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Protocol for modulating anesthesia delta oscillations using closed loop auditory stimulation.

Clara Pic Roca1,2, Hanieh Bazregarzadeh1, Louis Morisson1,3,4

  • 1Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et des Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.

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|March 25, 2026
PubMed
Summary
This summary is machine-generated.

Closed-loop auditory stimulation (CLAS) can modulate delta waves during sleep. This study investigates if CLAS can reinforce anesthetic delta-wave dynamics under propofol anesthesia, potentially stabilizing anesthesia without increasing drug dosage.

Keywords:
Bispectral Indexclosed-loop auditory stimulationdelta oscillationsgeneral anesthesiahigh-density EEGnociception level indexpropofol

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Area of Science:

  • Neuroscience
  • Anesthesiology

Background:

  • Delta waves (0.1-4 Hz) are key indicators of unconsciousness during sleep and general anesthesia (GA).
  • Closed-loop auditory stimulation (CLAS) modulates slow-wave activity (SWA) during sleep, but its effect during propofol anesthesia, especially with nociceptive input, is unknown.

Purpose of the Study:

  • To investigate the efficacy of CLAS in modulating delta-wave dynamics during propofol-induced general anesthesia.
  • To assess the robustness of CLAS under nociceptive stimulation and its potential to stabilize anesthesia.

Main Methods:

  • A prospective study involving 30 adults undergoing elective surgery under propofol GA.
  • High-density EEG (hd-EEG) recorded CLAS with in-phase, anti-phase, and sham conditions, alongside nociceptive stimulation.
  • Analysis of delta-wave morphology, SWA, depth of anesthesia (BIS), nociception (NOL), functional connectivity, and EEG microstates.

Main Results:

  • Hypothesized that in-phase CLAS would increase delta-wave amplitude, duration, and density, while decreasing frequency, compared to sham.
  • Anticipated CLAS to preserve delta-wave integrity under nociception, with attenuated effects.
  • Expected reduced nociceptive responses and deeper hypnosis (lower BIS) with in-phase CLAS.

Conclusions:

  • CLAS shows potential as a neuromodulation strategy to reinforce anesthetic delta-wave dynamics.
  • Findings could support stabilizing anesthesia without increasing pharmacological agents.
  • Provides insights into the role of slow oscillations in maintaining unconsciousness.