Changes in Brain Resting-state Functional Connectivity Associated with Peripheral Nerve Block: A Pilot Study.
Abstract
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.
Type
Journal articleSubject
AdultBrain
Female
Functional Laterality
Humans
Magnetic Resonance Imaging
Male
Motor Cortex
Nerve Block
Nerve Net
Neuroimaging
Neuronal Plasticity
Peripheral Nerves
Pilot Projects
Rest
Sensorimotor Cortex
Visual Cortex
Young Adult
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https://hdl.handle.net/10161/15957Published Version (Please cite this version)
10.1097/ALN.0000000000001198Publication Info
Melton, 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.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
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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