Evidence map›Paper›PMID 27178867›Full record

Observational studyClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2016

GABAA circuit mechanisms are associated with ether anesthesia-induced unconsciousness.

Oluwaseun Akeju, Allison E Hamilos, Andrew H Song, Kara J Pavone, Patrick L Purdon, Emery N Brown

Abstract readObservational Study
In one paragraph

Observational study in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed.

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  12. Modulatory dynamics mark the transition between anesthetic states of unconsciousness.Proceedings of the National Academy of Sciences of the United States of America · 2023
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  13. Article
  14. Facilitation of Behavioral and Cortical Emergence from Isoflurane Anesthesia by GABAergic Neurons in Basal Forebrain.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2023
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  15. Review
  16. Review
  17. Ketamine induces EEG oscillations that may aid anesthetic state but not dissociation monitoring.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Oluwaseun AkejuDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: oluwaseun.akeju@mgh.harvard.edu.
Allison E HamilosHarvard Medical School, Boston, MA, USA; Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA; Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
Andrew H SongDepartment of Brain and Cognitive Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
Kara J PavoneDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Patrick L PurdonDepartment 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, Massachusetts Institute of Technology, Cambridge, MA, USA.
Emery N BrownDepartment 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, Massachusetts Institute of Technology, Cambridge, MA, USA; Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA; Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.

Funding

PHD TRAINING IN NEUROSCIENCET32MH020017 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI JOHN ASSAD · 1997 to 2026
$15.8M
Redesigning General Anesthesia (Admin Supp)R01GM104948 · NIGMS · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI BOYDEN, EDWARD S., BROWN, EMERY N · 2012 to 2016
$4.4M
A Systems Neuroscience Approach for the Study of General AnesthesiaDP1OD003646 · OD · MASSACHUSETTS GENERAL HOSPITAL · PI BROWN, EMERY N · 2007 to 2011
$4.4M
Pathophysiology of postoperative delirium and the use of biomimetic sleep as a treatment strategy in the CSICUR01AG053582 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI JOHNSON-AKEJU, OLUWASEUN · 2016 to 2020
$4.0M
A Neural Systems Approach to Monitoring and Drug-Delivery for General AnesthesiaDP2OD006454 · OD · MASSACHUSETTS GENERAL HOSPITAL · PI PURDON, PATRICK L. · 2009 to 2009
$2.7M
NIA NIH HHS R01 AG053582NIGMS NIH HHS L30 GM102907NIGMS NIH HHS R01 GM104948NIH HHS DP1 OD003646NIH HHS DP2 OD006454NIMH NIH HHS T32 MH020017
6 · The paper itself

Abstract

objectiveAn emerging paradigm for understanding how anesthetics induce altered arousal is relating receptor targeting in specific neural circuits to electroencephalogram (EEG) activity. Enhanced gamma amino-butyric acid A (GABAA) inhibitory post-synaptic currents (IPSCs) manifest with large-amplitude slow (0.1-1Hz) and frontally coherent alpha (8-12Hz) EEG oscillations during general anesthesia. Therefore, we investigated the EEG signatures of modern day derivatives of ether (MDDE) anesthesia to assess the extent to which we could obtain insights into MDDE anesthetic mechanisms.

methodsWe retrospectively studied cases from our database in which patients received isoflurane anesthesia vs. isoflurane/ketamine anesthesia (n=10 each) or desflurane anesthesia vs. desflurane/ketamine anesthesia (n=9 each). We analyzed the EEG recordings with spectral power and coherence methods.

resultsSimilar to known GABAA circuit level mechanisms, we found that MDDE anesthesia induced large amplitude slow and frontally coherent alpha oscillations. Additionally, MDDE anesthesia also induced frontally coherent theta (4-8Hz) oscillations. Reduction of GABAergic IPSCs with ketamine resulted in beta/gamma (13-40Hz) oscillations, and significantly reduced MDDE anesthesia-induced slow, theta and alpha oscillation power.

conclusionsLarge amplitude slow oscillations and coherent alpha and theta oscillations are moderated by ketamine during MDDE anesthesia. SIGNIFICANCE: These observations are consistent with the notion that GABAA circuit-level mechanisms are associated with MDDE anesthesia-induced unconsciousness.

Indexed as

AdultAnesthetics, InhalationBrain WavesDesfluraneFemaleGABA-A Receptor AntagonistsHumansInhibitory Postsynaptic PotentialsIsofluraneKetamineMaleMiddle AgedReceptors, GABA-AAnesthetics, InhalationDesfluraneGABA-A Receptor AntagonistsIsofluraneKetamineReceptors, GABA-AAlpha oscillationsDesfluraneEEGIsofluraneKetamineSlow oscillations

Identifiers

PMID27178867
PMCPMC4869993

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.