Every day approximately 100,000 people undergo general anesthesia in the United States, and by the age of 70, almost all of us will experience general anesthesia. Yet it remains unknown how anesthetics produce unconsciousness, and how consciousness is restored after general anesthesia. The broad, long- term objectives of this project are to: (1) make general anesthesia safer by developing new ways to restore consciousness and cognition in anesthetized patients, and (2) aid the development of safer anesthetics by elucidating the mechanisms of anesthetic-induced unconsciousness. In our application we show that midbrain GABA neurons in the rostromedial tegmental nucleus (RMTg) are involved in anesthetic-induced unconsciousness, while midbrain dopamine neurons in the ventral tegmental area (VTA) are involved in emergence and cognitive recovery from general anesthesia.
The Specific Aims are to: (1) characterize the role of the RMTg-VTA circuit in anesthetic-induced unconsciousness, (2) characterize the role of VTA dopamine neurons and their projections in anesthetic emergence, and (3) identify the VTA dopaminergic projections that promote cognitive recovery from the anesthetized state, using a touchscreen-based visual discrimination task. Using genetically modified rodents that allow for selective targeting of dopamine and GABA neurons, we will employ a combination of optogenetics, chemogenetics, neurophysiological recordings, and touchscreen cognitive testing to elucidate the anesthetic circuitry of the midbrain. This project will shed light on fundamental mechanisms of anesthesia and consciousness, which will allow us to improve patient care by developing new techniques to help the brain recover from general anesthesia. In addition, this work will facilitate the development of new anesthetics with fewer side effects.

Public Health Relevance

The goals of this project are to understand how cells in the midbrain are involved in anesthetic-induced unconsciousness, and recovery of consciousness. Understanding these mechanisms will lead to new methods for inducing rapid recovery from general anesthesia, which will improve patient safety and hospital efficiency. This work will also aid the development of new anesthetics with fewer side effects.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Project (R01)
Project #
5R01GM126155-03
Application #
10059249
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Program Officer
Falcon-Morales, Edgardo
Project Start
2019-02-01
Project End
2022-11-30
Budget Start
2020-12-01
Budget End
2021-11-30
Support Year
3
Fiscal Year
2021
Total Cost
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02114