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Age-Related Changes in Cortical Connectivity During Surgical Anesthesia.

ABSTRACT: An advanced understanding of the neurophysiologic changes that occur with aging may help improve care for older, vulnerable surgical patients. The objective of this study was to determine age-related changes in cortical connectivity patterns during surgical anesthesia. This was a substudy analysis of a prospective, observational study characterizing cortical connectivity during surgical anesthesia in adult patients (n = 45) via whole-scalp (16-channel) electroencephalography. Functional connectivity was estimated using a weighted phase lag index (wPLI), which was classified into a discrete set of states through k-means analysis. Temporal dynamics were quantified by occurrence rate and state transition probabilities. The mean global connectivity state transition probability [13.4% (±8.1)] was not correlated with age (? = 0.100, p = 0.513). Increasing age was inversely correlated with prefrontal-frontal alpha-beta connectivity (? = -0.446, p = 0.002) and positively correlated with frontal-parietal theta connectivity (? = 0.414, p = 0.005). After adjusting for anesthetic-related confounders, prefrontal-frontal alpha-beta connectivity remained significantly associated with age (? = -0.625, 95% CI -0.99 to -0.26; p = 0.001), while frontal-parietal theta connectivity was no longer significant (? = 0.436, 95% CI -0.03 to 0.90; p = 0.066). Specific transition states were also examined. Between frontal-parietal connectivity states, transitioning from theta-alpha to theta-dominated connectivity positively correlated with age (? = 0.545, p = 0.001). Dynamic connectivity states during surgical anesthesia, particularly involving alpha and theta bandwidths, maybe an informative measure to assess neurophysiologic changes that occur with aging.

SUBMITTER: Li D

PROVIDER: S-EPMC6967734 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Age-Related Changes in Cortical Connectivity During Surgical Anesthesia.

Li Duan D Puglia Mike P MP Lapointe Andrew P AP Ip Ka I KI Zierau Mackenzie M McKinney Amy A Vlisides Phillip E PE

Frontiers in aging neuroscience 20200110

An advanced understanding of the neurophysiologic changes that occur with aging may help improve care for older, vulnerable surgical patients. The objective of this study was to determine age-related changes in cortical connectivity patterns during surgical anesthesia. This was a substudy analysis of a prospective, observational study characterizing cortical connectivity during surgical anesthesia in adult patients (<i>n</i> = 45) <i>via</i> whole-scalp (16-channel) electroencephalography. Funct ...[more]

PMID: 31998118

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Project description:BACKGROUND:Functional connectivity across the cortex has been posited to be important for consciousness and anesthesia, but functional connectivity patterns during the course of surgery and general anesthesia are unknown. The authors tested the hypothesis that disrupted cortical connectivity patterns would correlate with surgical anesthesia. METHODS:Surgical patients (n = 53) were recruited for study participation. Whole-scalp (16-channel) wireless electroencephalographic data were prospectively collected throughout the perioperative period. Functional connectivity was assessed using weighted phase lag index. During anesthetic maintenance, the temporal dynamics of connectivity states were characterized via Markov chain analysis, and state transition probabilities were quantified. RESULTS:Compared to baseline (weighted phase lag index, 0.163, ± 0.091), alpha frontal-parietal connectivity was not significantly different across the remaining anesthetic and perioperative epochs, ranging from 0.100 (± 0.041) to 0.218 (± 0.136) (P > 0.05 for all time periods). In contrast, there were significant increases in alpha prefrontal-frontal connectivity (peak = 0.201 [0.154, 0.248]; P < 0.001), theta prefrontal-frontal connectivity (peak = 0.137 [0.091, 0.182]; P < 0.001), and theta frontal-parietal connectivity (peak = 0.128 [0.084, 0.173]; P < 0.001) during anesthetic maintenance. Additionally, shifts occurred between states of high prefrontal-frontal connectivity (alpha, beta) with suppressed frontal-parietal connectivity, and high frontal-parietal connectivity (alpha, theta) with reduced prefrontal-frontal connectivity. These shifts occurred in a nonrandom manner (P < 0.05 compared to random transitions), suggesting structured transitions of connectivity during general anesthesia. CONCLUSIONS:Functional connectivity patterns dynamically shift during surgery and general anesthesia but do so in a structured way. Thus, a single measure of functional connectivity will likely not be a reliable correlate of surgical anesthesia.

