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General anesthesia and the neural correlates of consciousness.

机译:全身麻醉与意识的神经相关。

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The neural correlates of consciousness must be identified, but how? Anesthetics can be used as tools to dissect the nervous system. Anesthetics not only allow for the experimental investigation into the conscious-unconscious state transition, but they can also be titrated to subanesthetic doses in order to affect selected components of consciousness such as memory, attention, pain processing, or emotion. A number of basic neuroimaging examinations of various anesthetic agents have now been completed. A common pattern of regional activity suppression is emerging for which the thalamus is identified as a key target of anesthetic effects on consciousness. It has been proposed that a neuronal hyperpolarization block at the level of the thalamus, or thalamocortical and corticocortical reverberant loops, could contribute to anesthetic-induced unconsciousness. However, all anesthetics do not suppress global cerebral metabolism and cause a regionally specific effect on thalamic activity. Ketamine, a so-called dissociative anesthetic agent, increases global cerebral metabolism in humans at doses associated with a loss of consciousness. Nevertheless, it is proposed that those few anesthetics not associated with a global metabolic suppression effect might still have their effects on consciousness mediated at the level of thalamocortical interactions, if such agents scramble the signals associated with normal neuronal network reverberant activity. Functional and effective connectivity are analysis techniques that can be used with neuroimaging to investigate the signal scrambling effects of various anesthetics on network interactions. Whereas network interactions have yet to be investigated with ketamine, a thalamocortical and corticocortical disconnection effect during unconsciousness has been found for both suppressive anesthetic agents and for patients who are in the persistent vegetative state. Furthermore, recovery from a vegetative state is associated with a reconnection of functional connectivity. Taken togetherthese intriguing observations offer strong empirical support that the thalamus and thalamocortical reverberant network loop interactions are at the heart of the neurobiology of consciousness.
机译:必须确定意识的神经关联,但是如何识别?麻醉剂可用作解剖神经系统的工具。麻醉剂不仅可以进行有意识-无意识状态转换的实验研究,还可以滴定至亚麻醉剂量,以影响意识的选定组成部分,例如记忆,注意力,疼痛过程或情绪。各种麻醉剂的许多基本神经影像检查现已完成。正在出现一种常见的抑制区域活动的模式,丘脑被确定为麻醉药对意识的主要靶标。已经提出,在丘脑水平或丘脑皮质和皮层皮质混响回路的神经元超极化阻滞可能有助于麻醉剂引起的意识丧失。但是,所有麻醉剂均不能抑制整体脑部代谢,并会对丘脑活动造成区域特定影响。氯胺酮是一种所谓的解离性麻醉剂,它以与失去知觉有关的剂量增加人的整体脑代谢。然而,有人提出,如果这种药物扰乱了与正常神经元网络混响活动有关的信号,那么与全局代谢抑制作用无关的少数麻醉药仍可能对它们在丘脑皮质相互作用水平上介导的意识产生影响。功能和有效的连通性是可以与神经成像一起使用的分析技术,以研究各种麻醉剂对网络相互作用的信号加扰效果。尽管尚未与氯胺酮进行网络相互作用的研究,但是对于抑制性麻醉药和处于持续性植物状态的患者,意识障碍期间的丘脑皮层和皮层皮质断开作用已被发现。此外,从植物状态的恢复与功能连通性的重新连接有关。总之,这些有趣的观察结果提供了强有力的经验支持,即丘脑和丘脑皮质混响网络回路相互作用是意识神经生物学的核心。

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