The EEG readings revealed that the frontal regions of the brain were especially active around the time of recovery. If, for example, someone was waking up to a threat, structures like the prefrontal cortex would be important for categorizing the situation and generating an action plan," says Kelz. "Although initially surprising, it makes sense in evolutionary terms that higher cognition needs to recover early. To the investigators' surprise, one of the brain functions that came online first was abstract problem solving, controlled by the prefrontal cortex, whereas other functions such as reaction time and attention took longer to recover. A second control group of study participants, who did not receive general anesthesia and stayed awake, also completed tests over the same time period.Īnalyzing EEG and test performance, the researchers found that recovery of consciousness and cognition is a process that unfolds over time, not all at once. "How the brain recovers from states of unconsciousness is important clinically but also gives us insight into the neural basis of consciousness itself," says Mashour.Īfter the anesthetic was discontinued and participants regained consciousness, cognitive testing began. The study team sought to answer several fundamental questions: Just how does the brain wake up after profound unconsciousness-all at once or do some areas and functions come back online first? If so, which? MORE FROM THE LAB: Subscribe to our weekly newsletter Each participant was given cognitive tests-designed to measure reaction speed, memory, and other functions-before receiving anesthesia, right after the return of consciousness, and then every 30 minutes thereafter. Their brain activity was measured with EEG and their sleep-wake activity was measured before and after the experiment. In the study, 30 healthy adults were anesthetized for three hours. of the University of Pennsylvania Medical School, and Michael Avidan, MBBCh of the Washington University School of Medicine used the anesthetics propofol and isoflurane in humans to study the patterns of reemerging consciousness and cognitive function after anesthesia. of University of Michigan Medical School, Michigan Medicine, Max Kelz, M.D., Ph.D. In a new study published in the journal eLife, a team led by anesthesiologists George Mashour, M.D., Ph.D. Researchers are using this powerful tool to better understand how the brain reconstitutes consciousness and cognition after disruptions caused by sleep, medical procedures requiring anesthesia, and neurological dysfunctions such as coma. Millions of surgical procedures performed each year would not be possible without the aid of general anesthesia, the miraculous medical ability to turn off consciousness in a reversible and controllable way.
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