弱手术患者的护理。本研究的目的是确定手术麻醉期间与年龄相关的皮质连接模式变化。这是一项对一项前瞻性观察性研究的子研究分析，该研究通过全头皮（16通道）脑电图来表征成年患者（n = 45）手术麻醉期间的皮质连接情况。使用加权相位滞后指数（wPLI）估计功能连接，并通过k均值分析将其分类为一组离散状态。通过发生率和状态转换概率对时间动态进行量化。平均全局连接状态转换概率[13.4%（±8.1）]与年龄无关（r = 0.100，P = 0.513）。年龄增长与前额叶-额叶α-β连接呈负相关（r = -0.446，P = 0.002），与额叶-顶叶θ连接呈正相关（r = 0.414，P = 0.005）。在调整麻醉相关混杂因素后，前额叶-额叶α-β连接仍与年龄显著相关（r = -0.625，95%CI -0.99至-0.26；P = 0.001），而额叶-顶叶θ连接不再显著（r = 0.436，95%CI -0.03至0.90；P = 0.066）。还检查了特定的转换状态。在前额叶-顶叶连接状态之间，从θ-α连接转换为θ主导连接与年龄呈正相关（r = 0.545，P = 0.001）。手术麻醉期间的动态连接状态，特别是涉及α和θ带宽的状态，可能是评估衰老过程中发生的神经生理变化的一个有用指标。
