ABSTRACT

Objective:

The use of a cardiopulmonary machine during cardiac surgery causes a non-physiological circulation in the brain and the other body organs. This situation usually causes brain ischemia. Due to this or other factors, neurological disorders such as stroke and psychiatric disorders are encountered during the perioperative period. In this study, it was aimed to compare neuroelectrical activity measured during extracorporeal circulation in coronary bypass surgery with preoperative values of the patient.

Materials and Methods:

Six male patients who underwent coronary artery bypass surgery in cardiovascular surgery participated in the study. Both the preoperative (PrO) and during operation (InO) electroencephalography (EEG) data obtained from the frontal region. The delta (δ; 0.5-3.5 Hz), theta (θ; 3.5-7 Hz), alpha (α; 8-14 Hz), beta (β; 15-30 Hz) ve gamma (γ; 30-48 Hz) frequency power components were calculated. An equal number of PrO and InO period EEG power values from each participant were taken and used for statistical analysis. Results with a p-value of less than 0.05 were considered statistically significant.

Results:

The main finding of the study is that the frequency power spectrum values show a decrease in the extracorporeal circulation. When the percentage reduction is compared, it is seen that the fast frequencies decrease at a statistically significant with respect to the slow frequencies.

Conclusion:

Changes in the EEG frequencies of this preliminary study indicate that brain functions are reduced during extracorporeal circulation. In a broader group of patients, the study included a multi-channel EEG, as well as near-infra-red spectroscopy for cortical blood flow monitoring and the addition of neurocognitive assessment tests, will give us some indicator parameters calculated by meta-analyses from all these data. Early detection of the brain damage and take precaution may be achieved with this indicator data.

Keywords: Electroencephalography, neuroelectrical activity, delta, alpha, theta, beta, gamma, extracorporeal circulation

References

Golukhova EZ, Polunina AG, Lefterova NP, Begachev AV. Electroencephalography as a tool for assessment of brain ischemic alterations after open heart operations. Stroke Res Treat 2011;2011:980873.

Arrowsmith JE, Grocott HP, Newman MF. Neurologic risk assessment, monitoring and outcome in cardiac surgery. J Cardiothorac Vasc Anesth 1999;13:736-43.

Llinas R, Barbut D, Caplan LR. Neurologic complications of cardiac surgery. Prog Cardiovasc Dis 2000;43:101-12.

Zanatta P, Messerotti Benvenuti S, Bosco E, Baldanzi F, Palomba D, Valfrè C. Multimodal brain monitoring reduces major neurologic complications in cardiac surgery. J Cardiothorac Vasc Anesth 2011;25:1076-85.

Nisanoğlu V, Erdil N, Özgür B, Erdil F, But K, Çolak C, ve ark. Koroner arter cerrahisinde tek kros klemp tekniğinin erken dönem sonuçlara etkisi. Turkiye Klinikleri J Cardiovasc Sci 2006;18:112-17.

Orhan G, Sokullu O, Biçer Y, Şenay Ş, Yücel O, Özay B, ve ark. Koroner arter bypass cerrahisinde tek klemp tekniğinin inme riski üzerine etkisi. Türk Göğüs Kalp Damar Cer Derg 2007;15:45-50.

Klimesch W. EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. Brain Res Brain Res Rev 1999;29:169-95.

Herrmann CS, Strüber D, Helfrich RF, Engel AK. EEG oscillations: From correlation to causality. Int J Psychophysiol 2016;103:12-21.

Bayazit O, Üngür G. Neuroelectric responses of sportsmen and sedentaries under cognitive stress. Cogn Neurodyn 2018;12:295-301.

Van Belle G. Fisher LD, Heagerty PJ, Lumley T. Biostatistics A Methodology for the Health Sciences. 2nd ed. New Jersey, USA: Wiley-Interscience; 2004.

Başar E, Bullock TH. Brain Dynamics: Progress and Perspectives. 1st ed. Springer-Verlag Berlin Heidelberg, 1989.

Knyazev GG, Savostyanov AN, Levin EA. Alpha synchronization and anxiety: implications for inhibition vs. alertness hypotheses. Int J Psychophysiol 2006;59:151-8.

Başar E, Başar-Eroglu C, Karakaş S, Schürmann M. Gamma, alpha, delta, and theta oscillations govern cognitive processes. Int J Psychophysiol 2001;39:241-8.

Palva JM, Palva S, Kaila K. Phase synchrony among neuronal oscillations in the human cortex. J Neurosci 2005;25:3962-72.

