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A human intracranial map of consciousness returning from anesthesia

Xinyu Chen, Haoru Zhang, Xinran Deng, Yong Ren, Yiting Liu, Jialei Wang, Shiyi Xu, Yuchao Ji, Zihan Yang, Wenwen Jia, Xialei Huang, Yuanqing Wang, Lanhui Huang, Sixian Li, Yue Yuan, Aoqing Luo, Junfan Chen, Chen Yao, Yuchen Xiao

bioRxiv Preprint Server June 17, 2026 preprint DOI: 10.64898/2026.06.17.732807 via bioRxiv

Summary

Consciousness re-emerges from propofol-induced general anesthesia through a multiscale reorganization of brain activity, not a single event. Anesthesia is an organized low-frequency regime with aperiodic slow waves, alpha/beta rhythms, global alpha synchronization, and phase-amplitude coupling. After anesthetic cessation, this regime dissolves as neural excitability and complexity increase. Conscious behavior returns with a rapid transformation in high-gamma activity, shifting from random bursts to structured, task-selective, event-locked responses. The findings chart an electrophysiological map of how conscious cognition is extinguished, reconfigured, and restored in the human brain.

Study at a glance

Characteristics Observational cohort
Population Humans undergoing propofol-induced general anesthesia with intracranial recordings
Key finding Recovery of consciousness from anesthesia involves a multiscale reorganization where distinct neural dynamics rise and fall, with conscious behavior coinciding with a fast transformation in high-gamma activity from stochastic bursts to structured, task-selective responses.

Abstract

How consciousness arises from the brain remains a central yet unsolved question. Although substantial effort has been devoted to characterizing the neural correlates of conscious perception during wakefulness, how consciousness re-emerges from unconscious states remains poorly understood. Here, we took advantage of the rare opportunity to record human intracranial local field potentials from propofol-induced general anesthesia through the transition to behavioral engagement and subsequent full wakefulness, capturing both the stable states of unconsciousness and consciousness and the reconstituting neural dynamics that bridge them. Anesthesia cannot be defined by any single electrophysiological signature; rather, it is an organized low-frequency regime characterized by a constellation of coordinated neural phenomena, including aperiodic slow waves, alpha/beta periodicity, global alpha synchronization, and slow-wave-alpha/beta phase-amplitude coupling. Following anesthetic cessation, this regime progressively dissolved as neural excitability and dynamical complexity climbed. The appearance of conscious behavior coincided with a fast and dramatic transformation in high-gamma activity, from stochastic and unpredictable bursts to structured responses that were distributed, task-selective, and event-locked. These findings suggest that the recovery of consciousness is a multiscale reorganization in which distinct neural underpinnings rise and fall. Together, this work charts an electrophysiological map of how conscious cognition is extinguished, reconfigured, and restored in the human brain.

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