Decreased Cerebral Blood Flow in Mesial Thalamus and Precuneus/PCC during Midazolam Induced Sedation Assessed with ASL
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ORIGINAL ARTICLE
Decreased Cerebral Blood Flow in Mesial Thalamus and Precuneus/PCC during Midazolam Induced Sedation Assessed with ASL Peipeng Liang 1,2
&
Yachao Xu 3 & Fei Lan 3 & Daqing Ma 4 & Kuncheng Li 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract While some previous work suggests that midazolam-induced light sedation results from the functional disconnection within resting state network, little is known about the underlying alterations of cerebral blood flow (CBF) associated with its effects. A randomized, double-blind, within-subject, cross-over design was adopted, while 12 healthy young volunteers were scanned with arterial spin-labeling (ASL) perfusion MRI both before and after an injection of either saline or midazolam. The contrast of MRI signal before and after midazolam administration revealed the CBF decrease in the bilateral mesial thalamus and precuneus/ posterior cingulate cortex (PCC). These effects were confirmed after controlling for any effect of injection as well as head motions. These findings provide new evidences that midazolam-induced light sedation is related to the disruption of cortical functional integration, and have new implications to the neural basis of consciousness. Keywords Arterial spin labeling (ASL) . Magnetic resonance imaging (MRI) . Midazolam . Sedation
Introduction The neuroanatomical basis that underpins the consciousness is a topic of intense debate. Resting-state functional magnetic resonance imaging (rs-fMRI) combined with sedation has been widely used for locating changes in brain activity associated with altered consciousness. Based on low frequency fluctuations of blood-oxygen-level-dependent (BOLD) signal, previous studies reveal that functional disconnection associated with sedation induced by benzodiazepines (e.g., midazolam). Disruption of higher-level functional networks, including default mode network (DMN), executive control network * Peipeng Liang [email protected] 1
Department of Radiology, Xuanwu Hospital, Capital Medical University, 45 Chang Chun Street, Xuan Wu District, Beijing 100053, China
2
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, China
3
Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
4
Anaesthetcis, Pain Medicine and Intensive Care, Department of Surgery & Cancer, Imperial College London, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK
(ECN), and salience network (SN), were detected by light sedation (Boveroux et al. 2010; Greicius et al. 2008; Jordan et al. 2013; Guldenmund et al. 2013; Liang et al. 2015); while the integrity of lower-level networks, including sensorimotor network (SMN), auditory network (AN), and visual network (VN) kept intact. Although there are some consensuses on sedation induced systems level alterations, the regional changes induced by light sedation are still unclear. In contrast to BOLD fMRI which represents the combined changes of cerebral blood flow
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