Aperçu: G.M.
Les
études de connectivité fonctionnelle jouent un rôle important dans la
compréhension de la relation entre les connexions réseau et le phénotype
comportemental des personnes avec un trouble envahissant du développement (TED).
L'anesthésie
générale est un facteur de confusion dans les études d'imagerie
fonctionnelle en raison de son effet sur la connectivité fonctionnelle. L'objectif
de cette étude est d'examiner la connectivité fonctionnelle de l'état
de repos (RS-FC) sous anesthésie de sévoflurane chez des personnes avec TED.
Les données des sujets ont été comparées aux données de seize témoins sans TED non anesthésiés.
Un total de 13 patients a été étudié. Six
réseaux ont été étudiés, le réseau de mode par défaut (DMN), le réseau
de contrôle exécutif (ECN), le réseau de salience (SN) ainsi que les
réseaux auditifs, visuels et sensori-moteurs.
Les rapports précédents ont suggéré que même des niveaux d'anesthésie
légers pourraient réduire les niveaux globaux de fluctuation dans les
principaux réseaux de cerveau tels que DMN et ECN. Cependant, ces résultats fournissent des preuves solides que ces
réseaux peuvent supporter des niveaux d'activité détectables chez les
patients avec TED, même avec des niveaux profonds d'anesthésie.
Brain Connect. 2017 Apr 26. doi: 10.1089/brain.2016.0448.
Brain Resting State Functional Connectivity is preserved under Sevoflurane Anesthesia in patients with Pervasive Developmental disorders - a pilot study
Venkat Raghavan L1, Bharadwaj S2, Wourms V3, Tan A4, Jurkiewicz MT5, Mikulis DJ6, Crawley AP7.
Author information
- 1
- Toronto Western Hospital, 26625, Department of Anesthesia , 399 Bathurst Street , Toronto, Canada , M5T 2S8 ; lashmi.venkatraghavan@uhn.on.ca.
- 2
- Toronto Western Hospital, 26625, Department of Anesthesia, Toronto, Canada ; acharya.suparna@gmail.com.
- 3
- University of Manitoba, 8664, Anesthesia, Winnipeg, Manitoba, Canada ; vpw130@mail.usask.ca.
- 4
- King\'s College Hospital NHS Foundation Trust, 8948, Anesthesia, London, London, United Kingdom of Great Britain and Northern Ireland ; audreytan@me.com.
- 5
- Hospital of the University of Pennsylvia, Division of Neuroradiology, Department of Radiology, Philadelphia, Pennsylvania, United States ; Michael.Jurkiewicz@utorotnto.ca.
- 6
- Toronto Western Hospital, 26625, Joint Department of Medical imaging, Toronto, Canada ; mikulis@mac.com.
- 7
- Toronto Western Hospital, 26625, Joint Department of Medical imaging, Toronto, Ontario, Canada ; crawley@uhnres.utoronto.ca.
Abstract
Background
Functional connectivity studies play a huge role in understanding the
relationship between the network connections and the behavioral
phenotype of patients with Pervasive developmental disorders (PDD).
However, some patients with PDD may not tolerate the imaging procedure
while awake and they often need general anesthesia. General anesthesia
is a confounding factor in functional imaging studies due to its effect
on the functional connectivity. The objective of this study is to look
at the resting state functional connectivity (RS-FC) under sevoflurane
anesthesia in patients with pervasive developmental disorders. Method
Adults with PDD scheduled for MRI of the brain under general anesthesia
were recruited for the study. Resting state fMRI scans were acquired in
all patients on a 3-Tesla scanner at 1 Minimum Alveolar Concentration
(MAC) of sevoflurane. During the study period, end-tidal carbon dioxide
and blood pressure were maintained at baseline value. Spontaneous BOLD
fluctuations were measured, and a seed-voxel analysis done to identify
the resting state networks. Subjects' data were compared with data from
sixteen non-anesthetised healthy controls.. Results A total of 13
patients was studied. Six networks were investigated, the default mode
network (DMN), executive control network (ECN), salience network (SN) as
well as the auditory, visual and sensorimotor networks. At 1 MAC
sevoflurane anesthesia, RS-FC was preserved in all the networks.
Secondary analysis of connectivity showed a decrease in connectivity
within the thalamus and an increase in DMN-ECN and DMN-SN cross-network
connectivity in the anesthetized patient group compared to healthy
controls. Conclusion Previous reports suggested that even mild levels of
anesthesia could reduce overall fluctuation levels in major brain
networks such as the DMN and ECN. However, our results provide strong
evidence that these networks can sustain detectable levels of activity
in patients with pervasive developmental disorders even under deep
levels of anesthesia.
KEYWORDS:
Anesthesiology; Autism; Default mode network; Resting-state functional connectivity magnetic resonance imaging (R-fMRI)- PMID: 28443736
- DOI: 10.1089/brain.2016.0448
