The effect of burst suppression on cerebral blood flow and autoregulation: a scoping review of the human and animal literature

Review Anesthesiology

Electroencephalographic Burst-Suppression, Perioperative Neuroprotection, Postoperative Cognitive Function, and Mortality: A Focused Narrative Review of the Literature

Kan Ma et al.

Summary: This review summarizes the physiological mechanisms underlying the burst-suppression pattern and presents the available evidence both supporting and challenging its clinical use as a therapeutic measure in perioperative settings.

ANESTHESIA AND ANALGESIA (2022)

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Review Physiology

The Quantitative Associations Between Near Infrared Spectroscopic Cerebrovascular Metrics and Cerebral Blood Flow: A Scoping Review of the Human and Animal Literature

Alwyn Gomez et al.

Summary: Cerebral blood flow is a vital physiologic parameter for proper cerebral function and recovery. Current methods of measuring CBF are cumbersome, invasive, or have poor spatial or temporal resolution. Near infrared spectroscopy may provide a non-invasive, topographic, and continuous means of measuring CBF.

FRONTIERS IN PHYSIOLOGY (2022)

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Article Critical Care Medicine

Optimal bispectral index level of sedation and cerebral oximetry in traumatic brain injury: a non-invasive individualized approach in critical care?

Logan Froese et al.

Summary: This study suggests that COx_a is capable of detecting the relationship between depth of sedation and autoregulatory capacity, providing important guidance for individualized sedation in neuroprotection.

INTENSIVE CARE MEDICINE EXPERIMENTAL (2022)

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Review Clinical Neurology

Intracranial Pressure-Derived Cerebrovascular Reactivity Indices, Chronological Age, and Biological Sex in Traumatic Brain Injury: A Scoping Review

Carleen Batson et al.

Summary: To date, there is limited literature exploring the association between age and sex with cerebrovascular reactivity (CVR) in moderate/severe traumatic brain injury (TBI). The existing studies suggest a correlation between advanced age and worse CVR, as well as a potential impact of sex on CVR. However, the number of studies is insufficient and the results are not conclusive in characterizing the influence of age and sex on CVR in moderate/severe TBI.

NEUROTRAUMA REPORTS (2022)

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Article Psychology, Multidisciplinary

Etiology of Burst Suppression EEG Patterns

Akshay Shanker et al.

Summary: The burst-suppression EEG patterns, characterized by intermittent high-power broad-spectrum oscillations alternating with isoelectricity, have been observed in the human brain during general anesthesia, hypothermia, coma and early infantile encephalopathy. Recent research suggests that these patterns may have effects on the brain and could be used as a therapeutic tool. Monitoring and controlling burst suppression remains a technical challenge.

FRONTIERS IN PSYCHOLOGY (2021)

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Article Clinical Neurology

EEG Power Spectral Analysis of Abnormal Cortical Activations During REM/NREM Sleep in Obstructive Sleep Apnea

Shuling Liu et al.

Summary: The study found that elevated delta band power spectral density was observed in the severe OSA group during NREM sleep, while the PSD of other frequency bands showed a corresponding decrease. Similar changes were also observed in the frontal region during REM sleep. Delta band power spectral density was positively correlated with multiple PSG parameters such as AHI, ODI, and negatively correlated with N3% and minSaO2, providing evidence for pathological cortical activation in OSA.

FRONTIERS IN NEUROLOGY (2021)

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Article Clinical Neurology

Sedation-Induced Burst Suppression Predicts Positive Outcome Following Traumatic Brain Injury

Joel Frohlich et al.

Summary: The study found that sedation-induced burst-suppression (SIBS) was positively associated with outcomes at 6 months in patients with moderate-to-severe traumatic brain injury (TBI), but did not predict outcomes at discharge. These results suggest that burst suppression may have neuroprotective effects in acute patients with TBI etiologies.

FRONTIERS IN NEUROLOGY (2021)

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Article Endocrinology & Metabolism

Low neuronal metabolism during isoflurane-induced burst suppression is related to synaptic inhibition while neurovascular coupling and mitochondrial function remain intact

Nikolaus Berndt et al.

Summary: Deep anaesthesia may affect neuronal, vascular, and mitochondrial function, while it can also be used for neuroprotection in brain diseases. Research showed that the neurometabolic effects of isoflurane are superior to propofol, reducing ATP consumption and maintaining neurovascular coupling and mitochondrial function.

JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM (2021)

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Review Clinical Neurology

Continuous Time-Domain Cerebrovascular Reactivity Metrics and Discriminate Capacity for the Upper and Lower Limits of Autoregulation: A Scoping Review of the Animal Literature

Amanjyot Singh Sainbhi et al.

Summary: Cerebral blood flow is regulated by cerebral vessels within a range of systemic arterial pressures through a process known as cerebral autoregulation. Traumatic brain injury can impair this autoregulation, leading to changes in the autoregulatory curve. Surrogate metrics, such as cerebrovascular reactivity (CVR) metrics, have been increasingly used in bedside TBI care to assess individualized cerebral perfusion pressure targets. While some metrics show the ability to discriminate the lower limit of autoregulation, further research is needed to evaluate their validity against the upper limit.

