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British Journal of Anaesthesia

ISSN 0007-0912

2 papers in the library · 152 citations · publishing 2018

Papers

Subanaesthetic ketamine and altered states of consciousness in humans

British Journal of Anaesthesia April 13, 2018 Phillip E. Vlisides, Tarik Bel‐bahar, Amanda Nelson et al. 117 citations

Subanaesthetic doses of ketamine produce altered states of consciousness dominated by dissociative experiences such as disembodiment and ego transcendence, along with sensory disturbances. These subjective effects occur alongside a broad decrease in low-frequency brain electrical activity, with the largest reductions in alpha power (8–12 Hz) in parietal and occipital regions. Specific decreases in alpha power were identified in the precuneus and temporal-parietal junction, brain areas involved in multisensory integration, body representation, and consciousness. The findings suggest that modulation of these temporal-parietal loci may be a candidate mechanism for ketamine's psychoactive effects.

General anaesthesia as fragmentation of selfhood: insights from electroencephalography and neuroimaging

British Journal of Anaesthesia February 4, 2018 Jamie Sleigh, Catherine E. Warnaby, Irene Tracey 35 citations

Selfhood depends on brain processes that allow a person to experience being a distinct, capable agent. It includes a hierarchy of components: core self (awareness of existence), embodied self (sentience), executive self (agency), and higher-order cognition. Consciousness and selfhood are related but not identical; understanding selfhood helps explain partial consciousness during anesthesia. Brain-imaging and EEG studies show that anesthetic drugs selectively impair self-related networks, especially the anterior insula and salience network, causing depersonalization at moderate doses while preserving disembodied self-awareness. Unlike natural sleep, where loss of agency and sentience tracks with decreasing self-awareness, anesthesia maintains posterior brain connectivity even at high concentrations, possibly marking a core self involved in reduced energy homeostasis.