1. Electroencephalographic features of discontinuous activity in anesthetized infants and children
- Author
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Charles B. Berde, Uday Agrawal, and Laura Cornelissen
- Subjects
Male ,Younger age ,Physiology ,General Anesthesia ,Electroencephalography ,Classification of discontinuities ,Audiology ,Families ,0302 clinical medicine ,030202 anesthesiology ,Anesthesiology ,Medicine and Health Sciences ,Anesthesia ,Child ,Children ,Clinical Neurophysiology ,Anesthesiology Monitoring ,Brain Mapping ,Multidisciplinary ,medicine.diagnostic_test ,Pharmaceutics ,Brain ,Drugs ,Electrophysiology ,Bioassays and Physiological Analysis ,Brain Electrophysiology ,Engineering and Technology ,Medicine ,Female ,Propofol ,Infants ,Infant, Premature ,medicine.drug ,Research Article ,medicine.medical_specialty ,Brain development ,Imaging Techniques ,Science ,Neurophysiology ,Neuroimaging ,Anesthesia, General ,Research and Analysis Methods ,03 medical and health sciences ,Discontinuity (geotechnical engineering) ,Drug Therapy ,Multitaper ,medicine ,Humans ,Pain Management ,Electrodes ,Retrospective Studies ,Anesthetics ,Pharmacology ,business.industry ,Electrophysiological Techniques ,Infant, Newborn ,Infant ,Biology and Life Sciences ,Age Groups ,Anesthetic ,People and Places ,Population Groupings ,Clinical Medicine ,Electronics ,business ,030217 neurology & neurosurgery ,Neuroscience - Abstract
BackgroundDiscontinuous electroencephalographic activity in children is thought to reflect brain inactivation. Discontinuity has been observed in states of pathology, where it is predictive of adverse neurological outcome, as well as under general anesthesia. Though in preterm-infants discontinuity reflects normal brain development, less is known regarding its role in term children, particularly in the setting of general anesthesia. Here, we conduct a post-hoc exploratory analysis to investigate the spectral features of discontinuous activity in children under general anesthesia.MethodsWe previously recorded electroencephalography in children less than forty months of age under general anesthesia (n = 65). We characterized the relationship between age, anesthetic depth, and discontinuous activity, and used multitaper spectral methods to compare the power spectra of subjects with (n = 35) and without (n = 30) discontinuous activity. In the subjects with discontinuous activity, we examined the amplitude and power spectra associated with the discontinuities and analyzed how these variables varied with age.ResultsCumulative time of discontinuity was associated with increased anesthetic depth and younger age. In particular, age-matched children with discontinuity received higher doses of propofol during induction as compared with children without discontinuity. In the tens of seconds preceding the onset of discontinuous activity, there was a decrease in high-frequency power in children four months and older that could be visually observed with spectrograms. During discontinuous activity, there were distinctive patterns of amplitude, spectral edge, and power in canonical frequency bands that varied with age. Notably, there was a decline in spectral edge in the seconds immediately following each discontinuity.ConclusionDiscontinuous activity in children reflects a state of a younger or more deeply anesthetized brain, and characteristic features of discontinuous activity evolve with age and may reflect neurodevelopment.
- Published
- 2019