Changes in information integration and brain networks during propofol-, dexmedetomidine-, and ketamine-induced unresponsiveness

Br J Anaesth. 2024 Mar;132(3):528-540. doi: 10.1016/j.bja.2023.11.033. Epub 2023 Dec 16.

Abstract

Background: Information integration and network science are important theories for quantifying consciousness. However, whether these theories propose drug- or conscious state-related changes in EEG during anaesthesia-induced unresponsiveness remains unknown.

Methods: A total of 72 participants were randomised to receive i.v. infusion of propofol, dexmedetomidine, or ketamine at a constant infusion rate until loss of responsiveness. High-density EEG was recorded during the consciousness transition from the eye-closed baseline to the unresponsiveness state and then to the recovery of the responsiveness state. Permutation cross mutual information (PCMI) and PCMI-based brain networks in broadband (0.1-45 Hz) and sub-band frequencies were used to analyse drug- and state-related EEG signature changes.

Results: PCMI and brain networks exhibited state-related changes in certain brain regions and frequency bands. The within-area PCMI of the frontal, parietal, and occipital regions, and the between-area PCMI of the parietal-occipital region (median [inter-quartile ranges]), baseline vs unresponsive were as follows: 0.54 (0.46-0.58) vs 0.46 (0.40-0.50), 0.58 (0.52-0.60) vs 0.48 (0.44-0.53), 0.54 (0.49-0.59) vs 0.47 (0.42-0.52) decreased during anaesthesia for three drugs (P<0.05). Alpha PCMI in the frontal region, and gamma PCMI in the posterior area significantly decreased in the unresponsive state (P<0.05). The frontal, parietal, and occipital nodal clustering coefficients and parietal nodal efficiency decreased in the unresponsive state (P<0.05). The increased normalised path length in delta, theta, and gamma bands indicated impaired global integration (P<0.05).

Conclusions: The three anaesthetics caused changes in information integration patterns and network functions. Thus, it is possible to build a quantifying framework for anaesthesia-induced conscious state changes on the EEG scale using PCMI and network science.

Keywords: brain network; dexmedetomidine; electroencephalography; ketamine; neural correlates of responsiveness; permutation cross mutual information; propofol.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Brain
  • Dexmedetomidine* / pharmacology
  • Electroencephalography
  • Humans
  • Ketamine* / pharmacology
  • Propofol* / pharmacology

Substances

  • Propofol
  • Ketamine
  • Dexmedetomidine