MAR 15, 2018 7:30 AM PDT

Keynote Presentation: The Dynamics of the Unconscious Brain Under General Anesthesia

Presented at: Neuroscience 2018
Speaker
  • Warren M. Zapol Prof. of Anaesthesia Harvard Medical School, Prof. of Computational Neuroscience MIT, Director, Neuroscience Statistics Research Laboratory, Anesthetist, Massachusetts General
    Biography
      Emery N. Brown, M.D., Ph.D. is the Warren M. Zapol Professor of Anaesthesia at Harvard Medical School, a Professor of Computational Neuroscience at the Massachusetts Institute of Technology and a Professor of Health Sciences and Technology at the Harvard-MIT Division of Health Sciences and Technology. Brown is the Director of the Neuroscience Statistics Research Laboratory at the Massachusetts Institute of Technology, the co-director of the Harvard-MIT Division of Health Sciences and Technology and an associate director of M.I.T.'s Institute for Medical Engineering & Science.[1] Brown also works as a doctor in the department of anesthesiology, critical care and pain medicine at Massachusetts General Hospital.[2] In 2007, Brown was one of the recipients of the National Institutes of Health Director's Pioneer Award.[3] Brown is a fellow of the American Academy of Arts and Sciences, the Institute of Electrical and Electronics Engineers and the American Association for the Advancement of Science.

    Abstract

    General anesthesia is a drug-induced, reversible condition comprised of five behavioral states: unconsciousness, amnesia (loss of memory), analgesia (loss of pain sensation), akinesia (immobility), and hemodynamic stability with control of the stress response. Our work shows that a primary mechanism through which anesthetics create these altered states of arousal is by initiating and maintaining highly structured oscillations. These oscillations impair communication among brain regions. We illustrate these impressive dynamics by presenting findings from our human studies of general anesthesia using high-density EEG recordings and intracranial recordings. These studies have allowed us to give a detailed characterization of the neurophysiology of loss and recovery of consciousness due to propofol. We show how the oscillatory dynamics change systematically with different anesthetic classes and with age. The age-related changes reflect brain development in children and brain aging in adults. Finally, we demonstrate that the state of general anesthesia can be rapidly reversed by activating specific brain circuits. The success of our research has depended critically on tight coupling of experiments, signal processing research and mathematical modeling. These new insights into the mechanisms of anesthetic action suggest new strategies for using the EEG to monitor the brain states of patients receiving general anesthesia, more principled strategies to dose anesthetics and new approaches to using studies of general anesthesia to gain new, fundamental insights into how the brain works. 


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