Kliniken Nordoberpfalz AG, Klinikum Weiden, Germany.
University of Alexandria, Alexandria, Egypt.
World Neurosurg. 2021 Feb;146:e351-e358. doi: 10.1016/j.wneu.2020.10.102. Epub 2020 Oct 24.
In this study, we evaluated the changes in resting-state networks (RSNs) under anesthesia in neurosurgical patients.
RSNs were analyzed in 12 patients with pituitary adenoma presented by chiasma compression operated via standard transsphenoidal approach under propofol anesthesia before and after tumor resection. All the patients had suprasellar tumor extension with compression of the optic chiasma. We investigated second-level effects by contrasting dummy-encoded covariates representing the effects of the sessions (first vs. second) on RSNs. We corrected for multiple comparisons using a false discovery rate of 0.05 (2-sided).
Connectivity between the right and left precentral gyri (motor network) decreased significantly from the first to the second session (P = 0.0002), as did the connectivity between the postcentral gyri (P = 0.009). The same was valid for connectivity between the visual cortices (P = 0.0002). The salience network showed a significant decrease in the connectivity of the anterior part of the cingulate gyrus and insular cortex (P = 0.0001). The default mode network showed a decrease in the connectivity between the posterior part of the cingulate gyrus, parietal, and frontal cortices (P = 0.0002). There was no significant correlation between the reduction in connectivity and dose or duration of anesthesia.
Different RSNs could be identified under anesthesia and used for intraoperative brain mapping and remapping during tumor resection. However, RSNs showed a significant decrease in connectivity with the continuation of anesthesia.
本研究旨在评估神经外科患者麻醉状态下静息态网络(RSN)的变化。
对 12 例因视交叉受压而接受经蝶窦标准入路垂体瘤切除术的患者,在肿瘤切除前后,于丙泊酚麻醉下采集静息态功能磁共振数据。所有患者均有鞍上肿瘤延伸,伴有视交叉受压。我们通过对比代表会话(第一次与第二次)对 RSN 影响的伪编码协变量,来研究二级效应。我们使用 0.05(双侧)的错误发现率进行多重比较校正。
从第一次到第二次会话,右侧和左侧中央前回(运动网络)之间的连通性显著降低(P=0.0002),后中央回之间的连通性也显著降低(P=0.009)。同样,视觉皮层之间的连通性也显著降低(P=0.0002)。显着性网络中扣带前回和岛叶皮质的连接性显著降低(P=0.0001)。默认模式网络中扣带后回、顶叶和额叶皮质之间的连接性降低(P=0.0002)。连接性的降低与麻醉剂量或时间无显著相关性。
在麻醉状态下可以识别不同的 RSN,并可用于术中脑图绘制和肿瘤切除过程中的重绘。然而,随着麻醉的继续,RSN 的连通性显著降低。