Electroencephalographic markers of brain development during sevoflurane anesthesia in children aged 0 to 3 years old

Abstract

The general anesthetic sevoflurane acts on GABAergic-interneurons to generate stereotyped oscillations that relate fundamentally to neural circuit architecture. Each year, millions of children require general anesthesia, providing an experiment of nature that allows characterization of the developmental trajectory of GABAergic-inhibitory circuits in the human brain. We used multichannel electroencephalograph recordings in 91 children 0-40 months old. We mapped spatial power and coherence across the cortex. During sevoflurane exposure: (1) slow-delta oscillations are present in all ages; (2) theta and alpha oscillations emerge around 4 months; (3) alpha oscillations increase in power from 4 to 10 months; (4) frontal alpha oscillation predominance emerge at ~6 months; (5) frontal slow oscillations are coherent in the first 6 months of age only; and (6) frontal alpha oscillations become coherent around 10 months and persist in older ages. Our results suggest key developmental milestones are visible in the functional activity of sevoflurane-stimulated GABAergic circuits.