丙泊酚诱导的中度深度镇静可调节小儿神经活动:功能连接性研究

iRadiology Pub Date : 2024-12-05 DOI:10.1002/ird3.110
Qiang Zheng, Yiyu Zhang, Lin Zhang, Jian Wang, Jungang Liu
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引用次数: 0

摘要

背景以往的研究已经证实了成人全身麻醉时潜在的神经生理机制。然而,异丙酚诱导的中深度镇静(PMDS)调节儿童神经活动的机制尚不清楚,因此本研究基于功能磁共振成像(fMRI)进行了研究。方法41例儿童(5.10±1.14岁,男/女21/20)采用功能磁共振成像(fMRI)构建功能连接网络(FCN)。对镇静组(21例)和清醒组(20例)的网络通信、图论性质和网络枢纽识别进行统计学分析(t检验和Bonferroni校正)。所有相关分析均建立在全脑FCN和7个子网络上,包括默认模式网络(DMN)、背侧注意网络(DAN)、显著性网络(SAN)、听觉网络(AUD)、视觉网络(VIS)、皮质下网络(SUB)和其他网络(other)。结果在PMDS治疗下,视觉区、视觉区和视觉区之间以及颞叶、边缘系统和皮层下组织区域之间的网络通信明显减少。然而,没有观察到丘脑相关通讯的显著减少。镇静组大多数图论性质显著降低,DMN的所有图形特征均有显著组间差异。顶叶上皮层具有不同的神经功能,是受影响不大的网络中枢。结论虽然PMDS下儿童的神经活动水平下降,但与丘脑相关的关键通信得以维持,网络中枢顶叶上皮层保持活跃,这突出了临床实践表明PMDS下的人体仍然可以感知外部刺激,并且可以被声音或触摸唤醒。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Propofol-Induced Moderate–Deep Sedation Modulates Pediatric Neural Activity: A Functional Connectivity Study

Propofol-Induced Moderate–Deep Sedation Modulates Pediatric Neural Activity: A Functional Connectivity Study

Background

Previous studies have demonstrated the underlying neurophysiologic mechanism during general anesthesia in adults. However, the mechanism of propofol-induced moderate–deep sedation (PMDS) in modulating pediatric neural activity remains unknown, which therefore was investigated in the present study based on functional magnetic resonance imaging (fMRI).

Methods

A total of 41 children (5.10 ± 1.14 years, male/female 21/20) with fMRI were employed to construct the functional connectivity network (FCN). The network communication, graph-theoretic properties, and network hub identification were statistically analyzed (t test and Bonferroni correction) between sedation (21 children) and awake (20 children) groups. All involved analyses were established on the whole-brain FCN and seven sub-networks, which included the default mode network (DMN), dorsal attentional network (DAN), salience network (SAN), auditory network (AUD), visual network (VIS), subcortical network (SUB), and other networks (Other).

Results

Under PMDS, significant decreases in network communication were observed between SUB-VIS, SUB-DAN, and VIS-DAN, and between brain regions from the temporal lobe, limbic system, and subcortical tissues. However, no significant decrease in thalamus-related communication was observed. Most graph-theoretic properties were significantly decreased in the sedation group, and all graphical features of the DMN showed significant group differences. The superior parietal cortex with different neurological functions was identified as a network hub that was not greatly affected.

Conclusions

Although the children had a depressed level of neural activity under PMDS, the crucial thalamus-related communication was maintained, and the network hub superior parietal cortex stayed active, which highlighted clinical practices that the human body under PMDS is still perceptible to external stimuli and can be awakened by sound or touch.

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