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Exploring Nociceptive-Analgesic Balance and EEG Modulation Patterns During General Anesthesia Using Holo-Hilbert
Chun-Ning Ho1,2,3, Norden E Huang1, Jen-Yin Chen2,3
1Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, nctu.edu.tw.
Pain Research & Management
|February 5, 2026
Summary
Holo-Hilbert spectral analysis (HHSA) reveals layered brainwave modulation during anesthesia. This EEG analysis can monitor nociception (pain) and analgesia, improving patient care.
Area of Science:
- Neuroscience
- Anesthesiology
- Signal Processing
Background:
- Intraoperative electroencephalography (EEG) offers noninvasive insight into brain activity during anesthesia.
- Conventional spectral analysis of EEG struggles to detect dynamic modulation patterns related to pain processing.
- Nociceptive processing under anesthesia requires advanced analytical techniques for accurate monitoring.
Purpose of the Study:
- To apply Holo-Hilbert spectral analysis (HHSA) for characterizing cross-frequency modulation in EEG during general anesthesia.
- To investigate the relationship between these EEG modulation patterns and the Surgical Pleth Index (SPI) as a measure of nociception.
- To identify potential EEG markers for real-time nociception monitoring.
Main Methods:
- EEG data from 134 female patients undergoing gynecologic surgery were analyzed using HHSA.
- HHSA decomposed EEG signals into amplitude modulation patterns across a wide frequency range (1/64-64 Hz).
- Modulation patterns were analyzed in relation to SPI, minimum alveolar concentration (MAC), heart rate (HR), and mean arterial pressure (NIBP-m).
Main Results:
- Two dominant cross-frequency interactions were identified within the alpha-carrier band (8-16 Hz), modulated by delta (1-6 Hz) and theta (3-8 Hz) oscillations.
- During nociceptive states (SPI > 60), alpha and high-delta band modulation power increased, while theta and low-delta modulation decreased.
- Alpha-band modulation power positively correlated with SPI and negatively with MAC.
Conclusions:
- HHSA effectively reveals distinct cross-frequency modulation patterns reflecting the balance between nociception and analgesia.
- Alpha-band modulation identified through HHSA serves as a promising, physiologically grounded EEG marker.
- This approach enables individualized nociception monitoring during general anesthesia.
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