A Comparison of Propofol- and Dexmedetomidine-induced Electroencephalogram Dynamics Using Spectral and Coherence Analysis

• Main Authors: Akeju, Oluwaseun (Author), Pavone, Kara J. (Author), Westover, M. Brandon (Author), Vazquez, Rafael (Author), Prerau, Michael J. (Author), Harrell, Priscilla G. (Author), Hartnack, Katharine E. (Author), Rhee, James (Author), Sampson, Aaron L. (Author), Habeeb, Kathleen (Author), Lei, Gao (Author), Pierce, Eric T. (Author), Walsh, John L. (Author), Brown, Emery N. (Contributor), Purdon, Patrick Lee (Contributor)
• Other Authors: Institute for Medical Engineering and Science (Contributor), Harvard University- (Contributor), Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences (Contributor), Picower Institute for Learning and Memory (Contributor)
• Format: Article
• Language: English
• Published: Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2016-04-29T21:02:12Z.
• Subjects: Article
• Online Access: Get fulltext

Background:: Electroencephalogram patterns observed during sedation with dexmedetomidine appear similar to those observed during general anesthesia with propofol. This is evident with the occurrence of slow (0.1 to 1 Hz), delta (1 to 4 Hz), propofol-induced alpha (8 to 12 Hz), and dexmedetomidine-induced spindle (12 to 16 Hz) oscillations. However, these drugs have different molecular mechanisms and behavioral properties and are likely accompanied by distinguishing neural circuit dynamics. Methods:: The authors measured 64-channel electroencephalogram under dexmedetomidine (n = 9) and propofol (n = 8) in healthy volunteers, 18 to 36 yr of age. The authors administered dexmedetomidine with a 1-µg/kg loading bolus over 10 min, followed by a 0.7 µg kg−1 h−1 infusion. For propofol, the authors used a computer-controlled infusion to target the effect-site concentration gradually from 0 to 5 μg/ml. Volunteers listened to auditory stimuli and responded by button press to determine unconsciousness. The authors analyzed the electroencephalogram using multitaper spectral and coherence analysis. Results:: Dexmedetomidine was characterized by spindles with maximum power and coherence at approximately 13 Hz (mean ± SD; power, −10.8 ± 3.6 dB; coherence, 0.8 ± 0.08), whereas propofol was characterized with frontal alpha oscillations with peak frequency at approximately 11 Hz (power, 1.1 ± 4.5 dB; coherence, 0.9 ± 0.05). Notably, slow oscillation power during a general anesthetic state under propofol (power, 13.2 ± 2.4 dB) was much larger than during sedative states under both propofol (power, −2.5 ± 3.5 dB) and dexmedetomidine (power, −0.4 ± 3.1 dB). Conclusion:: The results indicate that dexmedetomidine and propofol place patients into different brain states and suggest that propofol enables a deeper state of unconsciousness by inducing large-amplitude slow oscillations that produce prolonged states of neuronal silence.
National Institutes of Health (U.S.) (Grant DP2-OD006454)
National Institutes of Health (U.S.) (Grant DP1-OD003646)
National Institutes of Health (U.S.) (Grant TR01-GM104948)