The effect of propofol on effective brain networks
D van Blooijs1, S Blok2, G J M Huiskamp2
1UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3584 GA Utrecht, The Netherlands; Stichting Epilepsie Instellingen Nederland (SEIN), P.O.box 540, 2130 AM Hoofddorp, The Netherlands.
Objective:
We compared the effective networks derived from Single Pulse Electrical Stimulation (SPES) in intracranial electrocorticography (ECoG) of awake epilepsy patients and while under general propofol-anesthesia to investigate the effect of propofol on these brain networks.
Methods:
We included nine patients who underwent ECoG for epilepsy surgery evaluation. We performed SPES when the patient was awake (SPES-clinical) and repeated this under propofol-anesthesia during the surgery in which the ECoG grids were removed (SPES-propofol). We detected the cortico-cortical evoked potentials (CCEPs) with an automatic detector. We constructed two effective networks derived from SPES-clinical and SPES-propofol. We compared three network measures (indegree, outdegree and betweenness centrality), the N1-peak-latency and amplitude of CCEPs between the two effective networks.
Results:
Fewer CCEPs were observed during SPES-propofol (median: 6.0, range: 0-29) compared to SPES-clinical (median: 10.0, range: 0-36). We found a significant correlation for the indegree, outdegree and betweenness centrality between SPES-clinical and SPES-propofol (respectively rs = 0.77, rs = 0.70, rs = 0.55, p < 0.001). The median N1-peak-latency increased from 22.0 ms during SPES-clinical to 26.4 ms during SPES-propofol.
Conclusions:
Our findings suggest that the number of effective network connections decreases, but network measures are only marginally affected.
Significance:
The primary network topology is preserved under propofol.
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