Age-dependent electroencephalogram (EEG) patterns during sevoflurane general anesthesia in infants

Abstract

Electroencephalogram (EEG) approaches may provide important information about developmental changes in brain-state dynamics during general anesthesia. We used multi-electrode EEG, analyzed with multitaper spectral methods and video recording of body movement to characterize the spatio-temporal dynamics of brain activity in 36 infants 0–6 months old when awake, and during maintenance of and emergence from sevoflurane general anesthesia. During maintenance: (1) slow-delta oscillations were present in all ages; (2) theta and alpha oscillations emerged around 4 months; (3) unlike adults, all infants lacked frontal alpha predominance and coherence. Alpha power was greatest during maintenance, compared to awake and emergence in infants at 4–6 months. During emergence, theta and alpha power decreased with decreasing sevoflurane concentration in infants at 4–6 months. These EEG dynamic differences are likely due to developmental factors including regional differences in synaptogenesis, glucose metabolism, and myelination across the cortex. We demonstrate the need to apply age-adjusted analytic approaches to develop neurophysiologic-based strategies for pediatric anesthetic state monitoring.DOI: http://dx.doi.org/10.7554/eLife.06513.001

Pilot study of EEG in neonates born to mothers with gestational diabetes mellitus

“…The low frequency range is the dominant rhythm in infants up to 1 year of age. This was also observed in newborns of 0-3 months or 4-6 months of age (Cornelissen et al, 2015), however, no significant frontooccipital power differences were found at any frequency in infants at 0-3 months of age (Cornelissen et al, 2015). This result supports that coherence patterns differ between brain regions at birth, since coherence was higher in the frontal vs. occipital region of the brain.…”

Thalamocortical synchronization during induction and emergence from propofol-induced unconsciousness

“…Spectrograms were computed with the multitaper method (18) (Code available at Chronux). To assess statistical significance for the difference in spectra at each frequency, we computed the 99% confidence intervals by using a published bootstrap algorithm (58,59). Only the frequencies whose confidence intervals did not include zero within at least one complete bandwidth unit (3 Hz for spectra and 1.5 Hz for coherence) were considered to be statistically significant (SI Materials and Methods).…”

Electroencephalographic discontinuity during sevoflurane anesthesia in infants and children

“…Most pediatric EEG studies have been performed with a limited number of EEG channels, or with variability in types of montages and analytical methods used; few have evaluated EEG in the first year of life (7)(8)(9)(10)(11)(12)(13)(14). Spatial and temporal aspects of discontinuity events and clinical correlates have not been studied in detail.…”