Ketamine, like propofol and sevoflurane, inhibits feedback (anterior-to-posterior) connectivity between frontal and parietal brain regions after loss of consciousness, while preserving feedforward (posterior-to-anterior) connectivity. In 30 surgical patients given intravenous ketamine (2 mg/kg), electroencephalography showed that feedback connectivity gradually diminished and was significantly reduced after loss of consciousness (mean baseline 0.0074 vs. anesthesia 0.0055). Feedforward connectivity remained unchanged. Ketamine reduced alpha power and increased gamma power, unlike propofol and sevoflurane. Despite molecular and neurophysiologic differences, diverse anesthetics disrupt frontal-parietal communication, suggesting that directional connectivity analysis could provide a common metric for general anesthesia.
General anesthesia with propofol reconfigures the brain's functional network hub structure and reverses the phase relationship between frontal and parietal regions. Using graph theoretical analysis of 21-channel electroencephalogram data from 10 volunteers, the study found that network topology—not connection strength—correlates with states of consciousness. After propofol administration, average path length, clustering coefficient, and modularity increased, long-range connections were disrupted, and hub node strength decreased. The primary hub shifted from parietal to frontal regions. The phase lead of frontal to parietal areas in the alpha frequency band (8-13 Hz) during wakefulness reversed direction after propofol and returned during recovery. Changes in network topology may be the primary mechanism for loss of frontal to parietal feedback during anesthesia.