Brain functional connectivity differentiates dexmedetomidine from propofol and natural sleep

[en] Background We used functional connectivity measures from brain resting state functional magnetic resonance imaging to identify human neural correlates of sedation with dexmedetomidine or propofol and their similarities with natural sleep. Methods Connectivity within the resting state networks that are proposed to sustain consciousness generation was compared between deep non-rapid-eye-movement (N3) sleep, dexmedetomidine sedation, and propofol sedation in volunteers who became unresponsive to verbal command. A newly acquired dexmedetomidine dataset was compared with our previously published propofol and N3 sleep datasets. Results In all three unresponsive states (dexmedetomidine sedation, propofol sedation, and N3 sleep), within-network functional connectivity, including thalamic functional connectivity in the higher-order (default mode, executive control, and salience) networks, was significantly reduced as compared with the wake state. Thalamic functional connectivity was not reduced for unresponsive states within lower-order (auditory, sensorimotor, and visual) networks. Voxel-wise statistical comparisons between the different unresponsive states revealed that thalamic functional connectivity with the medial prefrontal/anterior cingulate cortex and with the mesopontine area was reduced least during dexmedetomidine-induced unresponsiveness and most during propofol-induced unresponsiveness. The reduction seen during N3 sleep was intermediate between those of dexmedetomidine and propofol. Conclusions Thalamic connectivity with key nodes of arousal and saliency detection networks was relatively preserved during N3 sleep and dexmedetomidine-induced unresponsiveness as compared to propofol. These network effects may explain the rapid recovery of oriented responsiveness to external stimulation seen under dexmedetomidine sedation. Trial registry number Committee number: 'Comité d'Ethique Hospitalo-Facultaire Universitaire de Liège' (707); EudraCT number: 2012-003562-40; internal reference: 20121/135; accepted on August 31, 2012; Chair: Prof G. Rorive. As it was considered a phase I clinical trial, this protocol does not appear on the EudraCT public website. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Guldenmund, Pieter ^✱

VANHAUDENHUYSE, Audrey ^✱; Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Centre interdisciplinaire d'algologie

Sanders, R. D.; Department of Anesthesiology, University of Wisconsin-Madison, Madison, WI, United States, Wellcome Department of Imaging Neuroscience, Department of Anaesthesia, Surgical Outcomes Research Centre, University College London Hospital, London, United Kingdom

Sleigh, J.; Department of Anaesthesia, Waikato Clinical School, University of Auckland, Hamilton, New Zealand

Bruno, Marie-Aurélie ; GIGA-Consciousness, Coma Science Group, Pain and Hypnosis, Anesthesia and Intensive Care Laboratories, GIGA Research, University, CHU University Hospital of Liège, Liège, Belgium

Demertzi, Athina ; Université de Liège - ULiège > Centre de recherches du cyclotron

Bahri, Mohamed Ali ; Université de Liège - ULiège > Centre de recherches du cyclotron

JAQUET, Océane ; Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Service d'anesthésie - réanimation

Sanfilippo, Julien ; Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Service d'anesthésie - réanimation

Baquero Duarte, Katherine Andrea ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Biochimie et physiologie du système nerveux

More authors (4 more)

^✱ These authors have contributed equally to this work.

Language :

English

Title :

Brain functional connectivity differentiates dexmedetomidine from propofol and natural sleep

Publication date :

2017

Journal title :

British Journal of Anaesthesia

ISSN :

0007-0912

eISSN :

1471-6771

Publisher :

Oxford University Press

Volume :

119

Issue :

Pages :

674-684

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 25 June 2018

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