P L Purdon1, K J Pavone2, O Akeju3, A C Smith4, A L Sampson2, J Lee5, D W Zhou2, K Solt3, E N Brown6. 1. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Department of Brain and Cognitive Science patrickp@nmr.mgh.harvard.edu enb@neurostat.mit.edu. 2. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA. 3. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA. 4. Department of Brain and Cognitive Science. 5. Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology. 6. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Department of Brain and Cognitive Science Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA patrickp@nmr.mgh.harvard.edu enb@neurostat.mit.edu.
Abstract
BACKGROUND: Anaesthetic drugs act at sites within the brain that undergo profound changes during typical ageing. We postulated that anaesthesia-induced brain dynamics observed in the EEG change with age. METHODS: We analysed the EEG in 155 patients aged 18-90 yr who received propofol (n=60) or sevoflurane (n=95) as the primary anaesthetic. The EEG spectrum and coherence were estimated throughout a 2 min period of stable anaesthetic maintenance. Age-related effects were characterized by analysing power and coherence as a function of age using linear regression and by comparing the power spectrum and coherence in young (18- to 38-yr-old) and elderly (70- to 90-yr-old) patients. RESULTS: Power across all frequency bands decreased significantly with age for both propofol and sevoflurane; elderly patients showed EEG oscillations ∼2- to 3-fold smaller in amplitude than younger adults. The qualitative form of the EEG appeared similar regardless of age, showing prominent alpha (8-12 Hz) and slow (0.1-1 Hz) oscillations. However, alpha band dynamics showed specific age-related changes. In elderly compared with young patients, alpha power decreased more than slow power, and alpha coherence and peak frequency were significantly lower. Older patients were more likely to experience burst suppression. CONCLUSIONS: These profound age-related changes in the EEG are consistent with known neurobiological and neuroanatomical changes that occur during typical ageing. Commercial EEG-based depth-of-anaesthesia indices do not account for age and are therefore likely to be inaccurate in elderly patients. In contrast, monitoring the unprocessed EEG and its spectrogram can account for age and individual patient characteristics.
BACKGROUND: Anaesthetic drugs act at sites within the brain that undergo profound changes during typical ageing. We postulated that anaesthesia-induced brain dynamics observed in the EEG change with age. METHODS: We analysed the EEG in 155 patients aged 18-90 yr who received propofol (n=60) or sevoflurane (n=95) as the primary anaesthetic. The EEG spectrum and coherence were estimated throughout a 2 min period of stable anaesthetic maintenance. Age-related effects were characterized by analysing power and coherence as a function of age using linear regression and by comparing the power spectrum and coherence in young (18- to 38-yr-old) and elderly (70- to 90-yr-old) patients. RESULTS: Power across all frequency bands decreased significantly with age for both propofol and sevoflurane; elderly patients showed EEG oscillations ∼2- to 3-fold smaller in amplitude than younger adults. The qualitative form of the EEG appeared similar regardless of age, showing prominent alpha (8-12 Hz) and slow (0.1-1 Hz) oscillations. However, alpha band dynamics showed specific age-related changes. In elderly compared with young patients, alpha power decreased more than slow power, and alpha coherence and peak frequency were significantly lower. Older patients were more likely to experience burst suppression. CONCLUSIONS: These profound age-related changes in the EEG are consistent with known neurobiological and neuroanatomical changes that occur during typical ageing. Commercial EEG-based depth-of-anaesthesia indices do not account for age and are therefore likely to be inaccurate in elderly patients. In contrast, monitoring the unprocessed EEG and its spectrogram can account for age and individual patient characteristics.
Authors: H Viertiö-Oja; V Maja; M Särkelä; P Talja; N Tenkanen; H Tolvanen-Laakso; M Paloheimo; A Vakkuri; A Yli-Hankala; P Meriläinen Journal: Acta Anaesthesiol Scand Date: 2004-02 Impact factor: 2.105
Authors: Aylin Cimenser; Patrick L Purdon; Eric T Pierce; John L Walsh; Andres F Salazar-Gomez; Priscilla G Harrell; Casie Tavares-Stoeckel; Kathleen Habeeb; Emery N Brown Journal: Proc Natl Acad Sci U S A Date: 2011-05-09 Impact factor: 11.205
Authors: Laura D Lewis; Veronica S Weiner; Eran A Mukamel; Jacob A Donoghue; Emad N Eskandar; Joseph R Madsen; William S Anderson; Leigh R Hochberg; Sydney S Cash; Emery N Brown; Patrick L Purdon Journal: Proc Natl Acad Sci U S A Date: 2012-11-05 Impact factor: 11.205
Authors: Laura D Lewis; Shinung Ching; Veronica S Weiner; Robert A Peterfreund; Emad N Eskandar; Sydney S Cash; Emery N Brown; Patrick L Purdon Journal: Brain Date: 2013-07-25 Impact factor: 13.501
Authors: Thomas Thiery; Tarek Lajnef; Etienne Combrisson; Arthur Dehgan; Pierre Rainville; George A Mashour; Stefanie Blain-Moraes; Karim Jerbi Journal: Neuroimage Date: 2018-06-07 Impact factor: 6.556
Authors: George S Plummer; Reine Ibala; Eunice Hahm; Jingzhi An; Jacob Gitlin; Hao Deng; Kenneth T Shelton; Ken Solt; Jason Z Qu; Oluwaseun Akeju Journal: Clin Neurophysiol Date: 2018-11-16 Impact factor: 3.708
Authors: Oluwaseun Akeju; Andrew H Song; Allison E Hamilos; Kara J Pavone; Francisco J Flores; Emery N Brown; Patrick L Purdon Journal: Clin Neurophysiol Date: 2016-03-16 Impact factor: 3.708
Authors: Matthias Kreuzer; Matthew A Stern; Darren Hight; Sebastian Berger; Gerhard Schneider; James W Sleigh; Paul S García Journal: Anesthesiology Date: 2020-05 Impact factor: 7.892
Authors: Miles Berger; Niccolò Terrando; S Kendall Smith; Jeffrey N Browndyke; Mark F Newman; Joseph P Mathew Journal: Anesthesiology Date: 2018-10 Impact factor: 7.892
Authors: John H Abel; Marcus A Badgeley; Taylor E Baum; Sourish Chakravarty; Patrick L Purdon; Emery N Brown Journal: Proc IFAC World Congress Date: 2021-04-14