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Changes in information integration and brain networks during propofol-, dexmedetomidine-, and ketamine-induced unresponsiveness.

Zhenhu Liang, Yu Chang, Xiaoge Liu, Shumei Cao, Yali Chen, Tingting Wang, Jianghui Xu, Duan Li, Jun Zhang

British Journal of Anaesthesia March 1, 2024 DOI: 10.1016/j.bja.2023.11.033 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 72
Population Participants receiving propofol, dexmedetomidine, or ketamine
Interventions Propofol Dexmedetomidine Ketamine
Duration Consciousness transition from eye-closed baseline to unresponsiveness state and then to recovery of responsiveness state
Topics Ketamine Esketamine
Keywords Brain network Dexmedetomidine Electroencephalography Propofol
Citations 10
Post-publication review 1 comment on PubPeer (opens in new tab) · last active May 2026
Key findings Permutation cross mutual information and brain network measures showed state-related decreases in information integration and network efficiency during anaesthesia-induced unresponsiveness across three different drugs.

Abstract

Information integration and network science are important theories for quantifying consciousness. However, whether these theories propose drug- or conscious state-related changes in EEG during anaesthesia-induced unresponsiveness remains unknown. A total of 72 participants were randomised to receive i.v. infusion of propofol, dexmedetomidine, or ketamine at a constant infusion rate until loss of responsiveness. High-density EEG was recorded during the consciousness transition from the eye-closed baseline to the unresponsiveness state and then to the recovery of the responsiveness state. Permutation cross mutual information (PCMI) and PCMI-based brain networks in broadband (0.1-45 Hz) and sub-band frequencies were used to analyse drug- and state-related EEG signature changes. PCMI and brain networks exhibited state-related changes in certain brain regions and frequency bands. The within-area PCMI of the frontal, parietal, and occipital regions, and the between-area PCMI of the parietal-occipital region (median [inter-quartile ranges]), baseline vs unresponsive were as follows: 0.54 (0.46-0.58) vs 0.46 (0.40-0.50), 0.58 (0.52-0.60) vs 0.48 (0.44-0.53), 0.54 (0.49-0.59) vs 0.47 (0.42-0.52) decreased during anaesthesia for three drugs (P<0.05). Alpha PCMI in the frontal region, and gamma PCMI in the posterior area significantly decreased in the unresponsive state (P<0.05). The frontal, parietal, and occipital nodal clustering coefficients and parietal nodal efficiency decreased in the unresponsive state (P<0.05). The increased normalised path length in delta, theta, and gamma bands indicated impaired global integration (P<0.05). The three anaesthetics caused changes in information integration patterns and network functions. Thus, it is possible to build a quantifying framework for anaesthesia-induced conscious state changes on the EEG scale using PCMI and network science.

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