This study clearly indicates that memory is related to the depth of hypnosis. The observed memory performance should be interpreted in terms of implicit memory. Auditory information processing occurred at bispectral index levels between 60 and 40.

Recently we introduced a robust measure, integrated local correlation (ILC), of local connectivity in the brain using fMRI data which reflects the temporal correlation of brain activity in every voxel neighborhood. The current work studies ILC in fMRI data obtained in the absence and presence of sevoflurane anesthesia (0%, 2%, and 1% end-tidal concentration, respectively) administered to healthy volunteers. ILC was determined specifically in regions of the default mode network (DMN) to address local changes in each state. In addition, a potential confound in analyses based on correlations due to signal-to-noise variations was addressed by wavelet denoising. This accommodated decreases in signal power commonly seen during anesthesia without artificially reducing derived correlations. Results showed that ILC was significantly reduced in the entire DMN during 2% sevoflurane yet recovered in the posterior and anterior cingulate cortices as well as inferior parietal cortex during 1% sevoflurane. By contrast, ILC remained attenuated prefrontally in the 1% condition, which indicates uncoupling of the frontal areas of DMN during light anesthesia. These results confirm widespread anesthetic-induced cortical suppression but also demonstrate that the local connectivity of the prefrontal cortex is rapidly reduced by sevoflurane. It remains to be seen whether these alterations arise locally as a direct consequence of anesthetic action on local neurons or are driven by distant changes in oscillations and activity elsewhere in the brain.

Although persons with dementia (PWD) and their family caregivers need in-home support for common neuropsychiatric symptoms (NPS), few if any assistive technologies are available to help manage NPS. This implementation study tested the feasibility and adoption of a touch screen technology, the Companion, that delivers psychosocial, nondrug interventions to PWD in their home to address individual NPS and needs. Interventions were personalized and delivered in-home for a minimum of 3 weeks. Post-intervention measures indicated the technology was easy to use, significantly facilitated meaningful and positive engagement, and simplified caregivers’ daily lives. Although intervention goals were met, caregivers had high expectations of their loved-one’s ability to regain independence. Care recipients used the system independently, but were limited by cognitive and physical impairments. We conclude the Companion can help manage NPS and offer caregiver respite at home. These data provide important guidance for design and deployment of care technology for the home.

The incidence of awareness is underestimated when conscious recall is taken as evidence. Awareness can be monitored on-line with behavioral and modern neurophysiologic measures. Providing feedback during intra-anesthetic awareness helps patients to cope with a potentially stressful situation.

Sevoflurane induces dose-dependent suppression of auditory blood oxygenation level-dependent signals, which likely limits the ability of words to be processed during anesthesia and compromises memory.