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

Cornelissen L, Kim SE, Purdon PL, Brown EN, Berde CB - Elife (2015)

Bottom Line: 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.We demonstrate the need to apply age-adjusted analytic approaches to develop neurophysiologic-based strategies for pediatric anesthetic state monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, United States.

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.

No MeSH data available.


Frontal predominance of alpha power is low during MOSSA in infants 0–6 months of age.Frontal group-median power spectra (solid line, median; shaded area, 25th–75th percentile) showing similar EEG power across all frequencies in frontal and occipital channels in infants aged (A) 0–3 months (n = 11) and (B) 4–6 months (n = 19). Differences in frontal group-median power spectra presented with 95% CI from bootstrap analysis (pink line, 97.5th percentile; green line, 2.5th percentile) between frontal and occipital channels during MOSSA in infants aged (C–F) 0–3 months and (G–J) 4–6 months. A small but significant increase in frontal alpha power compared to occipital alpha power begins to emerge at 4–6 months of age. FPz and Oz electrodes presented using nearest neighbor Laplacian referencing.DOI:http://dx.doi.org/10.7554/eLife.06513.011
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fig7: Frontal predominance of alpha power is low during MOSSA in infants 0–6 months of age.Frontal group-median power spectra (solid line, median; shaded area, 25th–75th percentile) showing similar EEG power across all frequencies in frontal and occipital channels in infants aged (A) 0–3 months (n = 11) and (B) 4–6 months (n = 19). Differences in frontal group-median power spectra presented with 95% CI from bootstrap analysis (pink line, 97.5th percentile; green line, 2.5th percentile) between frontal and occipital channels during MOSSA in infants aged (C–F) 0–3 months and (G–J) 4–6 months. A small but significant increase in frontal alpha power compared to occipital alpha power begins to emerge at 4–6 months of age. FPz and Oz electrodes presented using nearest neighbor Laplacian referencing.DOI:http://dx.doi.org/10.7554/eLife.06513.011

Mentions: We evaluated the potential frontal predominance of alpha power by assessing power spectra differences between frontal (FPz) and occipital (Oz) electrodes for infants 0–3 months of age (Figure 7A,C–F) and for infants 4–6 months of age (Figure 7B,G–J). During MOSSA, there were no significant frontal-occipital power differences at any frequency in infants at 0–3 months (95% CI, paired bootstrap analysis) (Figure 7C–F). In contrast, a small but significant increase in frontal alpha power compared to occipital power (95% CI, paired bootstrap analysis) was present during MOSSA in infants 4–6 months of age (Figure 7G–J). These data suggest, that unlike in adults, infants 0–3 months of age do not show frontal predominance of alpha power during MOSSA, and that it may begin to emerge at around 4 months postnatal age (Ní Mhuircheartaigh et al., 2013; Purdon et al., 2013).10.7554/eLife.06513.011Figure 7.Frontal predominance of alpha power is low during MOSSA in infants 0–6 months of age.


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

Cornelissen L, Kim SE, Purdon PL, Brown EN, Berde CB - Elife (2015)

Frontal predominance of alpha power is low during MOSSA in infants 0–6 months of age.Frontal group-median power spectra (solid line, median; shaded area, 25th–75th percentile) showing similar EEG power across all frequencies in frontal and occipital channels in infants aged (A) 0–3 months (n = 11) and (B) 4–6 months (n = 19). Differences in frontal group-median power spectra presented with 95% CI from bootstrap analysis (pink line, 97.5th percentile; green line, 2.5th percentile) between frontal and occipital channels during MOSSA in infants aged (C–F) 0–3 months and (G–J) 4–6 months. A small but significant increase in frontal alpha power compared to occipital alpha power begins to emerge at 4–6 months of age. FPz and Oz electrodes presented using nearest neighbor Laplacian referencing.DOI:http://dx.doi.org/10.7554/eLife.06513.011
© Copyright Policy
Related In: Results  -  Collection

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fig7: Frontal predominance of alpha power is low during MOSSA in infants 0–6 months of age.Frontal group-median power spectra (solid line, median; shaded area, 25th–75th percentile) showing similar EEG power across all frequencies in frontal and occipital channels in infants aged (A) 0–3 months (n = 11) and (B) 4–6 months (n = 19). Differences in frontal group-median power spectra presented with 95% CI from bootstrap analysis (pink line, 97.5th percentile; green line, 2.5th percentile) between frontal and occipital channels during MOSSA in infants aged (C–F) 0–3 months and (G–J) 4–6 months. A small but significant increase in frontal alpha power compared to occipital alpha power begins to emerge at 4–6 months of age. FPz and Oz electrodes presented using nearest neighbor Laplacian referencing.DOI:http://dx.doi.org/10.7554/eLife.06513.011
Mentions: We evaluated the potential frontal predominance of alpha power by assessing power spectra differences between frontal (FPz) and occipital (Oz) electrodes for infants 0–3 months of age (Figure 7A,C–F) and for infants 4–6 months of age (Figure 7B,G–J). During MOSSA, there were no significant frontal-occipital power differences at any frequency in infants at 0–3 months (95% CI, paired bootstrap analysis) (Figure 7C–F). In contrast, a small but significant increase in frontal alpha power compared to occipital power (95% CI, paired bootstrap analysis) was present during MOSSA in infants 4–6 months of age (Figure 7G–J). These data suggest, that unlike in adults, infants 0–3 months of age do not show frontal predominance of alpha power during MOSSA, and that it may begin to emerge at around 4 months postnatal age (Ní Mhuircheartaigh et al., 2013; Purdon et al., 2013).10.7554/eLife.06513.011Figure 7.Frontal predominance of alpha power is low during MOSSA in infants 0–6 months of age.

Bottom Line: 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.We demonstrate the need to apply age-adjusted analytic approaches to develop neurophysiologic-based strategies for pediatric anesthetic state monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, United States.

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.

No MeSH data available.