Recovery of consciousness and cognition after general anesthesia in humans

Understanding how the brain recovers from unconsciousness can inform neurobiological theories of consciousness and guide clinical investigation. To address this question, we conducted a multicenter study of 60 healthy humans, half of whom received general anesthesia for three hours and half of whom...

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Published ineLife Vol. 10
Main Authors Mashour, George A, Palanca, Ben Ja, Basner, Mathias, Li, Duan, Wang, Wei, Blain-Moraes, Stephanie, Lin, Nan, Maier, Kaitlyn, Muench, Maxwell, Tarnal, Vijay, Vanini, Giancarlo, Ochroch, E Andrew, Hogg, Rosemary, Schwartz, Marlon, Maybrier, Hannah, Hardie, Randall, Janke, Ellen, Golmirzaie, Goodarz, Picton, Paul, McKinstry-Wu, Andrew R, Avidan, Michael S, Kelz, Max B
Format Journal Article
LanguageEnglish
Published England eLife Sciences Publications Ltd 10.05.2021
eLife Sciences Publications, Ltd
Subjects
Anesthesia
Blood pressure
Brain research
Cognition
Cognition & reasoning
Cognitive ability
Consciousness
EEG
Executive function
Experiments
Fractals
frontal cortex
General anesthesia
Health care
Medical personnel
Medicine
Memory
Neuroscience
Neurosciences
Prefrontal cortex
Recovery (Medical)
Sleep
Unconsciousness
human
neuroscience
medicine
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Summary:Understanding how the brain recovers from unconsciousness can inform neurobiological theories of consciousness and guide clinical investigation. To address this question, we conducted a multicenter study of 60 healthy humans, half of whom received general anesthesia for three hours and half of whom served as awake controls. We administered a battery of neurocognitive tests and recorded electroencephalography to assess cortical dynamics. We hypothesized that recovery of consciousness and cognition is an extended process, with differential recovery of cognitive functions that would commence with return of responsiveness and end with return of executive function, mediated by prefrontal cortex. We found that, just prior to the recovery of consciousness, frontal-parietal dynamics returned to baseline. Consistent with our hypothesis, cognitive reconstitution after anesthesia evolved over time. Contrary to our hypothesis, executive function returned first. Early engagement of prefrontal cortex in recovery of consciousness and cognition is consistent with global neuronal workspace theory.
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These authors contributed equally to this work.
ISSN:2050-084X
2050-084X
DOI:10.7554/eLife.59525