Tommer Nir1, Reut Raizman2, Inbar Meningher3, Yael Jacob4, Kuang-Han Huang4, Arthur E Schwartz5, Jess W Brallier6, Helen Ahn5, Prantik Kundu7, Cheuk Y Tang8, Bradley N Delman9, Patrick J McCormick6, Julia Scarpa10, Mary Sano11, Stacie G Deiner12, Abigail Livny13, Mark G Baxter14, Joshua S Mincer15. 1. Department of Anesthesiology, Sheba Medical Center, Tel-Hashomer, Israel. 2. Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel. 3. Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel. 4. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 5. Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 6. Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA. 7. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Hyperfine Research, Guilford, CT, USA. 8. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 9. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 10. Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA. 11. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 12. Department of Anesthesiology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. 13. Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Israel. 14. Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 15. Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA. Electronic address: mincerj@mskcc.org.
Abstract
BACKGROUND: Arousal and awareness are two important components of consciousness states. Functional neuroimaging has furthered our understanding of cortical and thalamocortical mechanisms of awareness. Investigating the relationship between subcortical functional connectivity and arousal has been challenging owing to the relatively small size of brainstem structures and thalamic nuclei, and their depth in the brain. METHODS: Resting state functional MRI scans of 72 healthy volunteers were acquired before, during, 1 h after, and 1 day after sevoflurane general anaesthesia. Functional connectivity of subcortical regions of interest vs whole brain and homotopic functional connectivity for assessment of left-right symmetry analyses of both cortical and subcortical regions of interest were performed. Both analyses used high resolution atlases generated from deep brain stimulation applications. RESULTS: Functional connectivity in subcortical loci within the thalamus and of the ascending reticular activating system was sharply restricted under anaesthesia, featuring a general lateralisation of connectivity. Similarly, left-right homology was sharply reduced under anaesthesia. Subcortical bilateral functional connectivity was not fully restored after emergence from anaesthesia, although greater restoration was seen between ascending reticular activating system loci and specific thalamic nuclei thought to be involved in promoting and maintaining arousal. Functional connectivity was fully restored to baseline by the following day. CONCLUSIONS: Functional connectivity in the subcortex is sharply restricted and lateralised under general anaesthesia. This restriction may play a part in loss and return of consciousness. CLINICAL TRIAL REGISTRATION: NCT02275026.
BACKGROUND: Arousal and awareness are two important components of consciousness states. Functional neuroimaging has furthered our understanding of cortical and thalamocortical mechanisms of awareness. Investigating the relationship between subcortical functional connectivity and arousal has been challenging owing to the relatively small size of brainstem structures and thalamic nuclei, and their depth in the brain. METHODS: Resting state functional MRI scans of 72 healthy volunteers were acquired before, during, 1 h after, and 1 day after sevoflurane general anaesthesia. Functional connectivity of subcortical regions of interest vs whole brain and homotopic functional connectivity for assessment of left-right symmetry analyses of both cortical and subcortical regions of interest were performed. Both analyses used high resolution atlases generated from deep brain stimulation applications. RESULTS: Functional connectivity in subcortical loci within the thalamus and of the ascending reticular activating system was sharply restricted under anaesthesia, featuring a general lateralisation of connectivity. Similarly, left-right homology was sharply reduced under anaesthesia. Subcortical bilateral functional connectivity was not fully restored after emergence from anaesthesia, although greater restoration was seen between ascending reticular activating system loci and specific thalamic nuclei thought to be involved in promoting and maintaining arousal. Functional connectivity was fully restored to baseline by the following day. CONCLUSIONS: Functional connectivity in the subcortex is sharply restricted and lateralised under general anaesthesia. This restriction may play a part in loss and return of consciousness. CLINICAL TRIAL REGISTRATION: NCT02275026.
Authors: Jaakko W Långsjö; Michael T Alkire; Kimmo Kaskinoro; Hiroki Hayama; Anu Maksimow; Kaike K Kaisti; Sargo Aalto; Riku Aantaa; Satu K Jääskeläinen; Antti Revonsuo; Harry Scheinin Journal: J Neurosci Date: 2012-04-04 Impact factor: 6.167
Authors: Joshua S Mincer; Mark G Baxter; Patrick J McCormick; Mary Sano; Arthur E Schwartz; Jess W Brallier; Heather G Allore; Bradley N Delman; Margaret C Sewell; Prantik Kundu; Cheuk Ying Tang; Angela Sanchez; Stacie G Deiner Journal: Anesth Analg Date: 2018-05 Impact factor: 5.108