TY - JOUR
T1 - Alteration of coupling between brain and heart induced by sedation with propofol and midazolam
AU - Won, Dong Ok
AU - Lee, Bo Ram
AU - Seo, Kwang Suk
AU - Kim, Hyun Jeong
AU - Lee, Seong Whan
N1 - Funding Information:
This work was supported by the Institute for Information & Communications Technology Planning & Evaluation (IITP) grant funded by the Korea government (No. 2017-0-00451 to SWL; Development of BCI based Brain and Cognitive Computing Technology for Recognizing User’s Intentions using Deep Learning), Defense Acquisition Program Administration (DAPA) and Agency for Defense Development (ADD) of Korea (06-201-305-001 to SWL, A Study on Human-Computer Interaction Technology for the Pilot Status Recognition), and grant No. 01-2015-0007 to KSS from the Seoul National University Dental Hospital (SNUDH) Research Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2019 Won et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - For a comprehensive understanding of the nervous system, several previous studies have examined the network connections between the brain and the heart in diverse conditions. In this study, we identified coupling between the brain and the heart along the continuum of sedation levels, but not in discrete sedation levels (e. g., wakefulness, conscious sedation, and deep sedation). To identify coupling between the brain and the heart during sedation, we induced several depths of sedation using patient-controlled sedation with propofol and midazolam. We performed electroencephalogram (EEG) spectral analysis and extracted the instantaneous heart rate (HR) from the electrocardiogram (ECG). EEG spectral power dynamics and mean HR were compared along the continuum of sedation levels. We found that EEG sigma power was the parameter most sensitive to changes in the sedation level and was correlated with the mean HR under the effect of sedative agents. Moreover, we calculated the Granger causality (GC) value to quantify brain-heart coupling at each sedation level. Additionally, the GC analysis revealed noticeably different strengths and directions of causality among different sedation levels. In all the sedation levels, GC values from the brain to the heart (GCb!h) were higher than GC values from the heart to the brain (GCh!b). Moreover, the mean GCb!h increased as the sedation became deeper, resulting in higher GCb!h values in deep sedation (1.97 ± 0.18 in propofol, 2.02 ± 0.15 in midazolam) than in pre-sedation (1.71 ± 0.13 in propofol, 1.75 ± 0.11 in midazolam; p < 0.001). These results show that coupling between brain and heart activities becomes stronger as sedation becomes deeper, and that this coupling is more attributable to the brain-heart direction than to the heart-brain direction. These findings provide a better understanding of the relationship between the brain and the heart under specific conditions, namely, different sedation states.
AB - For a comprehensive understanding of the nervous system, several previous studies have examined the network connections between the brain and the heart in diverse conditions. In this study, we identified coupling between the brain and the heart along the continuum of sedation levels, but not in discrete sedation levels (e. g., wakefulness, conscious sedation, and deep sedation). To identify coupling between the brain and the heart during sedation, we induced several depths of sedation using patient-controlled sedation with propofol and midazolam. We performed electroencephalogram (EEG) spectral analysis and extracted the instantaneous heart rate (HR) from the electrocardiogram (ECG). EEG spectral power dynamics and mean HR were compared along the continuum of sedation levels. We found that EEG sigma power was the parameter most sensitive to changes in the sedation level and was correlated with the mean HR under the effect of sedative agents. Moreover, we calculated the Granger causality (GC) value to quantify brain-heart coupling at each sedation level. Additionally, the GC analysis revealed noticeably different strengths and directions of causality among different sedation levels. In all the sedation levels, GC values from the brain to the heart (GCb!h) were higher than GC values from the heart to the brain (GCh!b). Moreover, the mean GCb!h increased as the sedation became deeper, resulting in higher GCb!h values in deep sedation (1.97 ± 0.18 in propofol, 2.02 ± 0.15 in midazolam) than in pre-sedation (1.71 ± 0.13 in propofol, 1.75 ± 0.11 in midazolam; p < 0.001). These results show that coupling between brain and heart activities becomes stronger as sedation becomes deeper, and that this coupling is more attributable to the brain-heart direction than to the heart-brain direction. These findings provide a better understanding of the relationship between the brain and the heart under specific conditions, namely, different sedation states.
UR - http://www.scopus.com/inward/record.url?scp=85069712740&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0219238
DO - 10.1371/journal.pone.0219238
M3 - Article
C2 - 31314775
AN - SCOPUS:85069712740
SN - 1932-6203
VL - 14
JO - PloS one
JF - PloS one
IS - 7
M1 - e0219238
ER -