ArticleProceedings of the National Academy of Sciences of the United States of America2023
Modulatory dynamics mark the transition between anesthetic states of unconsciousness.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Electroencephalographic Patterns Associated with the Pharmacokinetics and Pharmacodynamics of GABAergic Agents, Opioids, and Ketamine During General Anesthesia: A Systematic Review.Journal of personalized medicine · 2026Review
- Target concentrations of propofol predicted by four different pharmacokinetic/pharmacodynamic models to induce loss of consciousness in neurosurgical patients.Journal of anesthesia, analgesia and critical care · 2026Article
- Fabrication of High-Density Multimodal Neural Probes Based on Heterogeneously Integrated CMOS.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Esketamine Preserves Network Connectivity and Promotes Recovery in Consciousness Disorders.CNS neuroscience & therapeutics · 2026Article
- Dynamic neuronal ensembles encode burst-suppression revealed by cortex-wide optical-electrical interfaces.Nature communications · 2026Article
- Distinct origins of human low and high alpha rhythms revealed by simultaneous EEG-SEEG.Communications biology · 2026Article
- Neurophysiological differences between dexmedetomidine sedation and natural sleep across the rodent lifespan: implications for aging and perioperative brain health.Anesthesiology and perioperative science · 2026Article
- Clinical Electroencephalography for Anesthesiologists and Intensivists: Part 2-Physiologic Signatures and Active Management.Anesthesiology · 2025Review
- Evaluating the performance of the NarcotrendBMC anesthesiology · 2025Article
- Electroencephalogram signatures of propanidid-mediated sedation and unconsciousness.Journal of neurophysiology · 2025Article
- EEG-Guided Titration of Sevoflurane and Pediatric Anesthesia Emergence Delirium: A Randomized Clinical Trial.JAMA pediatrics · 2025Article
- Characterizing Canine Frontal Electroencephalographic Patterns and Cardiovascular Correlates at Different Anesthetic Levels of Sevoflurane.Animals : an open access journal from MDPI · 2025Article
- Ketamine can produce oscillatory dynamics by engaging mechanisms dependent on the kinetics of NMDA receptors.bioRxiv : the preprint server for biology · 2024Article
- Neural oscillations and memory: unraveling the mechanisms of anesthesia-induced amnesia.Frontiers in neuroscience · 2024Review
- Bridging neural circuits and clinical outcomes: a novel framework for perioperative disturbances of consciousness and cognition.Frontiers in neurologyReview
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
Unconsciousness maintained by GABAergic anesthetics, such as propofol and sevoflurane, is characterized by slow-delta oscillations (0.3 to 4 Hz) and alpha oscillations (8 to 14 Hz) that are readily visible in the electroencephalogram. At higher doses, these slow-delta-alpha (SDA) oscillations transition into burst suppression. This is a marker of a state of profound brain inactivation during which isoelectric (flatline) periods alternate with periods of the SDA patterns present at lower doses. While the SDA and burst suppression patterns have been analyzed separately, the transition from one to the other has not. Using state-space methods, we characterize the dynamic evolution of brain activity from SDA to burst suppression and back during unconsciousness maintained with propofol or sevoflurane in volunteer subjects and surgical patients. We uncover two dynamical processes that continuously modulate the SDA oscillations: alpha-wave amplitude and slow-wave frequency modulation. We present an alpha modulation index and a slow modulation index which characterize how these processes track the transition from SDA oscillations to burst suppression and back to SDA oscillations as a function of increasing and decreasing anesthetic doses, respectively. Our biophysical model reveals that these dynamics track the combined evolution of the neurophysiological and metabolic effects of a GABAergic anesthetic on brain circuits. Our characterization of the modulatory dynamics mediated by GABAergic anesthetics offers insights into the mechanisms of these agents and strategies for monitoring and precisely controlling the level of unconsciousness in patients under general anesthesia.
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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.