Electroencephalographic delta and alpha oscillations reveal phase-amplitude coupling in paediatric patients
Luai Zakaria1, Adela Desowska2, Charles B Berde2
1Department of Anesthesiology, Perioperative & Pain Medicine, Brigham & Women's Hospital, Boston, USA; Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Insights
Delta-alpha phase-amplitude coupling is present in young children under sevoflurane anesthesia. This coupling is stronger during anesthesia maintenance than emergence, offering insights into pediatric brain activity.
Area of Science:
- Neuroscience
- Anesthesiology
- Pediatric Medicine
Background:
- General anesthesia in children can alter brain activity patterns.
- Delta and alpha oscillations are key brainwave types.
- Phase-amplitude coupling links delta and alpha oscillations in adults.
Purpose of the Study:
- To investigate delta-alpha phase-amplitude coupling in pediatric patients.
- To determine if this coupling is a feature of sevoflurane anesthesia.
- To differentiate coupling during anesthesia maintenance versus emergence.
Main Methods:
- Retrospective analysis of electroencephalographic (EEG) data from 31 pediatric patients (10 months to 3 years).
- Evaluation of delta-alpha phase-amplitude coupling during sevoflurane anesthesia maintenance and emergence.
- Statistical analysis using Wilcoxon signed-rank test and circular uniformity tests.
Main Results:
- Delta-alpha phase-amplitude coupling was observed in pediatric patients.
- The strength of coupling was significantly greater during general anesthesia compared to emergence (P=0.002).
- Alpha power was concentrated during specific delta wave phases during anesthesia, indicating non-uniform coupling.
Conclusions:
- Sevoflurane anesthesia is associated with delta-alpha phase-amplitude coupling in children.
- This finding enhances understanding of pediatric cortical dynamics during anesthesia.
- Potential to improve intraoperative depth of anesthesia monitoring in children.
Background:
Sevoflurane-induced anaesthesia generates frontal alpha oscillations as early as 6 months of age, whereas strong delta oscillations are present at birth. In adults, delta oscillations and alpha oscillations are coupled: the phase of delta waves modulates the amplitude of alpha oscillations in a phenomenon known as phase-amplitude coupling. We hypothesise that delta-alpha phase-amplitude coupling exists in young children and is a feature of sevoflurane-based general anaesthesia distinct from emergence after anaesthesia.
Methods:
Electroencephalographic data from 31 paediatric patients aged 10 months to 3 yr undergoing elective surgery with sevoflurane-based anaesthesia were analysed retrospectively. Delta-alpha phase-amplitude coupling was evaluated during maintenance of anaesthesia and during emergence.
Results:
Delta-alpha phase-amplitude coupling was observed in the study population. Strength of phase-amplitude coupling, represented by the delta-alpha mean amplitude vector, was greater during general anaesthesia than during emergence (Wilcoxon paired signed-rank test, Z=3.107, P=0.002). Frontal alpha amplitude during anaesthesia was not uniformly distributed across all delta phases. During general anaesthesia, alpha power was restricted to the positive phase of the delta wave (omnibus circular uniformity, general anaesthesia: P<0.001, mean phase: 114º; 99% confidence interval: 90º-139º; emergence: P=0.35, mean phase 181º, 99% confidence interval: 110º-253º).
Conclusions:
Sevoflurane-based anaesthesia is associated with delta-alpha phase-amplitude coupling in paediatric patients. These findings improve our understanding of cortical dynamics in children undergoing general anaesthesia, which might improve paediatric intraoperative depth of anaesthesia monitoring techniques.
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