Simultaneous Electroencephalography and Functional Magnetic Resonance Imaging of General Anesthesia

It has been long appreciated that anesthetic drugs induce stereotyped changes in electroencephalogram (EEG), but the relationships between the EEG and underlying brain function remain poorly understood. Functional imaging methods including positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), have become important tools for studying how anesthetic drugs act in the human brain to induce the state of general anesthesia. To date, no investigation has combined functional MRI with EEG to study general anesthesia. We report here a paradigm for conducting combined fMRI and EEG studies of human subjects under general anesthesia. We discuss the several technical and safety problems that must be solved to undertake this type of multimodal functional imaging and show combined recordings from a human subject. Combined fMRI and EEG exploits simultaneously the high spatial resolution of fMRI and the high temporal resolution of EEG. In addition, combined fMRI and EEG offers a direct way to relate established EEG patterns induced by general anesthesia to changes in neural activity in specific brain regions as measured by changes in fMRI blood oxygen level dependent (BOLD) signals.

[1]  S L Shafer,et al.  The influence of age on propofol pharmacodynamics. , 1999, Anesthesiology.

[2]  J. Cooper,et al.  An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection. , 1984 .

[3]  R S Newbower,et al.  An Analysis of Major Errors and Equipment Failures in Anesthesia Management: Considerations for Prevention and Detection , 1984, Anesthesiology.

[4]  C J Fiebach,et al.  Sequential effects of propofol on functional brain activation induced by auditory language processing: an event-related functional magnetic resonance imaging study. , 2004, British journal of anaesthesia.

[5]  Scott Peltier,et al.  Attenuated Brain Response to Auditory Word Stimulation with Sevoflurane: A Functional Magnetic Resonance Imaging Study in Humans , 2005, Anesthesiology.

[6]  R. Haier,et al.  Functional brain imaging during anesthesia in humans: effects of halothane on global and regional cerebral glucose metabolism. , 1999, Anesthesiology.

[7]  E. Eger,et al.  Minimum alveolar anesthetic concentration: a standard of anesthetic potency. , 1965, Anesthesiology.

[8]  Alan C. Evans,et al.  Brain Mechanisms of Propofol-Induced Loss of Consciousness in Humans: a Positron Emission Tomographic Study , 1999, The Journal of Neuroscience.

[9]  M. Harms,et al.  Sound repetition rate in the human auditory pathway: representations in the waveshape and amplitude of fMRI activation. , 2002, Journal of neurophysiology.

[10]  E A Disbrow,et al.  Isoflurane anesthesia blunts cerebral responses to noxious and innocuous stimuli: a fMRI study. , 1997, Life sciences.

[11]  Donald B. Percival,et al.  Spectral Analysis for Physical Applications , 1993 .

[12]  B. Antkowiak,et al.  Molecular and systemic mechanisms of general anaesthesia: the ‘multi-site and multiple mechanisms’ concept , 2005, Current opinion in anaesthesiology.

[13]  S Thesen,et al.  Prospective acquisition correction for head motion with image‐based tracking for real‐time fMRI , 2000, Magnetic resonance in medicine.

[14]  Roger L. Black,et al.  Goodman and Gilman's The Pharmacological Basis of Therapeutics , 1991 .

[15]  G. Crelier,et al.  Investigation of BOLD signal dependence on cerebral blood flow and oxygen consumption: The deoxyhemoglobin dilution model , 1999, Magnetic resonance in medicine.

[16]  E Kochs,et al.  The effects of propofol on cerebral and spinal cord blood flow in rats. , 1993, Anesthesia and analgesia.

[17]  R. Zatorre,et al.  Cortical Processing of Complex Auditory Stimuli during Alterations of Consciousness with the General Anesthetic Propofol , 2006, Anesthesiology.

[18]  K. Miller,et al.  Mechanisms of actions of inhaled anesthetics. , 2003, The New England journal of medicine.

[19]  B. Orser,et al.  Emerging molecular mechanisms of general anesthetic action. , 2005, Trends in pharmacological sciences.

[20]  Matthew H. Davis,et al.  Dissociating speech perception and comprehension at reduced levels of awareness , 2007, Proceedings of the National Academy of Sciences.

[21]  S. Shafer,et al.  The Influence of Method of Administration and Covariates on the Pharmacokinetics of Propofol in Adult Volunteers , 1998, Anesthesiology.

