[en] PURPOSE OF REVIEW: To describe recent studies exploring brain function under the influence of hypnotic anesthetic agents, and their implications on the understanding of consciousness physiology and anesthesia-induced alteration of consciousness. RECENT FINDINGS: Cerebral cortex is the primary target of the hypnotic effect of anesthetic agents, and higher-order association areas are more sensitive to this effect than lower-order processing regions. Increasing concentration of anesthetic agents progressively attenuates connectivity in the consciousness networks, while connectivity in lower-order sensory and motor networks is preserved. Alteration of thalamic sub-cortical regulation could compromise the cortical integration of information despite preserved thalamic activation by external stimuli. At concentrations producing unresponsiveness, the activity of consciousness networks becomes anticorrelated with thalamic activity, while connectivity in lower-order sensory networks persists, although with cross-modal interaction alterations. SUMMARY: Accumulating evidence suggests that hypnotic anesthetic agents disrupt large-scale cerebral connectivity. This would result in an inability of the brain to generate and integrate information, while external sensory information is still processed at a lower order of complexity.
Disciplines :
Neurologie Anesthésie & soins intensifs
Auteur, co-auteur :
BONHOMME, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
BOVEROUX, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
HANS, Pol ; Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation
Cipolla MJ. The cerebral circulation. In: Colloquium series on integrated systems physiology: from molecule to function. 1st ed. San Rafael, CA: Morgan and Claypool Publishers; 2009: 1. pp. 1-59.
Fiset P, Paus T, Daloze T, et al. Brain mechanisms of propofol-induced loss of consciousness in humans: a positron emission tomographic study. J Neurosci 1999; 19:5506-5513. (Pubitemid 29300215)
Veselis RA, Reinsel RA, Beattie BJ, et al. Midazolam changes cerebral blood flow in discrete brain regions: an H2(15)O positron emission tomography study. Anesthesiology 1997; 87:1106-1117. (Pubitemid 27469310)
Veselis RA, Feshchenko VA, Reinsel RA, et al. Propofol and thiopental do not interfere with regional cerebral blood flow response at sedative concentrations. Anesthesiology 2005; 102:26-34. (Pubitemid 40082836)
Kaisti KK, Langsjo JW, Aalto S, et al. Effects of sevoflurane, propofol, and adjunct nitrous oxide on regional cerebral blood flow, oxygen consumption, and blood volume in humans. Anesthesiology 2003; 99:603-613. (Pubitemid 37051975)
Langsjo JW, Maksimow A, Salmi E, et al. S-ketamine anesthesia increases cerebral blood flow in excess of the metabolic needs in humans. Anesthesiology 2005; 103:258-268. (Pubitemid 41076722)
Dagal A, Lam AM. Cerebral autoregulation and anesthesia. Curr Opin Anaesthesiol 2009; 22:547-552.
Paulson OB, Hasselbalch SG, Rostrup E, et al. Cerebral blood flow response to functional activation. J Cereb Blood Flow Metab 2010; 30:2-14.
Koehler RC, Roman RJ, Harder DR. Astrocytes and the regulation of cerebral blood flow. Trends Neurosci 2009; 32:160-169.
Qiu M, Ramani R, Swetye M, et al. Anesthetic effects on regional CBF, BOLD, and the coupling between task-induced changes in CBF and BOLD: anfMRI study in normal human subjects. Magn Reson Med 2008; 60:987-996.
Lindauer U, Dirnagl U, Fuchtemeier M et al. Pathophysiological interference with neurovascular coupling: when imaging based on hemoglobin might go blind. Front Neuroenerg 2010; 2:25.
Shibasaki H. Human brain mapping: hemodynamic response and electro-physiology. Clin Neurophysiol 2008; 119:731-743.
Cherry SR, Phelps ME. Imaging brain function with positron emission tomography. In: Toga AW, Mazziotta JC, editors. Brain mapping: the methods, 1st ed. San Diego, CA: Academic Press; 1996. pp. 191-221.
