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  Effects of propofol anesthesia on the processing of noxious stimuli in the spinal cord and the brain

Lichtner, G., Auksztulewicz, R., Kirilina, E., Velten, H., Mavrodis, D., Scheel, M., et al. (2018). Effects of propofol anesthesia on the processing of noxious stimuli in the spinal cord and the brain. NeuroImage, 172, 642-653. doi:10.1016/j.neuroimage.2018.02.003.

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Lichtner, Gregor1, Autor
Auksztulewicz, Ryszard2, Autor
Kirilina, Evgeniya3, 4, Autor           
Velten, Helena1, Autor
Mavrodis, Dionysios1, Autor
Scheel, Michael5, Autor
Blankenburg, Felix3, Autor
von Dincklage, Falk1, Autor
Affiliations:
1Charité University Medicine Berlin, Germany, ou_persistent22              
2Department of Biomedical Sciences, City University of Hong Kong, China, ou_persistent22              
3Neurocomputation and Neuroimaging Unit, FU Berlin, Germany, ou_persistent22              
4Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              
5Berlin Institute of Health (BIH), Germany, ou_persistent22              

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Schlagwörter: Nociception; General anesthesia; Propofol; Unconsciousness; Pain; Nociceptive flexion reflex
 Zusammenfassung: Drug-induced unconsciousness is an essential component of general anesthesia, commonly attributed to attenuation of higher-order processing of external stimuli and a resulting loss of information integration capabilities of the brain. In this study, we investigated how the hypnotic drug propofol at doses comparable to those in clinical practice influences the processing of somatosensory stimuli in the spinal cord and in primary and higher-order cortices. Using nociceptive reflexes, somatosensory evoked potentials and functional magnet resonance imaging (fMRI), we found that propofol abolishes the processing of innocuous and moderate noxious stimuli at low to medium concentration levels, but that intense noxious stimuli evoked spinal and cerebral responses even during deep propofol anesthesia that caused profound electroencephalogram (EEG) burst suppression. While nociceptive reflexes and somatosensory potentials were affected only in a minor way by further increasing doses of propofol after the loss of consciousness, fMRI showed that increasing propofol concentration abolished processing of intense noxious stimuli in the insula and secondary somatosensory cortex and vastly increased processing in the frontal cortex. As the fMRI functional connectivity showed congruent changes with increasing doses of propofol – namely the temporal brain areas decreasing their connectivity with the bilateral pre-/postcentral gyri and the supplementary motor area, while connectivity of the latter with frontal areas is increased – we conclude that the changes in processing of noxious stimuli during propofol anesthesia might be related to changes in functional connectivity.

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Sprache(n): eng - English
 Datum: 2017-09-272018-02-022018-02-052018-05-15
 Publikationsstatus: Erschienen
 Seiten: -
 Ort, Verlag, Ausgabe: -
 Inhaltsverzeichnis: -
 Art der Begutachtung: Expertenbegutachtung
 Identifikatoren: DOI: 10.1016/j.neuroimage.2018.02.003
PMID: 29421324
Anderer: Epub 2018
 Art des Abschluß: -

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Projektname : -
Grant ID : DI1579/4-1
Förderprogramm : -
Förderorganisation : German Research Foundation (DFG)

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Titel: NeuroImage
Genre der Quelle: Zeitschrift
 Urheber:
Affiliations:
Ort, Verlag, Ausgabe: Orlando, FL : Academic Press
Seiten: - Band / Heft: 172 Artikelnummer: - Start- / Endseite: 642 - 653 Identifikator: ISSN: 1053-8119
CoNE: https://pure.mpg.de/cone/journals/resource/954922650166