Liang Zhenhu, Wang Xin, Yu Zhenyang, Tong Yunjie, Li Xiaoli, Ma Yaqun, Guo Hang
School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, China.
Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Qinhuangdao 066004, China.
Biomed Opt Express. 2023 Apr 24;14(5):2240-2259. doi: 10.1364/BOE.482127. eCollection 2023 May 1.
General anesthesia is an indispensable procedure in clinical practice. Anesthetic drugs induce dramatic changes in neuronal activity and cerebral metabolism. However, the age-related changes in neurophysiology and hemodynamics during general anesthesia remain unclear. Therefore, the objective of this study was to explore the neurovascular coupling between neurophysiology and hemodynamics in children and adults during general anesthesia. We analyzed frontal electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) signals recorded from children (6-12 years old, n = 17) and adults (18-60 years old, n = 25) during propofol-induced and sevoflurane-maintained general anesthesia. The neurovascular coupling was evaluated in wakefulness, maintenance of a surgical state of anesthesia (MOSSA), and recovery by using correlation, coherence and Granger-causality (GC) between the EEG indices [EEG power in different bands and permutation entropy (PE)], and hemodynamic responses the oxyhemoglobin (Δ[HbO]) and deoxy-hemoglobin (Δ[Hb]) from fNIRS in the frequency band in 0.01-0.1 Hz. The PE and Δ[Hb] performed well in distinguishing the anesthesia state (p > 0.001). The correlation between PE and Δ[Hb] was higher than those of other indices in the two age groups. The coherence significantly increased during MOSSA (p < 0.05) compared with wakefulness, and the coherences between theta, alpha and gamma, and hemodynamic activities of children are significantly stronger than that of adults' bands. The GC from neuronal activities to hemodynamic responses decreased during MOSSA, and can better distinguish anesthesia state in adults. Propofol-induced and sevoflurane-maintained combination exhibited age-dependent neuronal activities, hemodynamics, and neurovascular coupling, which suggests the need for separate rules for children's and adults' brain states monitoring during general anesthesia.
全身麻醉是临床实践中不可或缺的一项操作。麻醉药物会引起神经元活动和脑代谢的显著变化。然而，全身麻醉期间与年龄相关的神经生理学和血流动力学变化仍不清楚。因此，本研究的目的是探讨儿童和成人在全身麻醉期间神经生理学和血流动力学之间的神经血管耦合。我们分析了在丙泊酚诱导和七氟醚维持的全身麻醉期间，从儿童（6至12岁，n = 17）和成人（18至60岁，n = 25）记录的额叶脑电图（EEG）和功能近红外光谱（fNIRS）信号。通过使用脑电图指标[不同频段的脑电图功率和排列熵（PE）]之间的相关性、相干性和格兰杰因果关系（GC），以及0.01至0.1Hz频段内fNIRS的氧合血红蛋白（Δ[HbO]）和脱氧血红蛋白（Δ[Hb]）的血流动力学反应，在清醒、维持手术麻醉状态（MOSSA）和恢复过程中评估神经血管耦合。PE和Δ[Hb]在区分麻醉状态方面表现良好（p > 0.001）。在两个年龄组中，PE与Δ[Hb]之间的相关性高于其他指标。与清醒相比，MOSSA期间相干性显著增加（p < 0.05），儿童的θ波、α波和γ波与血流动力学活动之间的相干性明显强于成人的频段。在MOSSA期间，从神经元活动到血流动力学反应的GC降低，并且在成人中能更好地区分麻醉状态。丙泊酚诱导和七氟醚维持的联合麻醉表现出年龄依赖性的神经元活动、血流动力学和神经血管耦合，这表明在全身麻醉期间监测儿童和成人的脑状态需要分别制定规则。
