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. 2022 Apr 18;134(6):1140–1152. doi: 10.1213/ANE.0000000000006011

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Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Anesthesia Research Society.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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Figure 5. — Inactivation of prefrontal cortex attenuates electroencephalographic, physiologic, and behavioral arousal induced by bilateral electrical stimulation of basal forebrain during sevoflurane anesthesia. Each red dot (female) and blue dot (male) show the individual rat data. A, Comparison of behavioral arousal score after bilateral electrical stimulation of basal forebrain with or without concurrent inactivation of prefrontal cortex. Compared to the bilateral electrical stimulation of basal forebrain without prefrontal inactivation (session 1), bilateral electrical stimulation of basal forebrain with concurrent prefrontal inactivation (session 2) caused a significant decrease in the arousal score. Repeat of session 1 (ie, session 3) showed the arousal score to be significantly higher than that observed in session 2 and reached the levels observed during session 1. B, Behavioral arousal score after bilateral electrical stimulation of basal forebrain (session 1) was significantly higher than the arousal score after bilateral electrical stimulation of piriform cortex (anatomical control). Bilateral electrical stimulation of piriform cortex did not produce behavioral arousal as in session 1 rats. Session 1—bilateral electrical stimulation of basal forebrain in sevoflurane-anesthetized rats increased respiration rate (C), heart rate (D), and theta/delta ratio (E). The prestimulation data were quantified 300 s before stimulation (prestim), and the poststimulation data were quantified 300 s after the stimulation (poststim). Session 2—bilateral basal forebrain stimulation in the presence of TTX in prefrontal cortex produced a significant increase in respiration rate (F), but no significant change was observed in heart rate (G); theta/delta ratio showed a significant decrease during electrical stimulation (H). Session 3—bilateral electrical stimulation of basal forebrain in the same rats used in sessions 1 and 2 produced increase in respiration rate (I), heart rate (J), and theta/delta ratio (K). A video showing representative behavior after stimulation of (1) basal forebrain and (2) basal forebrain along with concurrent inactivation of prefrontal cortex is provided in Supplemental Digital Content 3, Video 2, http://links.lww.com/AA/D919. Bilateral electrical stimulation of piriform cortex during sevoflurane anesthesia did not produce any statistical change in respiration rate (L), heart rate (M), or theta/delta ratio (N). A linear mixed model controlling for sex was used for within-rat statistical comparisons, while a linear regression controlling for sex was used for between-rat (B) statistical comparisons. Post hoc comparisons were Tukey corrected. The P values are shown at <.05, but the actual P values are reported in the main text and in Supplemental Digital Content 1, Tables S4–S8, http://links.lww.com/AA/D917. For panel A: *compared to session 1. For panel B: *compared to control. For panels C–N: *compared to prestimulation, #compared to stimulation. BF indicates basal forebrain; PFC, prefrontal cortex; Piriform, piriform cortex; post-stim, 300 seconds following stimulation period; pre-stim, 300 seconds before stimulation; SD, standard deviation; stim, stimulation period; TTX, tetrodotoxin.