[22]  S. Strebel,et al.  The Impact of Systemic Vasoconstrictors on the Cerebral Circulation of Anesthetized Patients , 1998, Anesthesiology.

[23]  Alan C. Evans,et al.  Propofol anesthesia and cerebral blood flow changes elicited by vibrotactile stimulation: a positron emission tomography study. , 2001, Journal of neurophysiology.

[24]  M. Leider Goodman & Gilman's The Pharmacological Basis of Therapeutics , 1985 .

[25]  W. R. Lieb,et al.  Molecular and cellular mechanisms of general anaesthesia , 1994, Nature.

[26]  B. Matta,et al.  Direct cerebral vasodilatory effects of sevoflurane and isoflurane. , 1999, Anesthesiology.

[27]  B. Matta,et al.  Direct Cerebrovasodilatory Effects of Halothane, Isoflurane, and Desflurane during Propofol‐induced Isoelectric Electroencephalogram in Humans , 1995, Anesthesiology.

[28]  M. Harms,et al.  Detection and quantification of a wide range of fMRI temporal responses using a physiologically‐motivated basis set , 2003, Human brain mapping.

[29]  J. H. Fallon,et al.  Toward a Unified Theory of Narcosis: Brain Imaging Evidence for a Thalamocortical Switch as the Neurophysiologic Basis of Anesthetic-Induced Unconsciousness , 2000, Consciousness and Cognition.

[30]  Colin Norman,et al.  What Don't We Know? , 2005, Science.

[31]  W. White,et al.  Cerebral Physiologic Effects of Burst Suppression Doses of Propofol During Nonpulsatile Cardiopulmonary Bypass , 1995, Anesthesia and analgesia.

[32]  R W Cox,et al.  AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. , 1996, Computers and biomedical research, an international journal.

[33]  W. Stigelman,et al.  Goodman and Gilman's the Pharmacological Basis of Therapeutics , 1986 .

[34]  B. Matta,et al.  Burst suppression or isoelectric encephalogram for cerebral protection: evidence from metabolic suppression studies. , 1999, British journal of anaesthesia.

[35]  Wiklund Ra,et al.  First of two parts , 1997 .

[36]  J. Dilger,et al.  The effects of general anaesthetics on ligand-gated ion channels. , 2002, British journal of anaesthesia.

[37]  A. M. Dale,et al.  Spatiotemporal Brain Imaging of Visual-Evoked Activity Using Interleaved EEG and fMRI Recordings , 2001, NeuroImage.

[38]  L. Goodman,et al.  The Pharmacological Basis of Therapeutics , 1941 .

[39]  R. Wiklund,et al.  Anesthesiology. First of two parts. , 1997, The New England journal of medicine.

[40]  S L Shafer,et al.  Pharmacokinetics and Pharmacodynamics of Propofol Infusions during General Anesthesia , 1988, Anesthesiology.

[41]  J. R. Baker,et al.  Imaging subcortical auditory activity in humans , 1998, Human brain mapping.

[42]  A. Sollevi,et al.  Effects of propofol on cerebral blood flow, metabolism, and cerebral autoregulation in the anesthetized pig. , 1997, Journal of neurosurgical anesthesiology.

[43]  S. Larson,et al.  Midazolam Changes Cerebral Blood Flow in Discrete Brain Regions: An H2‐15O Positron Emission Tomography Study , 1997, Anesthesiology.

[44]  R. Bowtell,et al.  “sparse” temporal sampling in auditory fMRI , 1999, Human brain mapping.

[45]  J. Y. Kao,et al.  Cerebral Metabolism during Propofol Anesthesia in Humans Studied with Positron Emission Tomography , 1995, Anesthesiology.

[46]  R. Haier,et al.  Positron Emission Tomography Study of Regional Cerebral Metabolism in Humans during Isoflurane Anesthesia , 1997, Anesthesiology.

[47]  M. Alkire,et al.  Quantitative EEG Correlations with Brain Glucose Metabolic Rate during Anesthesia in Volunteers , 1998, Anesthesiology.

[48]  Giorgio Bonmassar,et al.  An open-source hardware and software system for acquisition and real-time processing of electrophysiology during high field MRI , 2008, Journal of Neuroscience Methods.

[49]  J. Belliveau,et al.  Metallic electrodes and leads in simultaneous EEG‐MRI: Specific absorption rate (SAR) simulation studies , 2004, Bioelectromagnetics.