Propofol Anesthesia Decreased the Efficiency of Long-Range Cortical Interaction in Humans.

Abstract

Phase-amplitude coupling (PAC) has recently been used to illuminate cross-frequency coordination in neurophysiological activity of electroencephalogram. However, the PAC at a meso-scale (electrocorticogram, ECoG) and PAC between different areas have still not been fully clarified. In this study, we analyzed ECoG data recorded from surgical patients (n = 9) with pharmaco-resistant epilepsy during the surgical treatment. The modulogram and a genuine modulation index, based on a Kullback-Leibler distance and permutation test method, were developed and used to measure the slow oscillation (SO) (0.15-1 Hz)-α (8-13 Hz) PAC of within-lead and cross-lead during transitions from states of wakefulness to unconsciousness during propofol induced general anesthesia. In within-lead SO-α PAC, the modulation index increased in the unconscious state (p < 0.05, Tukey's test), the percentages of genuine modulation indices also increased in the unconscious state (p < 0.001 in the frontal area and p < 0.01 in the parietal area), and distinct PAC patterns emerged more often. In cross-lead SO-α PAC, there are fewer PAC patterns compared to within-lead, and the percentages of genuine modulation indices decreased significantly (p < 0.001). The increased modulation index of within-lead and cross-lead SO-α PAC is associated with a reduction of information integration and the efficiency of long distance synchronization. These findings demonstrate that the propofol causes the neuronal populations to enter a 'busy' state in a local scale, which prevents the information integration in long-range areas.