一种对 GABAAR 慢速受体亚型具有选择性的新型麻醉剂和抗惊厥剂的脑电图对比图谱

IF 4.6 2区 医学 Q1 ANESTHESIOLOGY Anesthesia and analgesia Pub Date : 2024-10-04 DOI:10.1213/ANE.0000000000007178
M Bruce Maciver, Hillary S McCarren, Sarah L Eagleman, Frances M Davies, Alam Jahangir, Dinesh Pal, George A Mashour, Edward J Bertaccini
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引用次数: 0

摘要

背景:丙泊酚等麻醉剂会增加脑电图(EEG)在δ频率(0.1-4赫兹)的功率,而在带宽大于30赫兹时功率会下降。丙泊酚对γ氨基丁酸 A 型受体亚型(GABAAR)无选择性,因为它能增强所有 3 种 GABAAR 亚型(慢型、快型和强直型)。我们新开发的麻醉剂可选择性地靶向 GABAAR 慢突触,从而抑制大脑的反应性。我们假设,与广谱 GABAAR 激动剂(异丙酚)相比,选择性 GABAAR 慢激动剂 KSEB 01-S2 会产生不同的脑电图特征,并使用大鼠脑电图记录进行了测试:雄性大鼠是在美国陆军防化医学研究所和密歇根大学动物护理和使用委员会(IACUC)批准后进行研究的。大鼠使用异氟醚(3%-5% 诱导,1%-3% 维持)与氧气进行麻醉,氧气浓度为 0.5-1.0 升/分钟。在颅骨中植入不锈钢螺钉,用于记录颅下皮质脑电信号。恢复后,使用异丙酚或 KSEB 01-S2,并分析其对脑电图信号的影响:结果:正如之前所报道的,与用药前的记录相比,异丙酚会增加δ频率(0.1-4 Hz)的功率,并导致大于 30 Hz 的脑电图功率下降,但在右反射消失后的±20 秒内未见明显变化。相比之下,KSEB 01-S2 在大鼠意识丧失(LOC)±20 秒时,θ 频率百分比功率显著增加(中位数 14.7%,16.2/13.8,置信区间 75/25;至 34.7%,35/31.8;P < .015),低伽马频率百分比功率显著降低(16.9%,18.6/15.8;至 5.45%,5.5/5.39;P < .015)。这两种麻醉剂都会使非线性动态分析得出的混沌吸引子图变得平缓,就像挥发性麻醉剂和解离性麻醉剂在 LOC 时产生的效果一样:KSEB 01-S2 产生了明显不同的脑电图模式,在θ频率范围内观察到选择性增加。KSEB 01-S2 在 GABAAR 慢受体亚型上的活性也明显不同,这表明受体亚型特异性与脑电图频段特征之间可能存在机理联系。有趣的是,θ频率增加的同时γ频率降低,这是因为以前有人认为GABAAR慢突触是θ频率振荡的基础,而快突触控制着γ活动。这些相互影响支持了之前基于 GABAAR 快速和慢速中间神经元之间抑制性连接的θ和嵌套γ振荡模型。虽然每种麻醉剂都能产生独特的脑电图反应,但丙泊酚和 KSEB 01-S2 都能增加慢波活动,并使 LOC 点的混沌吸引子图变得平缓。
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Comparative Electroencephalographic Profile of a New Anesthetic and Anticonvulsant That Is Selective for the GABAAR Slow Receptor Subtype.

Background: Anesthetics like propofol increase electroencephalography (EEG) power in delta frequencies (0.1-4 Hz), with a decrease of power in bandwidths >30 Hz. Propofol is nonselective for gamma amino butyric acid type A receptor subtypes (GABAAR) as it enhances all 3 GABAAR subtypes (slow, fast, and tonic). Our newly developed anesthetic class selectively targets GABAAR-slow synapses to depress brain responsiveness. We hypothesized that a selective GABAAR-slow agonist, KSEB 01-S2, would produce a different EEG signature compared to the broad-spectrum GABAAR agonist (propofol), and tested this using rat EEG recordings.

Methods: Male rats were studied after Institutional Animal Care and Use Committees (IACUC) approval from the US Army Medical Research Institute of Chemical Defense and the University of Michigan. Rats were anesthetized using isoflurane (3%-5% induction, 1%-3% maintenance) with oxygen at 0.5 to 1.0 L/min. Stainless steel screws were placed in the skull and used to record subcranial cortical EEG signals. After recovery, either propofol or KSEB 01-S2 was administered and effects on EEG signals were analyzed.

Results: As previously reported, propofol produced increased power in delta frequencies (0.1-4 Hz) compared to predrug recordings and produced a decrease in EEG power >30 Hz but no significant changes were seen within ±20 seconds of losing the righting reflex. By contrast, KSEB 01-S2 produced a significant increase in theta frequency percent power (median 14.7%, 16.2/13.8, 75/25 confidence interval; to 34.7%, 35/31.8; P < .015) and a significant decrease in low gamma frequency percent power (16.9%, 18.6/15.8; to 5.45%, 5.5/5.39; P < .015) for all rats at ± 20 seconds of loss of consciousness (LOC). Both anesthetics produced a flattening of chaotic attractor plots from nonlinear dynamic analyses, like that produced by volatile and dissociative anesthetics at LOC.

Conclusions: KSEB 01-S2 produced a markedly different EEG pattern, with a selective increase observed in the theta frequency range. KSEB 01-S2 also differs markedly in its activity at the GABAAR-slow receptor subtype, suggesting a possible mechanistic link between receptor subtype specificity and EEG frequency band signatures. Increased theta together with depressed gamma frequencies is interesting because GABAAR slow synapses have previously been suggested to underlie theta frequency oscillations, while fast synapses control gamma activity. These reciprocal effects support a previous model for theta and nested gamma oscillations based on inhibitory connections between GABAAR fast and slow interneurons. Although each anesthetic produced a unique EEG response, propofol and KSEB 01-S2 both increased slow wave activity and flattened chaotic attractor plots at the point of LOC.

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来源期刊
Anesthesia and analgesia
Anesthesia and analgesia 医学-麻醉学
CiteScore
9.90
自引率
7.00%
发文量
817
审稿时长
2 months
期刊介绍: Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.
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