由异丙酚诱发的儿童脑电波随年龄依赖性变化的前瞻性研究
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A Prospective Study of Age-dependent Changes in Propofol-induced Electroencephalogram Oscillations in Children
背景与目的
在成年人中，在异丙酚诱发的昏迷期间观察到的脑电图模式包括慢波（0.1至1Hz）和相干α波（8至13Hz）。 鉴于神经系统在发育过程中发生了显着变化，儿童麻醉引起的脑电波可能会不同于在成年人。因此，我们在异丙酚诱导麻醉时调查了额面脑电图功率谱随年龄变化的一致性。
方 法
我们使用连续多窗谱方法分析了年龄在0到21岁（n = 97）之间，由丙泊酚诱导的无意识患者的脑电波数据。我们按年龄分成组：4个月至1岁（n = 4），大于1至7岁（n = 16），大于7至 14岁（n = 30），大于14岁至21岁（n = 47），再将功率和年龄列为一个函数，使用多元线性回归分析一致性。
结 果
总脑电功率（0.1至40Hz）顶峰约8岁，随后随着年龄的增长而下降。 对于大于1岁的患儿，异丙酚诱导的脑电图结构性质上与年龄无关，它们都具有缓慢和一致的α波。 对于1岁以下的患者，额面α波不一致。
结 论
儿童神经发育过程中的皮质发育，可能是麻醉期间脑电图功能随年龄依赖性变化的基础。麻醉诱导中产生的这些年龄依赖性的脑电波能更准确地地来监测儿科手术的脑状态。
原始文献摘要
Johanna M. Lee, A.B., Oluwaseun Akeju, M.D., M.M.Sc., Kristina Terzakis, Kara J. Pavone, B.S.,Hao Deng, M.B.B.S., M.P.H., Timothy T. Houle, Ph.D., Paul G. Firth, M.B., Ch.B.,Erik S. Shank, M.D., Emery N. Brown, M.D., Ph.D., Patrick L. Purdon, Ph.D.
Abstract：
Background: In adults, frontal electroencephalogram patterns observed during propofol-induced unconsciousness consist of slow oscillations (0.1 to 1 Hz) and coherent alpha oscillations (8 to 13 Hz). Given that the nervous system undergoes significant changes during development, anesthesia-induced electroencephalogram oscillations in children may differ from those observed in adults. Therefore, we investigated age-related changes in frontal electroencephalogram power spectra and coherence during propofol-induced unconsciousness.
Methods: We analyzed electroencephalogram data recorded during propofol-induced unconsciousness in patients between 0 and 21 yr of age (n = 97), using multitaper spectral and coherence methods. We characterized power and coherence as a function of age using multiple linear regression analysis and within four age groups: 4 months to 1 yr old (n = 4), greater than 1 to 7 yr old (n = 16), greater than 7 to 14 yr old (n = 30), and greater than 14 to 21 yr old (n = 47).
Results: Total electroencephalogram power (0.1 to 40 Hz) peaked at approximately 8 yr old and subsequently declined with increasing age. For patients greater than 1 yr old, the propofol-induced electroencephalogram structure was qualitatively similar regardless of age, featuring slow and coherent alpha oscillations. For patients under 1 yr of age, frontal alpha oscillations were not coherent.
Conclusions: Neurodevelopmental processes that occur throughout childhood, including thalamocortical development, may underlie age-dependent changes in electroencephalogram power and coherence during anesthesia. These age-dependent anes-thesia-induced electroencephalogram oscillations suggest a more principled approach to monitoring brain states in pediatric
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