Armijo Arthur J, Fine-Raquet Brier, Useinovic Nemanja, Manzella Francesca M, Jevtovic-Todorovic Vesna, Todorovic Slobodan M
From the Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Englewood, Colorado.
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Anesth Analg. 2025 Mar 6. doi: 10.1213/ANE.0000000000007462.
Normal sleep architecture is important for brain development, and we previously demonstrated that a single exposure to isoflurane during the neonatal period did not induce changes in the sleep architecture and only minimally altered neuronal beta oscillations in adolescent rats. Here, we hypothesized that a more clinically relevant scenario of repeated shorter exposures to isoflurane during brain development may have more profound effects on sleep and wake behavior and associated delta and theta oscillations, respectively.
Male and female rat pups were exposed to sham anesthesia (30% oxygen) or repeated isoflurane delivery for 2 hours each on 3 consecutive days (total exposure of 6 hours). The rat pups were divided into 2 cohorts. In cohort 1, we evaluated the neurotoxic effects of exposure postanesthesia. In cohort 2, electroencephalogram electrodes were implanted into the rat cortex between postnatal days 21-23, and sleep architecture was classified as wake, nonrapid eye movement (NREM), and rapid-eye movement (REM) sleep. Electroencephalogram power spectra were also measured in adolescent rats over a 72-hour period.
Isoflurane exposure (n = 11) increased neuroapoptosis to 27. 7 ± 6.5 per mm-2 when compared to the sham group (9. 6 ± 3.0 per mm-2, n = 12, P < .001) and disrupted sleep architecture in adolescent rats. Specifically, there was an increase in the total sleep time (light + dark period) from 89. 9 ± 14.2 minutes in sham group (n = 9) to 111. 2 ± 32.2 minutes in the experimental group (n = 11, P < .05). Furthermore, there were fewer transitions during the dark period from 157. 1 ± 43.3 in sham group (n = 9) to 110. 6 ± 52.5 in the experimental group (n = 11, P < .05). The absolute power of delta oscillations was significantly decreased during the light period of NREM from an average 2217 ± 2016 μV2 in the sham group (n = 8) to 791 ± 659 μV2 in the experimental group (n = 11, P < .05). Further, theta oscillations in the wake stage were significantly decreased in the light period from 1579 ± 885 μV2 in sham group (n = 8) to 690 ± 413 μV2 in the experimental group (n = 11, P < .05) and light + dark period from 1390 ± 808 μV2 in sham group (n = 8) to 691 ± 421 μV2 in the experimental group (n = 11, P < .05).
Exposing neonatal rats to isoflurane repeatedly causes significant neurotoxicity, and alters delta and theta thalamocortical oscillations, as well as sleep architecture in adolescence. This contrasts with a single continuous exposure to isoflurane, in which we previously reported no significant effects on sleep-wake architecture and only minimal effect on beta oscillations despite similar acute neurotoxicity.
正常的睡眠结构对大脑发育很重要,我们之前证明,新生期单次暴露于异氟烷不会引起睡眠结构的变化,且仅对青春期大鼠的神经元β振荡产生极小的改变。在此,我们推测,在大脑发育过程中,更符合临床实际情况的多次较短时间暴露于异氟烷,可能分别对睡眠和觉醒行为以及相关的δ波和θ波振荡产生更深远的影响。
雄性和雌性幼鼠接受假麻醉(30%氧气)或连续3天每天暴露于异氟烷2小时(总暴露时间为6小时)。幼鼠被分为2组。在第1组中,我们评估麻醉后暴露的神经毒性作用。在第2组中,在出生后第21 - 23天之间将脑电图电极植入大鼠皮层,睡眠结构被分类为觉醒、非快速眼动(NREM)和快速眼动(REM)睡眠。还在青春期大鼠中测量了72小时内的脑电图功率谱。
与假手术组(每平方毫米9.6±3.0个,n = 12)相比,异氟烷暴露组(n = 11)的神经细胞凋亡增加到每平方毫米27.7±6.5个(P <.001),并且扰乱了青春期大鼠的睡眠结构。具体而言,总睡眠时间(光照 + 黑暗期)从假手术组(n = 9)的89.9±14.2分钟增加到实验组(n = 11)的111.2±32.2分钟(P <.05)。此外,黑暗期的转换次数减少,从假手术组(n = 9)的157.1±43.3次减少到实验组(n = 11)的110.6±52.5次(P <.05)。在NREM睡眠的光照期,δ波振荡的绝对功率显著降低,从假手术组(n = 8)的平均2217±2016μV²降至实验组(n = 11)的791±659μV²(P <.05)。此外,觉醒期的θ波振荡在光照期从假手术组(n = 8)的1579±885μV²显著降低到实验组(n = 11)的690±413μV²(P <.05),在光照 + 黑暗期从假手术组(n = 8)的1390±808μV²降至实验组(n = 11)的691±421μV²(P <.05)。
新生大鼠反复暴露于异氟烷会导致显著的神经毒性,并改变δ波和θ波丘脑皮质振荡以及青春期的睡眠结构。这与单次持续暴露于异氟烷形成对比,我们之前报道,尽管单次持续暴露有类似的急性神经毒性,但对睡眠 - 觉醒结构没有显著影响,对β振荡的影响也极小。