Harel N, Ugurbil K, Uludag K, Yacoub E. Frontiers of brain mapping using MRI. J Magn Reson Imaging 2006; 23:945-957. (Pubitemid 43825446)
Vaghela V, Kesavadas C, Thomas B. Functional magnetic resonance imaging of the brain: a quick review. Neurol India 2010; 58:879-885.
Irani F, Platek SM, Bunce S, et al. Functional near infrared spectroscopy (fNIRS): an emerging neuroimaging technology with important applications for the study of brain disorders. Clin Neuropsychol 2007; 21:9-37. (Pubitemid 46277810)
Li K, Guo L, Nie J, et al. Review of methods for functional brain connectivity detection using fMRI. Comput Med Imaging Graph 2009; 33:131-139.
Kaisti KK, Metsahonkala L, Teras M, et al. Effects of surgical levels of propofol and sevoflurane anesthesia on cerebral blood flow in healthy subjects studied with positron emission tomography. Anesthesiology 2002; 96:1358-1370. (Pubitemid 34587204)
Veselis RA, Feshchenko VA, Reinsel RA, et al. Thiopental and propofol affect different regions of the brain at similar pharmacologic effects. Anesth Analg 2004; 99:399-408. (Pubitemid 38970409)
Bonhomme V, Maquet P, Phillips C, et al. The effect of clonidine infusion on distribution of regional cerebral blood flow in volunteers. Anesth Analg 2008; 106:899-909. (Pubitemid 351301414)
Xie G, Deschamps A, Backman SB, et al. Critical involvement of the thalamus and precuneus during restoration of consciousness with physostigmine in humans during propofol anaesthesia: a positron emission tomography study. Br J Anaesth 2011; 106:548-557.
Laureys S, Celesia GG, Cohadon F et al. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med 2010; 8:68.
Boveroux P, Bonhomme V, Boly M, et al. Brain function in physiologically, pharmacologically, and pathologically altered states of consciousness. Int Anesthesiol Clin 2008; 46:131-146.
Alkire MT, Haier RJ, Fallon JH. Toward a unified theory of narcosis: brain imaging evidence for a thalamocortical switch as the neurophysiologic basis of anesthetic-induced unconsciousness. Conscious Cogn 2000; 9:370-386.
Cavanna AE. The precuneus and consciousness. CNS Spectr 2007; 12:545-552. (Pubitemid 47195296)
Langsjo JW, Kaisti KK, Aalto S, et al. Effects of subanesthetic doses of ketamine on regional cerebral blood flow, oxygen consumption, and blood volume in humans. Anesthesiology 2003; 99:614-623. (Pubitemid 37051976)
Velly LJ, Rey MF, Bruder NJ, et al. Differential dynamic of action on cortical and subcortical structures of anesthetic agents during induction of anesthesia. Anesthesiology 2007; 107:202-212. (Pubitemid 47196482)
Bonhomme V, Fiset P, Meuret P, et al. Propofol anesthesia and cerebral blood flow changes elicited by vibrotactile stimulation: a positron emission tomography study. J Neurophysiol 2001; 85:1299-1308. (Pubitemid 32209615)
Heinke W, Koelsch S. The effects of anesthetics on brain activity and cognitive function. Curr Opin Anaesthesiol 2005; 18:625-631. (Pubitemid 41689642)
Tononi G. Consciousness as integrated information: a provisional manifesto. Biol Bull 2008; 215:216-242.
