title: Neural correlates of consciousness during general anesthesia using functional magnetic resonance imaging (fMRI).
abstract: This paper reviews the current knowledge about the mechanisms of anesthesia-induced alteration of consciousness. It is now evident that hypnotic anesthetic agents have specific brain targets whose function is hierarchically altered in a dose-dependent manner. Higher order networks, thought to be involved in mental content generation, as well as sub-cortical networks involved in thalamic activity regulation seems to be affected first by increasing concentrations of hypnotic agents that enhance inhibitory neurotransmission. Lower order sensory networks are preserved, including thalamo-cortical connectivity into those networks, even at concentrations that suppress responsiveness, but cross-modal sensory interactions are inhibited. Thalamo-cortical connectivity into the consciousness networks decreases with increasing concentrations of those agents, and is transformed into an anti-correlated activity between the thalamus and the cortex for the deepest levels of sedation, when the subject is non responsive. Future will tell us whether these brain function alterations are also observed with hypnotic agents that mainly inhibit excitatory neurotransmission. The link between the observations made using fMRI and the identified biochemical targets of hypnotic anesthetic agents still remains to be identified.
authors.affiliation: University Department of Anesthesia and ICM, CHR Citadelle, Liege, Belgium. vincent.bonhomme@chu.ulg.ac.be
authors.forename: V
authors.initials: V
authors.lastname: Bonhomme
authors.forename: P
authors.initials: P
authors.lastname: Boveroux
authors.forename: J F
authors.initials: JF
authors.lastname: Brichant
authors.forename: S
authors.initials: S
authors.lastname: Laureys
authors.forename: M
authors.initials: M
authors.lastname: Boly
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D000777:Anesthetics / Q000494:pharmacology; D001921:Brain / Q000098:blood supply* / Q000187:drug effects; D001931:Brain Mapping; D003243:Consciousness / Q000187:drug effects / Q000502:physiology*; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D010100:Oxygen / Q000097:blood
chemical_list: D000777:Anesthetics; D010100:Oxygen