Changes in Brain Resting-state Functional Connectivity Associated with Peripheral Nerve Block: A Pilot Study.
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BACKGROUND: Limited information exists on the effects of temporary functional deafferentation (TFD) on brain activity after peripheral nerve block (PNB) in healthy humans. Increasingly, resting-state functional connectivity (RSFC) is being used to study brain activity and organization. The purpose of this study was to test the hypothesis that TFD through PNB will influence changes in RSFC plasticity in central sensorimotor functional brain networks in healthy human participants. METHODS: The authors achieved TFD using a supraclavicular PNB model with 10 healthy human participants undergoing functional connectivity magnetic resonance imaging before PNB, during active PNB, and during PNB recovery. RSFC differences among study conditions were determined by multiple-comparison-corrected (false discovery rate-corrected P value less than 0.05) random-effects, between-condition, and seed-to-voxel analyses using the left and right manual motor regions. RESULTS: The results of this pilot study demonstrated disruption of interhemispheric left-to-right manual motor region RSFC (e.g., mean Fisher-transformed z [effect size] at pre-PNB 1.05 vs. 0.55 during PNB) but preservation of intrahemispheric RSFC of these regions during PNB. Additionally, there was increased RSFC between the left motor region of interest (PNB-affected area) and bilateral higher order visual cortex regions after clinical PNB resolution (e.g., Fisher z between left motor region of interest and right and left lingual gyrus regions during PNB, -0.1 and -0.6 vs. 0.22 and 0.18 after PNB resolution, respectively). CONCLUSIONS: This pilot study provides evidence that PNB has features consistent with other models of deafferentation, making it a potentially useful approach to investigate brain plasticity. The findings provide insight into RSFC of sensorimotor functional brain networks during PNB and PNB recovery and support modulation of the sensory-motor integration feedback loop as a mechanism for explaining the behavioral correlates of peripherally induced TFD through PNB.
Magnetic Resonance Imaging
Published Version (Please cite this version)10.1097/ALN.0000000000001198
Publication InfoMelton, M Stephen; Browndyke, Jeffrey N; Harshbarger, Todd B; Madden, David J; Nielsen, Karen C; & Klein, Stephen M (2016). Changes in Brain Resting-state Functional Connectivity Associated with Peripheral Nerve Block: A Pilot Study. Anesthesiology, 125(2). pp. 368-377. 10.1097/ALN.0000000000001198. Retrieved from https://hdl.handle.net/10161/15957.
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Jeffrey Nicholas Browndyke
Associate Professor of Psychiatry and Behavioral Sciences
Dr. Browndyke is an Associate Professor of Behavioral Health & Neurosciences in the Department of Psychiatry & Behavioral Sciences. He has a secondary appointment as Assistant Professor of Cardiovascular & Thoracic Surgery.Dr. Browndyke's research interests involve the use of advanced neurocognitive and neuroimaging techniques for perioperative contributions to delirium and later dementia risk, monitoring of late-life neuropathological disease progression, and inter
Todd B Harshbarger
Assistant Professor in Radiology
Stephen Matthew Klein
Professor of Anesthesiology
As an active member in the Division of Ambulatory Anesthesia Department of Anesthesiology, Duke University Medical Center, I am involved in numerous educational and research endeavors with the goal to improve a patient's peri-operative experience. The group focuses on all aspects of outpatient surgery. These include preoperative education, advanced anesthetic techniques, prolonged pain management and improving operative outcome. The division maintains an active clinical practice at the Du
David Joseph Madden
Professor in Psychiatry and Behavioral Sciences
My research focuses primarily on the cognitive neuroscience of aging: the investigation of age-related changes in perception, attention, and memory, using both behavioral measures and neuroimaging techniques, including positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and diffusion tensor imaging (DTI). The behavioral measures have focused on reaction time, with the goal of distinguishing age-related changes in specific cognitive abilities from mo
M. Stephen Melton
Associate Professor of Anesthesiology
Karen Cristina Nielsen
Associate Professor of Anesthesiology
* The Use of Advanced Regional Anesthesia for Ambulatory Surgery: The unique use of single injection and continuous peripheral nerve blocks has tremendous advantages for outpatients. This is the major focus of the textbook " Ambulatory Anesthesia and Perioperative Analgesia" (Editors Susan M. Steele, Karen C. Nielsen, Stephen M. Klein). * Ambulatory Anesthesiology Database: The ambulatory anesthesia database collects outcomes data for regional and ambulatory a
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