PROJECT 1. HUMAN STUDIES OF ANESTHETIC ACTION General anesthesia is a fascinating man-made, neurophysiological phenomenon that has been developed empirically over many years to enable safe and humane performance of surgical and non-surgical procedures. Specifically it is a drug-induced condition consisting of unconsciousness, amnesia, analgesia and immobility, along with physiological stability. General anesthesia is administered daily to 60,000 patients in the United States, the mechanisms for how anesthetics act in the brain to create the states of anesthesia are not well understood. Significant progress has been made recently in characterizing the molecular sites that anesthetics target. However, how actions at specific molecular targets lead to the behavioral states is less well understood. Addressing this issue requires a systems neuroscience approach to define how actions of the drugs at specific molecular targets and neural circuits lead to a behavioral state of general anesthesia. In this program project entitled, Integrated Systems Neuroscience Studies of Anesthesia, we will develop an integrated systems neuroscience program consisting of human, non-human primate, rodent and modeling studies of four anesthetics: the GABAA agents, propofol and sevoflurane; the alpha-2 adrenergic agonist, dexmedetomidine; and the NMDA receptor antagonist, ketamine. The program project will also include a DATA ANALYSIS CORE, which will provide assistant with data analysis and conduct research on statistical methods.
The Specific Aims are to understand how the actions of the anesthetics at specific molecular targets and neural circuits produce the oscillatory dynamics (EEG rhythms, changes in LFPs and neural spiking activity) that are likely a primary common mechanism through which anesthetics create altered states of arousal (sedation, hallucination, unconsciousness). In our first set of human studies we will empanel a cohort of normal human volunteers. Each volunteer will receive a controlled-dosing of one of the anesthetics while executing a behavioral task. The controlled-dosing of the anesthetic will be systematically increased to induce loss of consciousness then systematically decreased to allow recovery. During induction, maintenance and recovery, we will record in addition to standard physiological variables, up to 256-leads of EEG activity. We will characterize the altered states of arousal induced by each anesthetics by relating the dynamics of the neurophysiological and physiological variables to the changes in behavioral. In our second set of human studies we will study specifically sevoflurane and ketamine induced sedation and unconsciousness in neurosurgical patients with implanted intracortical electrodes. These latter studies provide the unique opportunity to record and study multiple single neuron spiking activity and local field potentials in the human brain during loss and recovery of consciousness. These studies will also provide fundamental new knowledge about the neurophysiology of the brain's arousal circuits that will be relevant to problems such as coma, sleep disorders, pain and depression.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Program Projects (P01)
Project #
5P01GM118269-03
Application #
9624790
Study Section
Special Emphasis Panel (ZGM1)
Project Start
Project End
Budget Start
2019-02-01
Budget End
2020-01-31
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02114
Cornelissen, L; Kim, S E; Lee, J M et al. (2018) Electroencephalographic markers of brain development during sevoflurane anaesthesia in children up to 3 years old. Br J Anaesth 120:1274-1286
Brown, Emery N; Pavone, Kara J; Naranjo, Marusa (2018) Multimodal General Anesthesia: Theory and Practice. Anesth Analg 127:1246-1258
Sherfey, Jason S; Soplata, Austin E; Ardid, Salva et al. (2018) DynaSim: A MATLAB Toolbox for Neural Modeling and Simulation. Front Neuroinform 12:10
Lewis, Laura D; Piantoni, Giovanni; Peterfreund, Robert A et al. (2018) A transient cortical state with sleep-like sensory responses precedes emergence from general anesthesia in humans. Elife 7:
Walsh, Elisa C; Lee, Johanna M; Terzakis, Kristina et al. (2018) Age-Dependent Changes in the Propofol-Induced Electroencephalogram in Children With Autism Spectrum Disorder. Front Syst Neurosci 12:23
Brown, E N; Purdon, P L; Akeju, O et al. (2018) Using EEG markers to make inferences about anaesthetic-induced altered states of arousal. Br J Anaesth 121:325-327
Akeju, Oluwaseun; Hobbs, Lauren E; Gao, Lei et al. (2018) Dexmedetomidine promotes biomimetic non-rapid eye movement stage 3 sleep in humans: A pilot study. Clin Neurophysiol 129:69-78
Guidera, Jennifer A; Taylor, Norman E; Lee, Justin T et al. (2017) Sevoflurane Induces Coherent Slow-Delta Oscillations in Rats. Front Neural Circuits 11:36
Akeju, Oluwaseun; Brown, Emery N (2017) Neural oscillations demonstrate that general anesthesia and sedative states are neurophysiologically distinct from sleep. Curr Opin Neurobiol 44:178-185
Flores, Francisco J; Hartnack, Katharine E; Fath, Amanda B et al. (2017) Thalamocortical synchronization during induction and emergence from propofol-induced unconsciousness. Proc Natl Acad Sci U S A 114:E6660-E6668

Showing the most recent 10 out of 12 publications