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Sattin D, Duran D, Visintini S, et al. Analyzing the Loss and the Recovery of Consciousness: Functional Connectivity Patterns and Changes in Heart Rate Variability During Propofol-Induced Anesthesia. Front Syst Neurosci. 2021;15:652080doi: 10.3389/fnsys.2021.652080.
Sattin, D., Duran, D., Visintini, S., Schiaffi, E., Panzica, F., Carozzi, C., Rossi Sebastiano, D., Visani, E., Tobaldini, E., Carandina, A., Citterio, V., Magnani, F. G., Cacciatore, M., Orena, E., Montano, N., Caldiroli, D., Franceschetti, S., Picozzi, M., & Matilde, L. (2021). Analyzing the Loss and the Recovery of Consciousness: Functional Connectivity Patterns and Changes in Heart Rate Variability During Propofol-Induced Anesthesia. Frontiers in systems neuroscience, 15652080. https://doi.org/10.3389/fnsys.2021.652080
Sattin, Davide, et al. "Analyzing the Loss and the Recovery of Consciousness: Functional Connectivity Patterns and Changes in Heart Rate Variability During Propofol-Induced Anesthesia." Frontiers in systems neuroscience vol. 15 (2021): 652080. doi: https://doi.org/10.3389/fnsys.2021.652080
Sattin D, Duran D, Visintini S, Schiaffi E, Panzica F, Carozzi C, Rossi Sebastiano D, Visani E, Tobaldini E, Carandina A, Citterio V, Magnani FG, Cacciatore M, Orena E, Montano N, Caldiroli D, Franceschetti S, Picozzi M, Matilde L. Analyzing the Loss and the Recovery of Consciousness: Functional Connectivity Patterns and Changes in Heart Rate Variability During Propofol-Induced Anesthesia. Front Syst Neurosci. 2021 Apr 06;15:652080. doi: 10.3389/fnsys.2021.652080. eCollection 2021. PMID: 33889078; PMCID: PMC8055941.
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Front Syst Neurosci. 2021 Apr 06;15:652080. doi: 10.3389/fnsys.2021.652080. eCollection 2021.

Analyzing the Loss and the Recovery of Consciousness: Functional Connectivity Patterns and Changes in Heart Rate Variability During Propofol-Induced Anesthesia.

Frontiers in systems neuroscience

Davide Sattin, Dunja Duran, Sergio Visintini, Elena Schiaffi, Ferruccio Panzica, Carla Carozzi, Davide Rossi Sebastiano, Elisa Visani, Eleonora Tobaldini, Angelica Carandina, Valeria Citterio, Francesca Giulia Magnani, Martina Cacciatore, Eleonora Orena, Nicola Montano, Dario Caldiroli, Silvana Franceschetti, Mario Picozzi, Leonardi Matilde

Affiliations

  1. Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  2. Clinical and Experimental Medicine and Medical Humanities-PhD Program, Insubria University, Varese, Italy.
  3. Clinical and Experimental Epileptology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  4. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  5. Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  6. Clinical Engineering Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  7. Department of Anaesthesia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
  8. Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
  9. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
  10. Center for Clinical Ethics, Biotechnology and Life Sciences Department, Insubria University, Varese, Italy.

PMID: 33889078 PMCID: PMC8055941 DOI: 10.3389/fnsys.2021.652080

Abstract

The analysis of the central and the autonomic nervous systems (CNS, ANS) activities during general anesthesia (GA) provides fundamental information for the study of neural processes that support alterations of the consciousness level. In the present pilot study, we analyzed EEG signals and the heart rate (HR) variability (HRV) in a sample of 11 patients undergoing spinal surgery to investigate their CNS and ANS activities during GA obtained with propofol administration. Data were analyzed during different stages of GA: baseline, the first period of anesthetic induction, the period before the loss of consciousness, the first period after propofol discontinuation, and the period before the recovery of consciousness (ROC). In EEG spectral analysis, we found a decrease in posterior alpha and beta power in all cortical areas observed, except the occipital ones, and an increase in delta power, mainly during the induction phase. In EEG connectivity analysis, we found a significant increase of local efficiency index in alpha and delta bands between baseline and loss of consciousness as well as between baseline and ROC in delta band only and a significant reduction of the characteristic path length in alpha band between the baseline and ROC. Moreover, connectivity results showed that in the alpha band there was mainly a progressive increase in the number and in the strength of incoming connections in the frontal region, while in the beta band the parietal region showed mainly a significant increase in the number and in the strength of outcoming connections values. The HRV analysis showed that the induction of anesthesia with propofol was associated with a progressive decrease in complexity and a consequent increase in the regularity indexes and that the anesthetic procedure determined bradycardia which was accompanied by an increase in cardiac sympathetic modulation and a decrease in cardiac parasympathetic modulation during the induction. Overall, the results of this pilot study showed as propofol-induced anesthesia caused modifications on EEG signal, leading to a "rebalance" between long and short-range cortical connections, and had a direct effect on the cardiac system. Our data suggest interesting perspectives for the interactions between the central and autonomic nervous systems for the modulation of the consciousness level.

Copyright © 2021 Sattin, Duran, Visintini, Schiaffi, Panzica, Carozzi, Rossi Sebastiano, Visani, Tobaldini, Carandina, Citterio, Magnani, Cacciatore, Orena, Montano, Caldiroli, Franceschetti, Picozzi and Matilde.

Keywords: anesthesia; connectivity; consciousness; heart rate variability; propofol

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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