NEUROTRAUMA REPORTS (2021)

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Article Neuroimaging

Hemodynamic changes associated with common EEG patterns in critically ill patients: Pilot results from continuous EEG-fNIRS study

Ali Kassab et al.

Summary: The study evaluated the feasibility of using continuous electroencephalography (cEEG) with functional near-infrared spectroscopy (fNIRS) to assess cortical hemodynamics in neuroICU patients. The results indicated significant hemodynamic changes associated with seizures, bursts, and periodic discharges, suggesting partial preservation of normal neurovascular coupling in these patients.

NEUROIMAGE-CLINICAL (2021)

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Article Anesthesiology

Impact of hypotension on cerebral perfusion during general anesthesia induction: A prospective observational study in adults

Isabelle Chaix et al.

ACTA ANAESTHESIOLOGICA SCANDINAVICA (2020)

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Article Critical Care Medicine

The PET Sandwich: Using Serial FDG-PET Scans with Interval Burst Suppression to Assess Ictal Components of Disease

Feras Akbik et al.

NEUROCRITICAL CARE (2020)

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Review Neurosciences

Functional Near-Infrared Spectroscopy and Its Clinical Application in the Field of Neuroscience: Advances and Future Directions

Wei-Liang Chen et al.

FRONTIERS IN NEUROSCIENCE (2020)

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Review Pharmacology & Pharmacy

The cerebrovascular response to norepinephrine: A scoping systematic review of the animal and human literature

Logan Froese et al.

PHARMACOLOGY RESEARCH & PERSPECTIVES (2020)

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Review Clinical Neurology

Cerebrovascular Response to Phenylephrine in Traumatic Brain Injury: A Scoping Systematic Review of the Human and Animal Literature

Logan Froese et al.

NEUROTRAUMA REPORTS (2020)

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Article Neurosciences

Isoflurane-Induced Burst Suppression Increases Intrinsic Functional Connectivity of the Monkey Brain

Zhao Zhang et al.

FRONTIERS IN NEUROSCIENCE (2019)

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Review Pharmacology & Pharmacy

Clinical Pharmacokinetics and Pharmacodynamics of Propofol

Marko M. Sahinovic et al.

CLINICAL PHARMACOKINETICS (2018)

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Review Endocrinology & Metabolism

Effects of anesthesia on cerebral blood flow, metabolism, and neuroprotection

Andrew M. Slupe et al.

JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM (2018)

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Article Medicine, General & Internal

PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Andrea C. Tricco et al.

ANNALS OF INTERNAL MEDICINE (2018)

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Review Critical Care Medicine

Burst Suppression for ICP Control: A Systematic Review

Frederick A. Zeiler et al.

JOURNAL OF INTENSIVE CARE MEDICINE (2017)

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Article Anesthesiology

The relative effects of dexmedetomidine and propofol on cerebral blood flow velocity and regional brain oxygenation A randomised noninferiority trial

Ehab Farag et al.

EUROPEAN JOURNAL OF ANAESTHESIOLOGY (2017)

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Article Behavioral Sciences

Coherence of BOLD signal and electrical activity in the human brain during deep sevoflurane anesthesia

Daniel Golkowski et al.

BRAIN AND BEHAVIOR (2017)

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Article Anesthesiology

Anesthesia with Dexmedetomidine and Low-dose Isoflurane Increases Solute Transport via the Glymphatic Pathway in Rat Brain When Compared with High-dose Isoflurane

Helene Benveniste et al.

ANESTHESIOLOGY (2017)

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Proceedings Paper Optics

Correlation between Cerebral Hemodynamic and Perfusion Pressure Changes in Non-Human Primates

A. Ruesch et al.

OPTICAL TOMOGRAPHY AND SPECTROSCOPY OF TISSUE XII (2017)

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Article Medicine, General & Internal

New insights into coupling and uncoupling of cerebral blood flow and metabolism in the brain

Poornima Venkat et al.

CROATIAN MEDICAL JOURNAL (2016)

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Article Biochemical Research Methods

Monitoring cerebral oxygenation and local field potential with a variation of isoflurane concentration in a rat model

Dong-Hyuk Choi et al.

BIOMEDICAL OPTICS EXPRESS (2016)

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Article Neurosciences

Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy

Maria Chalia et al.

NEUROPHOTONICS (2016)

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Review Behavioral Sciences

What does burst suppression really mean?

Florin Amzica

EPILEPSY & BEHAVIOR (2015)

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Article Critical Care Medicine

Characterization of the Relationship Between Intracranial Pressure and Electroencephalographic Monitoring in Burst-Suppressed Patients

Mark Connolly et al.

NEUROCRITICAL CARE (2015)

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Article Clinical Neurology

Burst-suppression with identical bursts: A distinct EEG pattern with poor outcome in postanoxic coma

Jeannette Hofmeijer et al.

