State-related Electroencephalography Microstate Complexity during Propofol- and Esketamine-induced Unconsciousness.

IF 9.1 1区医学 Q1 ANESTHESIOLOGY Anesthesiology Pub Date : 2024-05-01 DOI:10.1097/ALN.0000000000004896

Zhenhu Liang, Bo Tang, Yu Chang, Jing Wang, Duan Li, Xiaoli Li, Changwei Wei

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Abstract

Background: Identifying the state-related "neural correlates of consciousness" for anesthetics-induced unconsciousness is challenging. Spatiotemporal complexity is a promising tool for investigating consciousness. The authors hypothesized that spatiotemporal complexity may serve as a state-related but not drug-related electroencephalography (EEG) indicator during an unconscious state induced by different anesthetic drugs (e.g., propofol and esketamine).

Methods: The authors recorded EEG from patients with unconsciousness induced by propofol (n = 10) and esketamine (n = 10). Both conventional microstate parameters and microstate complexity were analyzed. Spatiotemporal complexity was constructed by microstate sequences and complexity measures. Two different EEG microstate complexities were proposed to quantify the randomness (type I) and complexity (type II) of the EEG microstate series during the time course of the general anesthesia.

Results: The coverage and occurrence of microstate E (prefrontal pattern) and the duration of microstate B (right frontal pattern) could distinguish the states of preinduction wakefulness, unconsciousness, and recovery under both anesthetics. Type I EEG microstate complexity based on mean information gain significantly increased from awake to unconsciousness state (propofol: from mean ± SD, 1.562 ± 0.059 to 1.672 ± 0.023, P < 0.001; esketamine: 1.599 ± 0.051 to 1.687 ± 0.013, P < 0.001), and significantly decreased from unconsciousness to recovery state (propofol: 1.672 ± 0.023 to 1.537 ± 0.058, P < 0.001; esketamine: 1.687 ± 0.013 to 1.608 ± 0.028, P < 0.001) under both anesthetics. In contrast, type II EEG microstate fluctuation complexity significantly decreased in the unconscious state under both drugs (propofol: from 2.291 ± 0.771 to 0.782 ± 0.163, P < 0.001; esketamine: from 1.645 ± 0.417 to 0.647 ± 0.252, P < 0.001), and then increased in the recovery state (propofol: 0.782 ± 0.163 to 2.446 ± 0.723, P < 0.001; esketamine: 0.647 ± 0.252 to 1.459 ± 0.264, P < 0.001).

Conclusions: Both type I and type II EEG microstate complexities are drug independent. Thus, the EEG microstate complexity measures that the authors proposed are promising tools for building state-related neural correlates of consciousness to quantify anesthetic-induced unconsciousness.

Editor’s perspective:

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丙泊酚和爱斯基胺诱导昏迷过程中与状态相关的脑电图微状态复杂性。

背景：对于麻醉剂诱导的无意识状态，确定与状态相关的 "意识神经相关性 "具有挑战性。时空复杂性是一种很有前景的意识研究工具。我们假设，在不同麻醉药物（如异丙酚和艾司卡胺）诱导的昏迷状态下，时空复杂性可作为与状态相关但与药物无关的脑电图指标：我们记录了由异丙酚（10 人）和艾司卡胺（10 人）诱导的昏迷患者的脑电图。对常规微状态参数和微状态复杂性进行了分析。时空复杂性由微态序列和复杂性测量值构建。提出了两种不同的脑电图微状态复杂性，以量化全身麻醉时间过程中脑电图微状态序列的随机性（I型）和复杂性（II型）：结果：微状态E（前额叶模式）的覆盖范围和发生率以及微状态B（右额叶模式）的持续时间可以区分两种麻醉剂下的诱导前清醒、无意识和恢复状态。从清醒状态到昏迷状态，基于平均信息增益的 I 型脑电图微状态复杂度显著增加（丙泊酚：从平均值（±SD）1.562±0.059 增加到 1.672±0.023，p < 0.001；艾司卡胺：从平均值（±SD）1.599±0.059 增加到 1.672±0.023，p < 0.001）：异丙酚：1.672±0.023 到 1.537±0.058，p < 0.001；艾司卡胺：1.687±0.013 到 1.687±0.013，p < 0.001：1.687±0.013 至 1.608±0.028，p < 0.001）。与此相反，在两种药物作用下，昏迷状态下II型脑电图微状态波动复杂性显著下降（丙泊酚：从2.291±0.771到0.782±0.163，p＜0.001；艾司卡胺：从1.645±0.417到0.647±0.252，p＜0.001），然后在恢复状态下上升（丙泊酚：从0.782±0.163到0.647±0.252，p＜0.001）：0.782±0.163 到 2.446±0.723，p <0.001；esketamine：0.647±0.252到1.459±0.264，p 结论：I型和II型脑电图微状态复杂性均与药物无关。因此，我们提出的脑电图微状态复杂性测量方法是一种很有前途的工具，可用于建立与意识状态相关的神经相关性，以量化麻醉剂诱导的无意识状态。

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来源期刊

Anesthesiology 医学-麻醉学

CiteScore

10.40

自引率

5.70%

发文量

542

审稿时长

3-6 weeks

期刊介绍： With its establishment in 1940, Anesthesiology has emerged as a prominent leader in the field of anesthesiology, encompassing perioperative, critical care, and pain medicine. As the esteemed journal of the American Society of Anesthesiologists, Anesthesiology operates independently with full editorial freedom. Its distinguished Editorial Board, comprising renowned professionals from across the globe, drives the advancement of the specialty by presenting innovative research through immediate open access to select articles and granting free access to all published articles after a six-month period. Furthermore, Anesthesiology actively promotes groundbreaking studies through an influential press release program. The journal's unwavering commitment lies in the dissemination of exemplary work that enhances clinical practice and revolutionizes the practice of medicine within our discipline.