Comparison of Modulations of Motor Brain Activity and SedLine After Median Nerve Stimulation in General Anesthesia
STIM-PSI: Comparison of Modulations of Motor Brain Activity and SedLine After Median Nerve Stimulation in General Anesthesia
To this date, no monitoring device can reliably detect episodes of accidental awakening during general anesthesia. One promising approach is the use of electroencephalography (EEG) to detect movement attempts via a brain-computer interface (BCI). Previous work has shown that combining a BCI with painless median nerve stimulation can detect cerebral motor activity under light propofol sedation. However, clinical data are still lacking regarding the persistence or otherwise of a cerebral motor response (neural synchronization, or ERS) induced by this stimulation during general anesthesia.
In this new study, the aim is to simultaneously record the EEG centered on the motor cortex and the signal from the SedLine Patient State Index (PSI) to better characterize the evolution of cerebral motor activity before, during general anesthesia, and up to awakening. This approach will allow us to explore the complementarity of the two signals for future automated detection of residual states of consciousness during surgery.
Preliminary data from a previous protocol (STIM-MOTANA) allowed to develop an EEG classification algorithm based on Riemannian geometry, capable of inferring a patient's state of consciousness from cortical responses induced by median nerve stimulation.
The objective of this new study is also to compare the sensitivity of this algorithm with that of PSI, in order to assess its potential as a complementary - or even alternative - indicator of the level of consciousness under general anesthesia.
Investigators hypothesize that it is possible to detect, using EEG, specific brain signatures related to median nerve stimulation, including during propofol-induced general anesthesia. Specifically, neuronal desynchronization and resynchronization phases (ERD/ERS), well characterized in wakefulness or light sedation, could partially persist at higher propofol concentrations. Parallel PSI recording will allow analyzing to what extent these EEG modulations are related to classically measured levels of consciousness, and to validate the relevance of the new algorithm based on Riemannian geometry as a tool for detecting intra-operative arousals.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Seyed Javad Bidgoli, MD
- Phone Number: 02 477 21 79
- Email: seyedjavad.bidgoli@chu-brugmann.be@chu-brugmann.be
Study Locations
-
-
-
Brussels, Belgium, 1020
- Recruiting
- CHU Brugmann
-
Contact:
- Seyed Javad Bidgoli, MD
- Phone Number: 003224772179
- Email: SEYEDJAVAD.BIDGOLI@chu-brugmann.be
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Right-handed patient
- Scheduled for surgery using intravenous anesthesia with propofol concentration
Exclusion Criteria:
- Allergy to propofol, soy, or peanuts.
- BMI < 20 or > 30
- Pregnant or breastfeeding women
- Medical or surgical history that may interfere with median nerve stimulation or EEG signal acquisition (e.g., diabetes, polyneuropathy, central neurodegenerative disease, epilepsy, brain surgery)
- History of right median nerve injury
- Right upper limb amputation
- Upper limb surgery
- Unable to wear an EEG headset (prone position, head and neck surgery)
- Drug abuse
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Sedation by intravenous anesthesia with propofol concentration target.
Any patient undergoing surgery requiring the use of sedation by intravenous anesthesia with propofol concentration target.
|
64-electrode device (including 16 on the motor cortex), placed on the scalp.
The EEG measurement is performed using OpenViBE software, in conjunction with an Eego amplifier (64 electrodes, ANT Neuro), both CE certified.
Median nerve stimulation: applied to the right forearm using two ECG electrodes positioned at the wrist (palmar side), allowing painless transcutaneous stimulation (intensity 3 to 14 mA; pulse duration: 0.1 ms; frequency: 5 Hz).
The stimulator used is a SD LTM STIM model (Micromed), CE certified.
Anesthetic depth monitoring: Performed using the SedLine® Brain Function Monitoring device (Masimo Corporation, model RDS7A, CE certified), using four forehead electrodes to record EEG activity.
The Patient State Index (PSi), calculated in real time, is interpreted within a target range of 25 to 50 to ensure adequate general anesthesia.
The device complies with international standards for electrical safety (IEC 60601) and hospital use.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Motor activity modulations (ERD/ERS) patterns
Time Frame: During the entire anesthesia
|
Detection of motor activity modulations (ERD/ERS) induced by median nerve stimulation by means of a EEG algorithm
|
During the entire anesthesia
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Seyed Javad Bidgoli, MD, CHU Brugmann
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- STIM-PSI
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Accidental Awareness During General Anesthesia
-
NCT05272202RecruitingAccidental Awareness During General Anesthesia
-
NCT07232160Not yet recruitingAwareness During General Anesthesia
-
NCT00689091CompletedAwareness During General Anesthesia
-
NCT04813952CompletedAnesthesia Awareness | Anesthesia; Functional
-
NCT03100396UnknownAwareness, Anesthesia | Obstetric Anesthesia Problems
-
NCT04697732UnknownTo Investigate the Incidence and Causes of Awareness During General Anesthesia | To Investigate the of Dreaming During Anesthesia | To Investigate the Intra-operative Experiences of Patients Who Report Awareness | To Investigate the Risk Factors That May be Associated With Awareness | To Analyze the Frequency of Posttraumatic Stress Disorder in Cases With Awareness and Possible Awareness | To Investigate the Risk Factors That May be Associated With Posttraumatic Stress Disorder
-
NCT03476213RecruitingAnesthesia Awareness
-
NCT03503357CompletedAnesthesia Awareness
Clinical Trials on EEG Headset
-
NCT05167396TerminatedProdromal Schizophrenia | Prodromal Symptoms | Healthy Controls | Psychotic Episode
-
NCT04942184WithdrawnAlzheimer Disease | Mild Cognitive Impairment | Dementia, Mild
-
NCT05615675CompletedPain | Anxiety | Virtual Reality
-
NCT04172948CompletedPelvic Floor Disorders | Functional Constipation
-
NCT03941119TerminatedDementia | Delirium Superimposed on Dementia
-
NCT05079568Suspended
-
NCT07451093Not yet recruitingEpilepsy | Seizure
-
NCT07287605Recruiting
-
NCT04751799CompletedPain | Anxiety | Cervical Dysplasia