Subcortical-cortical Network Dynamics of Anesthesia and Consciousness
Sponsor:
University of California, Los Angeles
Brief Summary:
General anesthesia (GA) is a medically induced state of unresponsiveness and unconsciousness,
which millions of people experience every year. Despite its ubiquity, a clear and consistent
picture of the brain circuits mediating consciousness and responsiveness has not emerged.
Studies to date are limited by lack of direct recordings in human brain during medically
induced anesthesia. Our overall hypothesis is that the current model of consciousness,
originally proposed to model disorders and recovery of consciousness after brain injury, can
be generalized to understand mechanisms of consciousness more broadly. This will be studied
through three specific aims. The first is to evaluate the difference in anesthesia
sensitivity in patients with and without underlying basal ganglia pathology. Second is to
correlate changes in brain circuitry with induction and emergence from anesthesia. The third
aim is to evaluate the effects of targeted deep brain stimulation on anesthesia induced loss
and recovery of consciousness. This study focuses on experimentally studying these related
brain circuits by taking advantage of pathological differences in movement disorder patient
populations undergoing deep brain stimulation (DBS) surgery. DBS is a neurosurgical procedure
that is used as treatment for movement disorders, such as Parkinson’s disease and essential
tremor, and provides a mechanism to acquire brain activity recordings in subcortical
structures. This study will provide important insight by using human data to shed light on
the generalizability of the current model of consciousness. The subject’s surgery for DBS
will be prolonged by up to 40 minutes in order to record the participant’s brain activity and
their responses to verbal and auditory stimuli.
which millions of people experience every year. Despite its ubiquity, a clear and consistent
picture of the brain circuits mediating consciousness and responsiveness has not emerged.
Studies to date are limited by lack of direct recordings in human brain during medically
induced anesthesia. Our overall hypothesis is that the current model of consciousness,
originally proposed to model disorders and recovery of consciousness after brain injury, can
be generalized to understand mechanisms of consciousness more broadly. This will be studied
through three specific aims. The first is to evaluate the difference in anesthesia
sensitivity in patients with and without underlying basal ganglia pathology. Second is to
correlate changes in brain circuitry with induction and emergence from anesthesia. The third
aim is to evaluate the effects of targeted deep brain stimulation on anesthesia induced loss
and recovery of consciousness. This study focuses on experimentally studying these related
brain circuits by taking advantage of pathological differences in movement disorder patient
populations undergoing deep brain stimulation (DBS) surgery. DBS is a neurosurgical procedure
that is used as treatment for movement disorders, such as Parkinson’s disease and essential
tremor, and provides a mechanism to acquire brain activity recordings in subcortical
structures. This study will provide important insight by using human data to shed light on
the generalizability of the current model of consciousness. The subject’s surgery for DBS
will be prolonged by up to 40 minutes in order to record the participant’s brain activity and
their responses to verbal and auditory stimuli.
Criteria
Inclusion Criteria:
– Willingness and ability to cooperate during conscious operative procedure for up to 40
minutes
– Clinical diagnosis of Parkinson’s disease or essential tremor
– Preoperative MRI without evidence of cortical or subdural adhesions or vascular
abnormalities
Exclusion Criteria:
– Patients with recent use (within one week) of anticoagulant or antiplatelet agent use
– Neurocognitive testing indicating amnestic cognitive deficits
– History of intolerance of propofol or medical indications to use an anesthetic other
than propofol
Locations
- Nader Pouratian, Los Angeles, California, United States, 90095