Seeley WW, Menon V, Schatzberg AF, et al. Dissociable intrinsic connectivity networks for salience processing and executive control. J Neurosci 2007; 27:2349-2356. (Pubitemid 46340968)
Damoiseaux JS, Rombouts SA, Barkhof F, et al. Consistent resting-state networks across healthy subjects. Proc Natl Acad Sci USA 2006; 103:13848-13853. (Pubitemid 44413996)
Mason MF, Norton MI, Van Horn JD, et al. Wandering minds: the default network and stimulus-independent thought. Science 2007; 315:393-395. (Pubitemid 46175523)
Boly M, Phillips C, Balteau E, et al. Consciousness and cerebral baseline activity fluctuations. Hum Brain Mapp 2008; 29:868-874. (Pubitemid 351813088)
Vanhaudenhuyse A, Demertzi A, Schabus M, et al. Two distinct neuronal networks mediate the awareness of environment and of self. J Cogn Neurosci 2011; 23:570-578.
Sperling R, Greve D, Dale A, et al. Functional MRI detection of pharmacologically induced memory impairment. Proc Natl Acad Sci USA 2002; 99:455-460. (Pubitemid 34060382)
Paulus MP, Feinstein JS, Castillo G, et al. Dose-dependent decrease of activation in bilateral amygdala and insula by lorazepam during emotion processing. Arch Gen Psychiatry 2005; 62:282-288. (Pubitemid 40990973)
Coghill RC, Talbot JD, Evans AC, et al. Distributed processing of pain and vibration by the human brain. J Neurosci 1994; 14:4095-4108. (Pubitemid 24200535)
Alkire MT, Hudetz AG, Tononi G. Consciousness and anesthesia. Science 2008; 322:876-880.
Dueck MH, Petzke F, Gerbershagen HJ, et al. Propofol attenuates responses of the auditory cortex to acoustic stimulation in a dose-dependent manner: a FMRI study. Acta Anaesthesiol Scand 2005; 49:784-791. (Pubitemid 40941893)
Ramani R, Qiu M, Constable RT. Sevoflurane 0.25 MAC preferentially affects higher order association areas: a functional magnetic resonance imaging study in volunteers. Anesth Analg 2007; 105:648-655. (Pubitemid 47300838)
Boveroux P, Vanhaudenhuyse A, Bruno MA, et al. Breakdown of within-and between-network resting state functional magnetic resonance imaging con nectivity during propofol-induced loss of consciousness. Anesthesiology 2010; 113:1038-1053.
Martuzzi R, Ramani R, Qiu M, et al. Functional connectivity and alterations in baseline brain state in humans. Neuroimage 2010; 49:823-834.
Stamatakis EA, Adapa RM, Absalom AR, Menon DK. Changes in resting neural connectivity during propofol sedation. PLoS One 2010; 5:e14224.
Alkire MT, Gruver R, Miller J, et al. Neuroimaging analysis of an anesthetic gas that blocks human emotional memory. Proc Natl Acad Sci USA 2008; 105:1722-1727. (Pubitemid 351346581)
Greicius MD, Kiviniemi V, Tervonen O, et al. Persistent default-mode network connectivity during light sedation. Hum Brain Mapp 2008; 29:839-847. (Pubitemid 351813085)
Mhuircheartaigh RN, Rosenorn-Lanng D, Wise R, et al. Cortical and subcortical connectivity changes during decreasing levels of consciousness in humans: a functional magnetic resonance imaging study using propofol. J Neurosci 2010; 30:9095-9102.
Vanhaudenhuyse A, Noirhomme Q, Tshibanda LJ, et al. Default network connectivity reflects the level of consciousness in noncommunicative brain damaged patients. Brain 2010; 133:161-171.
Samann PG, Wehrle R, Hoehn D et al. Development of the brain's default mode network from wakefulness to slow wave sleep. Cereb Cortex 2011 [Epub ahead of print]
Larson-Prior LJ, Zempel JM, Nolan TS, et al. Cortical network functional connectivity in the descent to sleep. Proc Natl Acad Sci USA 2009; 106:4489-4494.
Koike T, Kan S, Misaki M, Miyauchi S. Connectivity pattern changes in default-mode network with deep non-REM and REM sleep. Neurosci Res 2011; 69:322-330.