Project description:Disruption of cortical connectivity likely contributes to loss of consciousness (LOC) during both sleep and general anesthesia, but the degree of overlap in the underlying mechanisms is unclear. Both sleep and anesthesia comprise states of varying levels of arousal and consciousness, including states of largely maintained conscious experience (sleep: N1, REM; anesthesia: sedated but responsive) as well as states of substantially reduced conscious experience (sleep: N2/N3; anesthesia: unresponsive). Here, we tested the hypotheses that (1) cortical connectivity will exhibit clear changes when transitioning into states of reduced consciousness, and (2) these changes will be similar for arousal states of comparable levels of consciousness during sleep and anesthesia. Using intracranial recordings from five adult neurosurgical patients, we compared resting state cortical functional connectivity (as measured by weighted phase lag index, wPLI) in the same subjects across arousal states during natural sleep [wake (WS), N1, N2, N3, REM] and propofol anesthesia [pre-drug wake (WA), sedated/responsive (S), and unresponsive (U)]. Analysis of alpha-band connectivity indicated a transition boundary distinguishing states of maintained and reduced conscious experience in both sleep and anesthesia. In wake states WS and WA, alpha-band wPLI within the temporal lobe was dominant. This pattern was largely unchanged in N1, REM, and S. Transitions into states of reduced consciousness N2, N3, and U were characterized by dramatic changes in connectivity, with dominant connections shifting to prefrontal cortex. Secondary analyses indicated similarities in reorganization of cortical connectivity in sleep and anesthesia. Shifts from temporal to frontal cortical connectivity may reflect impaired sensory processing in states of reduced consciousness. The data indicate that functional connectivity can serve as a biomarker of arousal state and suggest common mechanisms of LOC in sleep and anesthesia.

Project description:Aging affects pain experience and brain functioning. However, how aging leads to changes in pain perception and brain functional connectivity has not yet been completely understood. To investigate resting-state and pain perception changes in old and young participants, this study employed region of interest (ROI) to ROI resting-state functional connectivity (rsFC) analysis of imaging data by using regions implicated in sensory and affective dimensions of pain, descending pain modulation, and the default-mode networks (DMNs). Thirty-seven older (66.86 ± 4.04 years; 16 males) and 38 younger healthy participants (20.74 ± 4.15 years; 19 males) underwent 10 min' eyes-closed resting-state scanning. We examined the relationship between rsFC parameters with pressure pain thresholds. Older participants showed higher pain thresholds than younger. Regarding rsFC, older adults displayed increased connectivity of pain-related sensory brain regions in comparison to younger participants: increased rsFC between bilateral primary somatosensory area (SI) and anterior cingulate cortex (ACC), and between SI(L) and secondary somatosensory area (SII)-(R) and dorsolateral prefrontal cortex (PFC). Moreover, decreased connectivity in the older compared to the younger group was found among descending pain modulatory regions: between the amygdala(R) and bilateral insula(R), thalamus(R), ACC, and amygdala(L); between the amygdala(L) and insula(R) and bilateral thalamus; between ACC and bilateral insula, and between periaqueductal gray (PAG) and bilateral thalamus. Regarding the DMN, the posterior parietal cortex and lateral parietal (LP; R) were more strongly connected in the older group than in the younger group. Correlational analyses also showed that SI(L)-SII(R) rsFC was positively associated with pressure pain thresholds in older participants. In conclusion, these findings suggest a compensatory mechanism for the sensory changes that typically accompanies aging. Furthermore, older participants showed reduced functional connectivity between key nodes of the descending pain inhibitory pathway.

Dataset Information

Age-Related Changes in Cortical Connectivity During Surgical Anesthesia.

Publications

Age-Related Changes in Cortical Connectivity During Surgical Anesthesia.

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