The posterior dominant rhythm: an electroencephalographic biomarker for cognitive recovery after general anaesthesia.

Adult Humans Isoflurane / pharmacology Electroencephalography Anesthesia, General Anesthetics / pharmacology Cognition Alpha Rhythm
alpha oscillations anaesthesia biomarker cognitive function electroencephalography posterior dominant rhythm

Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
02 2023
Historique:
received: 16 11 2021
revised: 22 12 2021
accepted: 09 01 2022
pmc-release: 01 02 2024
pubmed: 21 2 2022
medline: 24 1 2023
entrez: 20 2 2022
Statut: ppublish

Résumé

The posterior dominant rhythm (PDR) was the first oscillatory pattern noted in the EEG. Evoked by wakeful eyelid closure, these oscillations dissipate over seconds during loss of arousal. The peak frequency of the PDR maintains stability over years, suggesting utility as a state biomarker in the surveillance of acute cognitive impairments. This EEG signature has not been systematically investigated for tracking cognitive dysfunction after anaesthetic-induced loss of consciousness. This substudy of Reconstructing Consciousness and Cognition (NCT01911195) investigated the PDR and cognitive function in 60 adult volunteers randomised to either 3 h of isoflurane general anaesthesia or resting wakefulness. Serial measurements of EEG power and cognitive task performance were assessed relative to pre-intervention baseline. Mixed-effects models allowed quantification of PDR and neurocognitive trajectories after return of responsiveness (ROR). Individuals in the control group showed stability in the PDR peak frequency over several hours (median difference/inter-quartile range [IQR] of 0.02/0.20 Hz, P=0.39). After isoflurane general anaesthesia, the PDR peak frequency was initially reduced at ROR (median difference/IQR of 0.88/0.65 Hz, P<0.001). PDR peak frequency recovered at a rate of 0.20 Hz h The temporal trajectory of the PDR peak frequency could be a useful perioperative marker for tracking cognitive dysfunction on the order of hours after surgery, particularly for cognitive domains of working memory, visuomotor speed, and executive function. NCT01911195.

Sections du résumé

BACKGROUND
The posterior dominant rhythm (PDR) was the first oscillatory pattern noted in the EEG. Evoked by wakeful eyelid closure, these oscillations dissipate over seconds during loss of arousal. The peak frequency of the PDR maintains stability over years, suggesting utility as a state biomarker in the surveillance of acute cognitive impairments. This EEG signature has not been systematically investigated for tracking cognitive dysfunction after anaesthetic-induced loss of consciousness.
METHODS
This substudy of Reconstructing Consciousness and Cognition (NCT01911195) investigated the PDR and cognitive function in 60 adult volunteers randomised to either 3 h of isoflurane general anaesthesia or resting wakefulness. Serial measurements of EEG power and cognitive task performance were assessed relative to pre-intervention baseline. Mixed-effects models allowed quantification of PDR and neurocognitive trajectories after return of responsiveness (ROR).
RESULTS
Individuals in the control group showed stability in the PDR peak frequency over several hours (median difference/inter-quartile range [IQR] of 0.02/0.20 Hz, P=0.39). After isoflurane general anaesthesia, the PDR peak frequency was initially reduced at ROR (median difference/IQR of 0.88/0.65 Hz, P<0.001). PDR peak frequency recovered at a rate of 0.20 Hz h
CONCLUSION
The temporal trajectory of the PDR peak frequency could be a useful perioperative marker for tracking cognitive dysfunction on the order of hours after surgery, particularly for cognitive domains of working memory, visuomotor speed, and executive function.
CLINICAL TRIAL REGISTRATION
NCT01911195.

Identifiants

DOI: 10.1016/j.bja.2022.01.019 PMID: 35183346 PMC: PMC9900730
pubmed: 35183346
pii: S0007-0912(22)00028-9
doi: 10.1016/j.bja.2022.01.019
pmc: PMC9900730
pii:
doi:

Substances chimiques

Isoflurane CYS9AKD70P
Anesthetics 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e233-e242

Subventions

Organisme : NIA NIH HHS
ID : R01 AG057901
Pays : United States

Investigateurs

Maxwell Muench (M)
Vijay Tarnal (V)
Giancarlo Vanini (G)
E Andrew Ochroch (EA)
Rosemary Hogg (R)
Marlon Schwarz (M)
Ellen Janke (E)
Goodarz Golmirzaie (G)
Paul Picton (P)
Andrew R McKinstry-Wu (AR)

Informations de copyright

Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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Auteurs

Alyssa K Labonte (AK)

Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.

MohammadMehdi Kafashan (M)

Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, Missouri.

Emma R Huels (ER)

Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Anesthesiology, Center for Consciousness Science and Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI, USA.

Stefanie Blain-Moraes (S)

School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.

Mathias Basner (M)

Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

Max B Kelz (MB)

Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

George A Mashour (GA)

Department of Anesthesiology, Center for Consciousness Science and Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI, USA.

Michael S Avidan (MS)

Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, Missouri; Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.

Ben Julian A Palanca (BJA)

Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: palancab@wustl.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › The posterior dominant rhythm: an...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The posterior dominant rhythm: an...
questionsmedicales.fr › Composés chimiques organiques › Éthers › Éthers méthyliques › Isoflurane › The posterior dominant rhythm: an...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Électroencéphalographie › The posterior dominant rhythm: an...
questionsmedicales.fr › Anesthésie et analgésie › Anesthésie › Anesthésie générale › The posterior dominant rhythm: an...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Dépresseurs du système nerveux central › Anesthésiques › The posterior dominant rhythm: an...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Cognition › The posterior dominant rhythm: an...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système nerveux › Ondes du cerveau › Rythme alpha › The posterior dominant rhythm: an...