Wallace H. Coulter Distinguished Lecture in Biomedical Engineering

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Wallace H. Coulter Distinguished Lecture in Biomedical Engineering
"Deciphering the Dynamics of the Unconscious Brain Under General Anesthesia"

Emery Brown, M.D., Ph.D.

Institute for Medical Engineering and Science
Department of Brain and Cognitive Sciences
Massachusetts Institute of Technology

Department of Anesthesia, Critical Care and Pain Medicine
Massachusetts General Hospital
Harvard Medical School



General anesthesia is a drug-induced, reversible condition comprised of five behavioral states: unconsciousness, amnesia (loss of memory), analgesia (loss of pain sensation), akinesia (immobility), and hemodynamic stability with control of the stress response. The mechanisms by which anesthetic drugs induce the state of general anesthesia are considered one of the biggest mysteries of modern medicine. We study four problems to decipher this mystery. First, we present findings from our human studies of general anesthesia using high-density EEG and intracranial recordings which have allowed us to give a detailed characterization of the neurophysiology of loss and recovery of consciousness due to the standard anesthetics. Second, we show how the response to anesthesia changes as a function of age. Third, we present a neuro-metabolic model of burst suppression, the profound state of brain inactivation seen in deep states of general anesthesia. We show that our characterization of burst suppression can be used to design a closed-loop anesthesia delivery system for control of a medically-induced coma. Finally, we demonstrate that the state of general anesthesia can be rapidly reversed by activating specific brain circuits. Our results show that it is now possible to have a detailed neurophysiological understanding of the brain under general anesthesia, and that this understanding can be used to precisely monitor and control anesthetic states. Hence, general anesthesia is not a mystery. 

Faculty Host: Garrett Stanley


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