Emergence from general anesthesia and the sleep-manifold.

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dc.contributor.author Hight, Darren F en
dc.contributor.author Dadok, Vera M en
dc.contributor.author Szeri, Andrew J en
dc.contributor.author García, Paul S en
dc.contributor.author Voss, Logan en
dc.contributor.author Sleigh, James en
dc.date.accessioned 2018-11-01T20:36:44Z en
dc.date.issued 2014-01 en
dc.identifier.citation Frontiers in Systems Neuroscience 8, 14 pages 2014 en
dc.identifier.issn 1662-5137 en
dc.identifier.uri http://hdl.handle.net/2292/43733 en
dc.description.abstract The electroencephalogram (EEG) during the re-establishment of consciousness after general anesthesia and surgery varies starkly between patients. Can the EEG during this emergence period provide a means of estimating the underlying biological processes underpinning the return of consciousness? Can we use a model to infer these biological processes from the EEG patterns? A frontal EEG was recorded from 84 patients. Ten patients were chosen for state-space analysis. Five showed archetypal emergences; which consisted of a progressive decrease in alpha power and increase peak alpha frequency before return of responsiveness. The five non-archetypal emergences showed almost no spectral EEG changes (even as the volatile general anesthetic decreased) and then an abrupt return of responsiveness. We used Bayesian methods to estimate the likelihood of an EEG pattern corresponding to the position of the patient on a 2-dimensional manifold in a state space of excitatory connection strength vs. change in intrinsic resting neuronal membrane conductivity. We could thus visualize the trajectory of each patient in the state-space during their emergence period. The patients who followed an archetypal emergence displayed a very consistent pattern; consisting of progressive increase in conductivity, and a temporary period of increased connection strength before return of responsiveness. The non-archetypal emergence trajectories remained fixed in a region of phase space characterized by a relatively high conductivity and low connection strength throughout emergence. This unexpected progressive increase in conductivity during archetypal emergence may be due to an abating of the surgical stimulus during this period. Periods of high connection strength could represent forays into dissociated consciousness, but the model suggests all patients reposition near the fold in the state space to take advantage of bi-stable cortical dynamics before transitioning to consciousness. en
dc.format.medium Electronic-eCollection en
dc.language eng en
dc.relation.ispartofseries Frontiers in Systems Neuroscience en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/3.0/ en
dc.title Emergence from general anesthesia and the sleep-manifold. en
dc.type Journal Article en
dc.identifier.doi 10.3389/fnsys.2014.00146 en
pubs.begin-page 146 en
pubs.volume 8 en
dc.rights.holder Copyright: The authors en
dc.identifier.pmid 25165436 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 455555 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Anaesthesiology en
dc.identifier.eissn 1662-5137 en
pubs.record-created-at-source-date 2014-08-28 en
pubs.dimensions-id 25165436 en

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