Modelling general anaesthesia as a first-order phase transition in the cortex.

Since 1997 we have been developing a theoretical foundation for general anaesthesia. We have been able to demonstrate that the abrupt change in brain state brought on by anaesthetic drugs can be characterized as a first-order phase transition in the population-average membrane voltage of the cortical neurons. The theory predicts that, as the critical point of phase change into unconsciousness is approached, the electrical fluctuations in cortical activity will grow strongly in amplitude while slowing in frequency, becoming more correlated both in time and in space. Thus the bio-electrical change of brain-state has deep similarities with thermodynamic phase changes of classical physics. The theory further predicts the existence of a second critical point, hysteretically separated from the first, corresponding to the return path from comatose unconsciousness back to normal responsiveness. There is a steadily accumulating body of clinical evidence in support of all of the phase-transition predictions: low-frequency power surge in EEG activity; increased correlation time and correlation length in EEG fluctuations; hysteresis separation, with respect to drug concentration, between the point of induction and the point of emergence. Copyright 2004 Elsevier Ltd.