A transient cortical state with sleep-like sensory responses precedes emergence from general anesthesia in humans

Laura D. Lewis, Giovanni Piantoni, Robert A. Peterfreund, Emad N. Eskandar, Priscilla Grace Harrell, Oluwaseun Akeju, Linda S. Aglio, Sydney S. Cash, Emery N. Brown, Eran A. Mukamel, Patrick L. Purdon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

During awake consciousness, the brain intrinsically maintains a dynamical state in which it can coordinate complex responses to sensory input. How the brain reaches this state spontaneously is not known. General anesthesia provides a unique opportunity to examine how the human brain recovers its functional capabilities after profound unconsciousness. We used intracranial electrocorticography and scalp EEG in humans to track neural dynamics during emergence from propofol general anesthesia. We identify a distinct transient brain state that occurs immediately prior to recovery of behavioral responsiveness. This state is characterized by large, spatially distributed, slow sensory-evoked potentials that resemble the K-complexes that are hallmarks of stage two sleep. However, the ongoing spontaneous dynamics in this transitional state differ from sleep. These results identify an asymmetry in the neurophysiology of induction and emergence, as the emerging brain can enter a state with a sleep-like sensory blockade before regaining responsivity to arousing stimuli.

Original languageEnglish (US)
Article numbere33250
JournaleLife
Volume7
DOIs
StatePublished - Aug 10 2018
Externally publishedYes

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General Anesthesia
Brain
Sleep
Neurophysiology
Unconsciousness
Sleep Stages
Bioelectric potentials
Propofol
Electroencephalography
Scalp
Consciousness
Evoked Potentials
Recovery

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

Cite this

Lewis, L. D., Piantoni, G., Peterfreund, R. A., Eskandar, E. N., Harrell, P. G., Akeju, O., ... Purdon, P. L. (2018). A transient cortical state with sleep-like sensory responses precedes emergence from general anesthesia in humans. eLife, 7, [e33250]. https://doi.org/10.7554/eLife.33250

A transient cortical state with sleep-like sensory responses precedes emergence from general anesthesia in humans. / Lewis, Laura D.; Piantoni, Giovanni; Peterfreund, Robert A.; Eskandar, Emad N.; Harrell, Priscilla Grace; Akeju, Oluwaseun; Aglio, Linda S.; Cash, Sydney S.; Brown, Emery N.; Mukamel, Eran A.; Purdon, Patrick L.

In: eLife, Vol. 7, e33250, 10.08.2018.

Research output: Contribution to journalArticle

Lewis, LD, Piantoni, G, Peterfreund, RA, Eskandar, EN, Harrell, PG, Akeju, O, Aglio, LS, Cash, SS, Brown, EN, Mukamel, EA & Purdon, PL 2018, 'A transient cortical state with sleep-like sensory responses precedes emergence from general anesthesia in humans', eLife, vol. 7, e33250. https://doi.org/10.7554/eLife.33250
Lewis, Laura D. ; Piantoni, Giovanni ; Peterfreund, Robert A. ; Eskandar, Emad N. ; Harrell, Priscilla Grace ; Akeju, Oluwaseun ; Aglio, Linda S. ; Cash, Sydney S. ; Brown, Emery N. ; Mukamel, Eran A. ; Purdon, Patrick L. / A transient cortical state with sleep-like sensory responses precedes emergence from general anesthesia in humans. In: eLife. 2018 ; Vol. 7.
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