CLINICAL NEUROPHYSIOLOGY (2014)

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Article Physiology

Cerebral blood flow velocity underestimates cerebral blood flow during modest hypercapnia and hypocapnia

Nicole S. Coverdale et al.

JOURNAL OF APPLIED PHYSIOLOGY (2014)

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Article Anesthesiology

Differential Effects of Deep Sedation with Propofol on the Specific and Nonspecific Thalamocortical Systems A Functional Magnetic Resonance Imaging Study

Xiaolin Liu et al.

ANESTHESIOLOGY (2013)

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Article Developmental Biology

Resistance of brain glucose metabolism to thiopental-induced CNS depression in newborn piglets

Bernd Walter et al.

INTERNATIONAL JOURNAL OF DEVELOPMENTAL NEUROSCIENCE (2013)

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Article Neurosciences

The human brain pacemaker: Synchronized infra-slow neurovascular coupling in patients undergoing non-pulsatile cardiopulmonary bypass

Paolo Zanatta et al.

NEUROIMAGE (2013)

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Article Neurosciences

Multiphasic modification of intrinsic functional connectivity of the rat brain during increasing levels of propofol

Xiping Liu et al.

NEUROIMAGE (2013)

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Article Anesthesiology

Cerebral physiology

Alifia Tameem et al.

BJA EDUCATION (2013)

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Article Anesthesiology

The effects of sevoflurane on cerebral blood flow autoregulation and flow-metabolism coupling during cardiopulmonary bypass

B. Reinsfelt et al.

ACTA ANAESTHESIOLOGICA SCANDINAVICA (2011)

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Article Neurosciences

Optically measured NADH concentrations are unaffected by propofol induced EEG silence during transient cerebral hypoperfusion in anesthetized rabbits

Mei Wang et al.

BRAIN RESEARCH (2011)

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Article Anesthesiology

Human cerebral microcirculation and oxygen saturation during propofol-induced reduction of bispectral index

K. U. Klein et al.

BRITISH JOURNAL OF ANAESTHESIA (2011)

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Article Neurosciences

Neural Origin of Spontaneous Hemodynamic Fluctuations in Rats under Burst-Suppression Anesthesia Condition

Xiao Liu et al.

CEREBRAL CORTEX (2011)

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Meeting Abstract Clinical Neurology

Basic physiology of burst-suppression

Florin Amzica

EPILEPSIA (2009)

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Article Biochemical Research Methods

Simultaneous bilateral laser Doppler fluxmetry and electrophysiological recording during middle cerebral artery occlusion in rats

E Hungerhuber et al.

JOURNAL OF NEUROSCIENCE METHODS (2006)

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Article Anesthesiology

Cerebral blood flow affects dose requirements of intracarotid propofol for electrocerebral silence

S Joshi et al.

ANESTHESIOLOGY (2006)

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Article Anesthesiology

Reducing cerebral blood flow increases the duration of electroencephalographic silence by intracarotid thiopental

S Joshi et al.

ANESTHESIA AND ANALGESIA (2005)

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Article Anesthesiology

Propofol and thiopental do not interfere with regional cerebral blood flow response at sedative concentrations

RA Veselis et al.

ANESTHESIOLOGY (2005)

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Article Anesthesiology

Electrocerebral silence by intracarotid anesthetics does not affect early hyperemia after transient cerebral ischemia in rabbits

S Joshi et al.

ANESTHESIA AND ANALGESIA (2004)

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Article Clinical Neurology

Treatment of refractory status epilepticus with inhalational anesthetic agents isoflurane and desflurane

SM Mirsattari et al.

ARCHIVES OF NEUROLOGY (2004)

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Article Anesthesiology

Effects of propofol on cerebral oxygenation and metabolism after head injury

AJ Johnston et al.

BRITISH JOURNAL OF ANAESTHESIA (2003)

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Review Medicine, General & Internal

Drug therapy: Mechanisms of actions of inhaled anesthetics

JA Campagna et al.

NEW ENGLAND JOURNAL OF MEDICINE (2003)

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Article Anesthesiology

The effects of isoflurane-induced electroencephalographic burst suppression on cerebral blood flow velocity and cerebral oxygen extraction during cardiopulmonary bypass

B Reinsfelt et al.

ANESTHESIA AND ANALGESIA (2003)

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Article Anesthesiology

Propofol - Relation between brain concentrations, electroencephalogram, middle cerebral artery blood flow velocity, and cerebral oxygen extraction during induction of anesthesia

GL Ludbrook et al.

ANESTHESIOLOGY (2002)

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Article Biology

The neural basis of the blood-oxygen-level-dependent functional magnetic resonance imaging signal

NK Logothetis

PHILOSOPHICAL TRANSACTIONS OF THE ROYAL SOCIETY B-BIOLOGICAL SCIENCES (2002)

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Article Clinical Neurology

No additional neuroprotection provided by barbiturate-induced burst suppression under mild hypothermic conditions in rats subjected to reversible focal ischemia

T Westermaier et al.

JOURNAL OF NEUROSURGERY (2000)

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The effect of burst suppression on cerebral blood flow and autoregulation: a scoping review of the human and animal literature

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