Evidence map›Paper›PMID 41189957›Full record

ArticleBrain communications2025

Normative high-frequency oscillation phase-amplitude coupling and effective connectivity under sevoflurane.

Ethan Firestone, Hiroshi Uda, Naoto Kuroda, Kazuki Sakakura, Masaki Sonoda, Riyo Ueda, Yu Kitazawa, Min-Hee Lee, Jeong-Won Jeong, Aimee F Luat and 3 more

Abstract read
In one paragraph

Article in Brain communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Ethan FirestoneDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Hiroshi UdaDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Naoto KurodaDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Kazuki SakakuraDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Masaki SonodaDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Riyo UedaDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Yu KitazawaDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Min-Hee LeeDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Jeong-Won JeongDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Aimee F LuatDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Michael J CoolsDepartment of Neurosurgery, Children's Hospital of Michigan, Detroit Medical Center, Detroit, MI 48201, USA.
Sandeep SoodDepartment of Neurosurgery, Children's Hospital of Michigan, Detroit Medical Center, Detroit, MI 48201, USA.
Eishi AsanoDepartment of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.ORCID https://orcid.org/0000-0001-8391-4067

Funding

Functional brain mapping in pediatric neurosurgeryR01NS064033 · NINDS · WAYNE STATE UNIVERSITY · PI EISHI ASANO · 2009 to 2026
$5.7M
Novel DWI Methods to Minimize Postoperative Deficits in Pediatric Epilepsy Surgery.R01NS089659 · NINDS · WAYNE STATE UNIVERSITY · PI JEONG, JEONG-WON · 2015 to 2025
$3.7M
Novel MRI Approaches to Improve Presurgical Benefit-Risk Evaluation in Pediatric Epilepsy SurgeryR56NS089659 · NINDS · WAYNE STATE UNIVERSITY · PI Jeong-Won Jeong · 2026 to 2026
$551k
Intraoperative Localization of Epileptic Brain Regions Under Sevoflurane Anesthesia.F30NS129239 · NINDS · WAYNE STATE UNIVERSITY · PI FIRESTONE, ETHAN JOSEPH · 2023 to 2024
$101k
NINDS NIH HHS F30 NS129239NINDS NIH HHS R01 NS064033NINDS NIH HHS R01 NS089659NINDS NIH HHS R56 NS089659
6 · The paper itself

Abstract

Resective surgery for paediatric drug-resistant focal epilepsy often requires extraoperative intracranial electroencephalography recording to accurately localize the epileptogenic zone. This procedure entails multiple neurosurgeries, intracranial electrode implantation and explantation, and days of invasive in-patient evaluation. There is a need for methods to reduce the diagnostic burden and introduce objective epilepsy biomarkers. Our preliminary studies aimed to address these issues by using sevoflurane anaesthesia to rapidly and reversibly activate intraoperative phase-amplitude coupling between delta and high-frequency activities, as well as high-frequency activity-based effective connectivity. Phase-amplitude coupling can serve as a proxy for spike-and-wave discharges, and effective connectivity describes the spatiotemporal dynamics of neural information flow among regions. Notably, sevoflurane activated these interictal electrocorticography biomarkers most robustly in areas whose resection led to seizure freedom. However, they were also increased in normative brain regions that did not require removal for seizure control. Before using these electrocorticography biomarkers prospectively to guide resection, we should understand their endogenous distribution and propagation pathways at different anaesthetic stages. In the current study, we highlighted the normative distribution of delta and high-frequency activity phase-amplitude coupling and effective connectivity under sevoflurane. Normative data were derived from 19 patients, whose ages ranged from 4 to 18 years and included 11 males. All achieved seizure control following focal resection. Electrocorticography was recorded at an isoflurane baseline, during stepwise increases in sevoflurane concentration, and also during extraoperative slow-wave sleep without anaesthesia. Normative electrode sites were then mapped onto a standard cortical surface for anatomical visualization. Dynamic tractography traced white matter pathways that connected sites with significantly augmented biomarkers. Finally, we analysed all sites-regardless of normal or abnormal status-to determine whether sevoflurane-enhanced biomarker values could intraoperatively localize the epileptogenic sites. We found that normative electrocorticography biomarkers increased as a function of sevoflurane concentration, especially in bilateral frontal and parietal lobe regions (Bonferroni-corrected

Indexed as

acute electrocorticography (ECoG)dynamic tractographygeneral anaesthesiamodulation-index-based phase–amplitude couplingtransfer-entropy-based effective connectivity

Identifiers

PMID41189957
PMCPMC12582361

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Registered trials

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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.