Sotaniemi KA, Sulg IA, Hokkanen TE. Quantitative EEG as a measure of cerebral dysfunction before and after open-heart surgery. Electroencephalogr Clin Neurophysiol 1980;50:81-95.

Glaria AP, Murray A. Comparison of EEG monitoring techniques: An evaluation during cardiac surgery. Electroencephalogr Clin Neurophysiol 1985;61:323-30.

Bastiaansen MC, van Berkum JJ, Hagoort P. Syntactic processing modulates the theta rhythm of the human EEG. Neuroimage 2002;17:1479-92.

Babiloni C, Bares M, Vecchio F, Brazdil M, Jurak P, Moretti DV, et al. Synchronization of gamma oscillations increases functional connectivity of human hippocampus and inferior-middle temporal cortex during repetitive visuomotor events. Eur J Neurosci 2004;19:3088-98.

Başar-Eroglu C, Başar E, Demiralp T, Schürmann M. P300-response: possible psychophysiological correlates in delta and theta frequency channels. A review. Int J Psychophysiol 1992;13:161-79.

Başar E, Düzgün A. Links of consciousness, perception, and memory by means of delta oscillations of brain. Front Psychol 2016;7:275.

Karakaş S, Kafadar H. Şizofrenideki bilişsel süreçlerin değerlendirilmesinde nöropsikolojik testler: Bellek ve dikkatin ölçülmesi. Şizofreni Dizisi 1999;4:132-52.

Keller AS, Payne L, Sekuler R. Characterizing the roles of alpha and theta oscillations in multisensory attention. Neuropsychologia 2017;99:48-63.

Klimesch W, Freunberger R, Sauseng P, Gruber W. A short review of slow phase synchronization and memory: evidence for control processes in different memory systems? Brain Res 2008;1235:31-44.

Bazanova OM, Vernon D. Interpreting EEG alpha activity. Neurosci Biobehav Rev 2014;44:94-110.

Başar E, Güntekin B. A short review of alpha activity in cognitive processes and in cognitive impairment. Int J Psychophysiol 2012;86:25-38.

Başar E, Güntekin B. Darwin’s evolution theory, brain oscillations, and complex brain function in a new “Cartesian view”. Int J Psychophysiol 2009;71:2-8.

Klimesch W. α-band oscillations, attention, and controlled access to stored information. Trends Cogn Sci 2012;16:606-17.

Schürmann M, Başar-Eroglu C, Başar E. A possible role of evoked alpha in primary sensory processing: common properties of cat intracranial recordings and human EEG and MEG. Int J Psychophysiol 1997;26:149-70.

Pfurtscheller G, Bauernfeind G, Neuper C, Lopes da Silva FH. Does conscious intention to perform a motor act depend on slow prefrontal (de)oxyhemoglobin oscillations in the resting brain? Neurosci Lett 2012;508:89-94.

Knyazev GG, Schutter DJ, van Honk J. Anxious apprehension increases coupling of delta and beta oscillations. Int J Psychophysiol 2006;61:283-7.

Chakarov V, Naranjo JR, Schulte-Mönting J, Omlor W, Huethe F, Kristeva R. Beta-range EEG-EMG coherence with isometric compensation for increasing modulated low-level forces. J Neurophysiol 2009;102:1115-20.

Canolty RT, Knight RT. The functional role of cross-frequency coupling. Trends Cogn Sci 2010;14:506-15.

Edmonds HL Jr, Rodriguez RA, Audenaert SM, Austin EH 3rd, Pollock SB Jr, Ganzel BL. The role of neuromonitoring in cardiovascular surgery. J Cardiothorac Vasc Anesth 1996;10:15-23.

Mierbekov EM, Flerov EV, Dement’eva II, Seleznev MN, Kukaeva EA, Sablin IN. Changes in bioelectric activity and metabolism of the brain during surgery of the aorta under deep hypothermic arrest of circulation. Anesteziol Reanimatol 1997;45-9.

Akiyama T, Kobayashi K, Nakahori T, Yoshinaga H, Ogino T, Ohtsuka Y, et al. Electroencephalographic changes and their regional differences during pediatric cardiovascular surgery with hypothermia. Brain Dev 2001;23:115-21.

Mathew JP, Weatherwax KJ, East CJ, White WD, Reves JG. Bispectral analysis during cardiopulmonary bypass: The effect of hypothermia on the hypnotic state. J Clin Anesth 2001;13:301-5.

The Neuroelectric Activity of The Brain in Extracorporeal Circulation: Preliminary Results

ABSTRACT

References