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丙泊酚、右美托咪定和氯胺酮诱导无反应状态期间信息整合及脑网络的变化

Changes in information integration and brain networks during propofol-, dexmedetomidine-, and ketamine-induced unresponsiveness.

作者信息

Liang Zhenhu, Chang Yu, Liu Xiaoge, Cao Shumei, Chen Yali, Wang Tingting, Xu Jianghui, Li Duan, Zhang Jun

机构信息

Institute of Electrical Engineering, Yanshan University, Qinhuangdao, P.R. China; Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Qinhuangdao, P.R. China.

Department of Anaesthesiology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.

出版信息

Br J Anaesth. 2024 Mar;132(3):528-540. doi: 10.1016/j.bja.2023.11.033. Epub 2023 Dec 16.

Abstract

BACKGROUND

Information integration and network science are important theories for quantifying consciousness. However, whether these theories propose drug- or conscious state-related changes in EEG during anaesthesia-induced unresponsiveness remains unknown.

METHODS

A total of 72 participants were randomised to receive i.v. infusion of propofol, dexmedetomidine, or ketamine at a constant infusion rate until loss of responsiveness. High-density EEG was recorded during the consciousness transition from the eye-closed baseline to the unresponsiveness state and then to the recovery of the responsiveness state. Permutation cross mutual information (PCMI) and PCMI-based brain networks in broadband (0.1-45 Hz) and sub-band frequencies were used to analyse drug- and state-related EEG signature changes.

RESULTS

PCMI and brain networks exhibited state-related changes in certain brain regions and frequency bands. The within-area PCMI of the frontal, parietal, and occipital regions, and the between-area PCMI of the parietal-occipital region (median [inter-quartile ranges]), baseline vs unresponsive were as follows: 0.54 (0.46-0.58) vs 0.46 (0.40-0.50), 0.58 (0.52-0.60) vs 0.48 (0.44-0.53), 0.54 (0.49-0.59) vs 0.47 (0.42-0.52) decreased during anaesthesia for three drugs (P<0.05). Alpha PCMI in the frontal region, and gamma PCMI in the posterior area significantly decreased in the unresponsive state (P<0.05). The frontal, parietal, and occipital nodal clustering coefficients and parietal nodal efficiency decreased in the unresponsive state (P<0.05). The increased normalised path length in delta, theta, and gamma bands indicated impaired global integration (P<0.05).

CONCLUSIONS

The three anaesthetics caused changes in information integration patterns and network functions. Thus, it is possible to build a quantifying framework for anaesthesia-induced conscious state changes on the EEG scale using PCMI and network science.

摘要

背景

信息整合与网络科学是量化意识的重要理论。然而,这些理论是否能揭示麻醉诱导无反应状态期间脑电图(EEG)中与药物或意识状态相关的变化仍不明确。

方法

总共72名参与者被随机分组,以恒定输注速率静脉输注丙泊酚、右美托咪定或氯胺酮,直至失去反应。在意识从闭眼基线状态转变为无反应状态,然后再恢复到反应状态的过程中记录高密度脑电图。使用排列交叉互信息(PCMI)以及基于PCMI的宽带(0.1 - 45Hz)和子频段频率的脑网络来分析与药物和状态相关的脑电图特征变化。

结果

PCMI和脑网络在某些脑区和频段表现出与状态相关的变化。额叶、顶叶和枕叶区域的区域内PCMI,以及顶枕叶区域的区域间PCMI(中位数[四分位间距]),基线状态与无反应状态相比分别如下:三种药物麻醉期间,0.54(0.46 - 0.58)对0.46(0.40 - 0.50)、0.58(0.52 - 0.60)对0.48(0.44 - 0.53)、0.54(0.49 - 0.59)对0.47(0.42 - 0.52)均降低(P<0.05)。额叶区域的α波PCMI以及后部区域的γ波PCMI在无反应状态下显著降低(P<0.05)。额叶、顶叶和枕叶的节点聚类系数以及顶叶的节点效率在无反应状态下降低(P<0.05)。δ波、θ波和γ波频段中归一化路径长度增加表明全局整合受损(P<0.05)。

结论

三种麻醉药引起了信息整合模式和网络功能的变化。因此,有可能利用PCMI和网络科学在脑电图尺度上建立一个用于麻醉诱导意识状态变化的量化框架。

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