Isik Oliver G, Cassim Tuan Z, Ahmed Meah T, Kreuzer Matthias, Daramola Alice M, Garcia Paul S
Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States.
Department of Psychology, School of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States.
Front Psychiatry. 2024 Jul 16;15:1362749. doi: 10.3389/fpsyt.2024.1362749. eCollection 2024.
During general anesthesia, frontal electroencephalogram (EEG) activity in the alpha frequency band (8-12 Hz) correlates with the adequacy of analgesia. Transcranial direct current stimulation (tDCS) and auditory stimulation, two noninvasive neuromodulation techniques, can entrain alpha activity in awake or sleeping patients. This study evaluates their effects on alpha oscillations in patients under general anesthesia.
30 patients receiving general anesthesia for surgery were enrolled in this two-by-two randomized clinical trial. Each participant received active or sham tDCS followed by auditory stimulation or silence according to assigned group (TDCS/AUD, TDCS/SIL, SHAM/AUD, SHAM/SIL). Frontal EEG was recorded before and after neuromodulation. Patients with burst suppression, mid-study changes in anesthetic, or incomplete EEG recordings were excluded from analysis. The primary outcome was post-stimulation change in oscillatory alpha power, compared in each intervention group against the change in the control group SHAM/SIL by Wilcoxon Rank Sum testing.
All 30 enrolled participants completed the study. Of the 22 included for analysis, 8 were in TDCS/AUD, 4 were in TDCS/SIL, 5 were in SHAM/AUD, and 5 were in SHAM/SIL. The median change in oscillatory alpha power was +4.7 dB (IQR 4.4, 5.8 dB) in SHAM/SIL, +2.8 dB (IQR 1.5, 8.9 dB) in TDCS/SIL ( = 0.730), +5.5 dB in SHAM/AUD ( = 0.421), and -6.1 dB (IQR -10.2, -2.2 dB) in TDCS/AUD ( = 0.045).
tDCS and auditory stimulation can be administered safely intraoperatively. However, these interventions did not increase alpha power as administered and measured in this pilot study.
在全身麻醉期间，额叶脑电图（EEG）的α频段（8-12赫兹）活动与镇痛效果相关。经颅直流电刺激（tDCS）和听觉刺激这两种非侵入性神经调节技术，可以在清醒或睡眠患者中诱导α活动。本研究评估它们对全身麻醉患者α振荡的影响。
30例接受手术全身麻醉的患者纳入了这项二乘二随机临床试验。根据分组情况（TDCS/AUD、TDCS/SIL、SHAM/AUD、SHAM/SIL），每位参与者接受主动或假tDCS，随后接受听觉刺激或无刺激。在神经调节前后记录额叶脑电图。爆发抑制患者、研究中期麻醉变化或脑电图记录不完整的患者被排除在分析之外。主要结局是刺激后振荡α功率的变化，通过Wilcoxon秩和检验，将每个干预组与对照组SHAM/SIL的变化进行比较。
所有30名纳入的参与者均完成了研究。在纳入分析的22名患者中，8名在TDCS/AUD组，4名在TDCS/SIL组，5名在SHAM/AUD组，5名在SHAM/SIL组。SHAM/SIL组振荡α功率的中位数变化为+4.7 dB（四分位间距4.4，5.8 dB），TDCS/SIL组为+2.8 dB（四分位间距1.5，8.9 dB）（P = 0.730），SHAM/AUD组为+5.5 dB（P = 0.421），TDCS/AUD组为-6.1 dB（四分位间距-10.2，-2.2 dB）（P = 0.045）。
tDCS和听觉刺激可在术中安全使用。然而，在这项初步研究中，按照所给予和测量的方式，这些干预措施并未增加α功率。
