Transcranial magnetic stimulation tracks subminute changes in cortical excitability during propofol anesthesia.

Ann Clin Transl Neurol

The Neuromodulation Program, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Published: March 2020

Automated anesthesia systems that continuously monitor cortical excitability (CE) changes to govern drug infusion rates, are desirable. Paired-pulse transcranial magnetic stimulation (ppTMS), with electromyography (EMG), provides noninvasive CE measures. We tested whether, and with what temporal resolution, ppTMS-EMG detects dose-dependent CE in rats anesthetized with continuous intravenous propofol. Motor-evoked potentials (MEPs) were recorded every 20 seconds as either propofol bolus or change in infusion rate was applied. ppTMS-derived measures varied in direct proportion to propofol dose with subminute temporal resolution. We conclude that ppTMS-EMG enables real-time markers of target engagement by anesthetics that may be incorporated into an automated device.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085996PMC
http://dx.doi.org/10.1002/acn3.50981DOI Listing

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