Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousness

Abstract Understanding the neurophysiological changes underlying conscious-unconscious transitions is a key goal in neuroscience. Using magnetic resonance neuroimaging, we investigate the network connectivity and neurovascular changes occurring as the human brain transitions from wakefulness to dexm...

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Main Authors: Panagiotis Fotiadis, Andrew R. McKinstry-Wu, Sarah M. Weinstein, Philip A. Cook, Mark Elliott, Matthew Cieslak, Jeffrey T. Duda, Theodore D. Satterthwaite, Russell T. Shinohara, Alexander Proekt, Max B. Kelz, John A. Detre, Dani S. Bassett
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Communications Biology
Online Access:https://doi.org/10.1038/s42003-025-08577-9
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author Panagiotis Fotiadis
Andrew R. McKinstry-Wu
Sarah M. Weinstein
Philip A. Cook
Mark Elliott
Matthew Cieslak
Jeffrey T. Duda
Theodore D. Satterthwaite
Russell T. Shinohara
Alexander Proekt
Max B. Kelz
John A. Detre
Dani S. Bassett
author_facet Panagiotis Fotiadis
Andrew R. McKinstry-Wu
Sarah M. Weinstein
Philip A. Cook
Mark Elliott
Matthew Cieslak
Jeffrey T. Duda
Theodore D. Satterthwaite
Russell T. Shinohara
Alexander Proekt
Max B. Kelz
John A. Detre
Dani S. Bassett
author_sort Panagiotis Fotiadis
collection DOAJ
description Abstract Understanding the neurophysiological changes underlying conscious-unconscious transitions is a key goal in neuroscience. Using magnetic resonance neuroimaging, we investigate the network connectivity and neurovascular changes occurring as the human brain transitions from wakefulness to dexmedetomidine-induced hypnosis, and recovery. Hypnosis led to widespread decreases in functional connectivity strength and increased structure-function coupling, indicating functional patterns more constrained by the underlying anatomical connectivity. As individuals began to regain consciousness, both connectivity markers returned towards awake levels, with particularly prominent coupling changes across the cerebellum. Neurovascular dynamics were disrupted during hypnosis as well: cerebral blood flow decreased globally—most notably in the brainstem, thalamus, and cerebellum—and continued decreasing even as recovery commenced, except within the cerebellum. Notably, regions with higher functional connectivity strength during wakefulness exhibited greater blood flow reductions during hypnosis. Hypnosis also heightened the amplitude of low-frequency fluctuations in the hemodynamic signal, especially in visual and somatomotor regions. Critically, individuals who regained consciousness faster displayed higher baseline levels of both neurovascular, but not connectivity, markers. Together, these results reveal that the induction of, and emergence from, dexmedetomidine-induced unconsciousness involve widespread, coordinated changes in brain connectivity and neurovascular function; across our findings, we also highlight the recurrent role of cerebellum in conscious-unconscious transitions.
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spelling doaj-art-8d1f86c7978b41909c3ee969f3e66afc2025-08-24T11:46:17ZengNature PortfolioCommunications Biology2399-36422025-08-018111710.1038/s42003-025-08577-9Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousnessPanagiotis Fotiadis0Andrew R. McKinstry-Wu1Sarah M. Weinstein2Philip A. Cook3Mark Elliott4Matthew Cieslak5Jeffrey T. Duda6Theodore D. Satterthwaite7Russell T. Shinohara8Alexander Proekt9Max B. Kelz10John A. Detre11Dani S. Bassett12Department of Neuroscience, Perelman School of Medicine, University of PennsylvaniaDepartment of Anesthesiology & Critical Care, Perelman School of Medicine, University of PennsylvaniaDepartment of Epidemiology and Biostatistics, Temple University College of Public HealthDepartment of Radiology, Perelman School of Medicine, University of PennsylvaniaDepartment of Radiology, Perelman School of Medicine, University of PennsylvaniaPenn Lifespan Informatics and Neuroimaging Center, University of PennsylvaniaDepartment of Radiology, Perelman School of Medicine, University of PennsylvaniaPenn Lifespan Informatics and Neuroimaging Center, University of PennsylvaniaPenn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of PennsylvaniaDepartment of Anesthesiology & Critical Care, Perelman School of Medicine, University of PennsylvaniaDepartment of Anesthesiology & Critical Care, Perelman School of Medicine, University of PennsylvaniaDepartment of Radiology, Perelman School of Medicine, University of PennsylvaniaDepartment of Bioengineering, University of PennsylvaniaAbstract Understanding the neurophysiological changes underlying conscious-unconscious transitions is a key goal in neuroscience. Using magnetic resonance neuroimaging, we investigate the network connectivity and neurovascular changes occurring as the human brain transitions from wakefulness to dexmedetomidine-induced hypnosis, and recovery. Hypnosis led to widespread decreases in functional connectivity strength and increased structure-function coupling, indicating functional patterns more constrained by the underlying anatomical connectivity. As individuals began to regain consciousness, both connectivity markers returned towards awake levels, with particularly prominent coupling changes across the cerebellum. Neurovascular dynamics were disrupted during hypnosis as well: cerebral blood flow decreased globally—most notably in the brainstem, thalamus, and cerebellum—and continued decreasing even as recovery commenced, except within the cerebellum. Notably, regions with higher functional connectivity strength during wakefulness exhibited greater blood flow reductions during hypnosis. Hypnosis also heightened the amplitude of low-frequency fluctuations in the hemodynamic signal, especially in visual and somatomotor regions. Critically, individuals who regained consciousness faster displayed higher baseline levels of both neurovascular, but not connectivity, markers. Together, these results reveal that the induction of, and emergence from, dexmedetomidine-induced unconsciousness involve widespread, coordinated changes in brain connectivity and neurovascular function; across our findings, we also highlight the recurrent role of cerebellum in conscious-unconscious transitions.https://doi.org/10.1038/s42003-025-08577-9
spellingShingle Panagiotis Fotiadis
Andrew R. McKinstry-Wu
Sarah M. Weinstein
Philip A. Cook
Mark Elliott
Matthew Cieslak
Jeffrey T. Duda
Theodore D. Satterthwaite
Russell T. Shinohara
Alexander Proekt
Max B. Kelz
John A. Detre
Dani S. Bassett
Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousness
Communications Biology
title Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousness
title_full Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousness
title_fullStr Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousness
title_full_unstemmed Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousness
title_short Changes in brain connectivity and neurovascular dynamics during dexmedetomidine-induced loss of consciousness
title_sort changes in brain connectivity and neurovascular dynamics during dexmedetomidine induced loss of consciousness
url https://doi.org/10.1038/s42003-025-08577-9
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