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Chamadia S, Gitlin J, Mekonnen J, et al. Ketamine induces EEG oscillations that may aid anesthetic state but not dissociation monitoring. Clin Neurophysiol. 2021;132(12):3010-3018doi: 10.1016/j.clinph.2021.08.021.
Chamadia, S., Gitlin, J., Mekonnen, J., Ethridge, B. R., Ibala, R., Colon, K. M., Qu, J., & Akeju, O. (2021). Ketamine induces EEG oscillations that may aid anesthetic state but not dissociation monitoring. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 132(12), 3010-3018. https://doi.org/10.1016/j.clinph.2021.08.021
Chamadia, Shubham, et al. "Ketamine induces EEG oscillations that may aid anesthetic state but not dissociation monitoring." Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology vol. 132,12 (2021): 3010-3018. doi: https://doi.org/10.1016/j.clinph.2021.08.021
Chamadia S, Gitlin J, Mekonnen J, Ethridge BR, Ibala R, Colon KM, Qu J, Akeju O. Ketamine induces EEG oscillations that may aid anesthetic state but not dissociation monitoring. Clin Neurophysiol. 2021 Dec;132(12):3010-3018. doi: 10.1016/j.clinph.2021.08.021. Epub 2021 Oct 08. PMID: 34715426; PMCID: PMC8629941.
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Clin Neurophysiol. 2021 Dec;132(12):3010-3018. doi: 10.1016/j.clinph.2021.08.021. Epub 2021 Oct 08.

Ketamine induces EEG oscillations that may aid anesthetic state but not dissociation monitoring.

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

Shubham Chamadia, Jacob Gitlin, Jennifer Mekonnen, Breanna R Ethridge, Reine Ibala, Katia M Colon, Jason Qu, Oluwaseun Akeju

Affiliations

  1. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
  2. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA. Electronic address: [email protected].

PMID: 34715426 PMCID: PMC8629941 DOI: 10.1016/j.clinph.2021.08.021

Abstract

OBJECTIVE: Ketamine is an anesthetic drug associated with dissociation. Decreased electroencephalogram alpha (8-13 Hz) and low-beta (13-20 Hz) oscillation power have been associated with ketamine-induced dissociation. We aimed to characterize surface electroencephalogram signatures that may serve as biomarkers for dissociation.

METHODS: We analyzed data from a single-site, open-label, high-density surface electroencephalogram study of ketamine anesthesia (2 mg/kg, n = 15). We assessed dissociation longitudinally using the Clinician Administered Dissociation States Scale (CADSS) and administered midazolam to attenuate dissociation and enable causal inference. We analyzed electroencephalogram power and global coherence with multitaper spectral methods. Mixed effects models were used to assess whether power and global coherence signatures of ketamine could be developed into dissociation-specific biomarkers.

RESULTS: Compared to baseline, ketamine unresponsiveness was associated with increased frontal power between 0.5 to 9.3 Hz, 12.2 to 16.6 Hz, and 24.4 to 50 Hz. As subjects transitioned into a responsive but dissociated state (mean CADSS ± SD, 22.1 ± 17), there was a decrease in power between 0.5 to 10.3 Hz and 11.7 to 50 Hz. Midazolam reduced dissociation scores (14.3 ± 11.6), decreased power between 4.4 to 11.7 Hz and increased power between 14.2 to 50 Hz. Our mixed-effects model demonstrated a quadratic relationship between time and CADSS scores. When models (frontal power, occipital power, global coherence) were reanalyzed with midazolam and electroencephalogram features as covariates, only midazolam was retained.

CONCLUSIONS: Ketamine is associated with structured electroencephalogram power and global coherence signatures that may enable principled anesthetic state but not dissociation monitoring.

SIGNIFICANCE: A neurophysiological biomarker for dissociation may lead to a better understanding of neuropsychiatric disorders.

Copyright © 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Keywords: CADSS; Dissociation; EEG; Ketamine; Spectral

Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: OA has received speaker's honor

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