Traffic of the Mind
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Voyage related Need more than the basics? Dimensions Need more than the basics? Loadline Need more than the basics? Article Information. Anesthesiology 11 , Vol.enter site
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You will receive an email whenever this article is corrected, updated, or cited in the literature. You can manage this and all other alerts in My Account. You must be logged in to access this feature. Image: A. HOW consciousness emerges from the coordinated activity of neural firing across the brain remains among the most important questions of twenty-first-century science.
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A related foundational question in the field of anesthesiology is how the anesthetic drugs we use on a daily basis reversibly suppress consciousness. When considering such information processing, it might be helpful to consider the analogy of traffic. Streets and highways represent the structural basis that enables transport to and from various locations.
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Cars are the vehicles that carry the people and, collectively, traffic patterns emerge. We can imagine that, at certain times of the day, traffic can be dynamic, efficient, and complex. At other times, or under other conditions, there might be gridlock or the streets could be empty. On and off ramps along major highways help create the kinds of dynamic patterns that are observed in daily life. In the brain, the anatomic connections between different regions are the structural highways, neural spikes across those highways are the vehicles, and information is the passenger being transported.
Just as in the highway system, there can be dynamic patterns of traffic such as in the waking state or completely empty streets such as in brain death.
But what happens during the state of general anesthesia? In this issue of A nesthesiology , Uhrig et al. The investigators studied monkeys in a state of wakefulness, followed by general anesthesia with propofol, sevoflurane, or ketamine. They assessed the relationship between the functional magnetic resonance imaging signals in different parts of the brain, which is referred to as functional connectivity and which can be much more diverse than the structural connectivity highway itself.
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In other words, they observed what appeared to be dynamic patterns of signals in the same way we can observe dynamic patterns of traffic, even assuming the same highway. What happened during anesthesia is that the repertoire of connectivity patterns contracted and the functional connectivity pattern more closely adhered to the structural connectivity.
Returning to the analogy, you could imagine a variety of traffic situations in which your flexibility would be constrained and your travel much less efficient. Importantly, the specific restriction of flexibility in the functional connectivity patterns was a consistent finding across each of these molecularly and pharmacologically diverse anesthetics. Although Uhrig et al. To be more neuroanatomically specific, the investigators found that general anesthesia is dominated by brain states in which there is a disruption of correlated activity between the prefrontal, parietal, and posterior cingulate cortices.
It was posited that this particular and consistent contraction of functional repertoire observed in the monkeys explains past observations in humans regarding the disruption of functional connectivity between the frontal cortex and more posterior cortex by the same three anesthetics propofol, sevoflurane, and ketamine.
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Global workspace theory is a framework for explaining consciousness that originated in the field of psychology in the s. In the past two decades, the theory has become increasingly informed by neuroscience and has thus metamorphosed into global neuronal workspace theory. Clinically, it matters because access consciousness might be the consciousness that is going away when we administer general anesthetics.
Whether we should extinguish all forms of experience is a separate question, but what is actually suppressed during what we typically consider a successful general anesthetic could, in fact, be access consciousness. Scientifically, it matters because current thinking suggests that access consciousness requires more extensive involvement of the prefrontal cortex in the front of the brain , whereas phenomenal consciousness, i. The consideration of access versus phenomenal consciousness, global neuronal workspace versus integrated information theories of consciousness, and anterior versus posterior neural correlates of consciousness is now an active debate in the neurosciences—anesthesiology surely has an important role to play in informing it and, possibly, resolving it.
In conclusion, Uhrig et al. Additional studies clearly need to be conducted to understand how these cortical patterns relate to—or are driven by—the well-described effects of general anesthetics in subcortical regions, their causal significance, and the clinical relevance to the more complex perioperative environment that often includes a prolonged surgical anesthetic. The investigation of Uhrig et al. The author is not supported by, nor maintains any financial interest in, any commercial activity that may be associated with the topic of this article. A nesthesiology ; — A nesthesiology ; —75 [Article] [PubMed].
Trends Neurosci ; 41 —60 [Article] [PubMed]. Neuron ; 70 —27 [Article] [PubMed]. Mashour, GA The controversial correlates of consciousness. Science ; —4 [Article] [PubMed]. Science ; —42 [Article] [PubMed].