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A Prospective Study of Age-dependent Changes in Propofol-induced Electroencephalogram Oscillations in Children
Johanna M Lee1, Oluwaseun Akeju, Kristina Terzakis
1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts (J.M.L., O.A., K.T., K.J.P., H.D., T.T.H., P.G.F., E.S.S., E.N.B., P.L.P.); Harvard Medical School, Boston, Massachusetts (J.M.L., O.A., P.G.F., E.S.S., E.N.B., P.L.P.); Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts (J.M.L., E.N.B.); Department of Brain and Cognitive Science, Massachusetts Institute of Technology, Cambridge, Massachusetts (E.N.B.); and Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts (E.N.B.).
Background:
In adults, frontal electroencephalogram patterns observed during propofol-induced unconsciousness consist of slow oscillations (0.1 to 1 Hz) and coherent alpha oscillations (8 to 13 Hz). Given that the nervous system undergoes significant changes during development, anesthesia-induced electroencephalogram oscillations in children may differ from those observed in adults. Therefore, we investigated age-related changes in frontal electroencephalogram power spectra and coherence during propofol-induced unconsciousness.
Methods:
We analyzed electroencephalogram data recorded during propofol-induced unconsciousness in patients between 0 and 21 yr of age (n = 97), using multitaper spectral and coherence methods. We characterized power and coherence as a function of age using multiple linear regression analysis and within four age groups: 4 months to 1 yr old (n = 4), greater than 1 to 7 yr old (n = 16), greater than 7 to 14 yr old (n = 30), and greater than 14 to 21 yr old (n = 47).
Results:
Total electroencephalogram power (0.1 to 40 Hz) peaked at approximately 8 yr old and subsequently declined with increasing age. For patients greater than 1 yr old, the propofol-induced electroencephalogram structure was qualitatively similar regardless of age, featuring slow and coherent alpha oscillations. For patients under 1 yr of age, frontal alpha oscillations were not coherent.
Conclusions:
Neurodevelopmental processes that occur throughout childhood, including thalamocortical development, may underlie age-dependent changes in electroencephalogram power and coherence during anesthesia. These age-dependent anesthesia-induced electroencephalogram oscillations suggest a more principled approach to monitoring brain states in pediatric patients.
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