What effect does measuring children under anesthesia have on the blood oxygenation level-dependent signal? A functional magnetic resonance imaging study of visual cortex

We performed functional magnetic resonance measurements involving visual stimuli on 10 children. Half of the children were measured awake, the other half were measured under light Sevoflurane anesthesia corresponding to 0.5 mean alveolar concentration. Each child was presented with a flashed and a reversing checkerboard, which previous investigations have shown to induce identical increases in cerebral blood flow. The latter stimulus activated double the number of neurons as the former so that cerebral metabolic rate of oxygen consumption (CMRO(2)) was doubled, leading to an effective rise of the oxygen extraction fraction. We measured the extent of activation by counting the number of activated pixels and assessed the change in CMRO(2) by measuring the change in the local deoxyhemoglobin (HbR) concentration, using change in spin relaxivity. In both groups of children, the extent of activation was larger for the flashed than the reversing checkerboard, although the absolute number of activated voxels was smaller for the children who were measured under anesthesia. The HbR concentration was significantly higher during the presentation of the reversing compared with the flashed checkerboard. The relative change in the HbR concentration to the flashed and reversing checkerboard was the same in the children who were measured under anesthesia as in the children who were measured awake. We conclude that light levels of anesthesia may reduce the extent of activation but does not unduly influence either CMRO(2) or cerebral blood flow, thus preserving the blood oxygenation level-dependent signal amplitude.