Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA.
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA.
Neuron. 2023 Nov 1;111(21):3479-3495.e6. doi: 10.1016/j.neuron.2023.08.007. Epub 2023 Sep 1.
What happens in the human brain when we are unconscious? Despite substantial work, we are still unsure which brain regions are involved and how they are impacted when consciousness is disrupted. Using intracranial recordings and direct electrical stimulation, we mapped global, network, and regional involvement during wake vs. arousable unconsciousness (sleep) vs. non-arousable unconsciousness (propofol-induced general anesthesia). Information integration and complex processing we`re reduced, while variability increased in any type of unconscious state. These changes were more pronounced during anesthesia than sleep and involved different cortical engagement. During sleep, changes were mostly uniformly distributed across the brain, whereas during anesthesia, the prefrontal cortex was the most disrupted, suggesting that the lack of arousability during anesthesia results not from just altered overall physiology but from a disconnection between the prefrontal and other brain areas. These findings provide direct evidence for different neural dynamics during loss of consciousness compared with loss of arousability.
当我们处于无意识状态时，人类大脑中会发生什么？尽管已经做了大量工作，但我们仍不确定意识受到干扰时涉及哪些脑区，以及它们受到了怎样的影响。我们使用颅内记录和直接电刺激，绘制了清醒状态与可唤醒无意识（睡眠）和不可唤醒无意识（异丙酚诱导的全身麻醉）之间的全局、网络和区域参与图谱。信息整合和复杂处理减少，而在任何类型的无意识状态下，变异性增加。这些变化在麻醉期间比睡眠期间更为明显，并且涉及到不同的皮质参与。在睡眠期间，变化主要均匀分布在整个大脑中，而在麻醉期间，前额叶皮层受到的干扰最大，这表明麻醉期间缺乏唤醒能力不仅仅是由于整体生理改变，还因为前额叶皮层与其他大脑区域之间的脱节。这些发现为意识丧失与唤醒能力丧失期间不同的神经动力学提供了直接证据。
