Dr. Cornelissen’s Research

Cerebral Dynamics of General Anesthesia in Childhood

In the US, more than 200,000 children receive general anesthesia during the first year of life. There is worldwide concern among pediatric anesthesiologists that exposure to general anesthesia exposure in early-life is associated with neurotoxicity, with youngest infants being most vulnerable. Perioperative brain monitoring systems are becoming more commonly used to complement traditional physiological monitoring procedures. Monitoring systems include electroencephalography (EEG) and near-infra red spectroscopy (NIRS) to provide real-time information on precise neural and hemodynamic physiology. These systems facilitate our understanding of the cerebral neurovascular response seen in states of severely reduced brain activity such as high-dose general anesthesia, hypoxic brain injury and hypotension. EEG-derived indices used in the adult provide inaccurate assessment of anesthetic states in children, particularly infants. There is a great need to develop and validate brain-monitoring approaches in children given their highly promised use as a tool to monitor adequacy of anesthetic depth, cerebral perfusion and to validate surrogate markers of potential harm and anesthetic neurotoxicity. Dr. Cornelissen’s overall aim is to expand ongoing research to better understand cortical dynamics underlying general anesthesia in children. To achieve this aim, Dr. Cornelissen and her team will characterize neurophysiologic and hemodynamic activity using combined electrophysiological (EEG), and advanced cerebral hemodynamic (NIRS) measurements in infants aged 0-3 years during anesthesia (general and spinal), natural-sleep and wakefulness. Dr. Cornelissen will correlate EEG-NIRS measures with postnatal age, anesthetic depth, systemic hemodynamics and pCO2. The rationale of the proposed research is that understanding the developmental physiology of brain homeostasis will provide strategies to develop new tools and surrogate measures to identify and mitigate potential risk of neurotoxicity during anesthesia.

Related Publications

Age-dependent electroencephalogram (EEG) patterns during sevoflurane general anesthesia in infants.
Cornelissen L, Kim SE, Purdon PL, Brown EN, Berde CB.

Electroencephalogram (EEG) approaches may provide important information about developmental changes in brain-state dynamics during general anesthesia. We used multi-electrode EEG, analyzed with multitaper-spectral methods and video recording of body movement to characterize the spatiotemporal dynamics of brain activity in 36 infants 0-6 months old when awake, and during maintenance-of and emergence-from…

Pain hypersensitivity in juvenile idiopathic arthritis: a quantitative sensory testing study.
Cornelissen L, Donado C, Kim J, Chiel L, Zurakowski D, Logan DE, Meier P, Sethna NF, Blankenburg M, Zernikow B, Sundel RP, Berde CB.

Juvenile Idiopathic Arthritis (JIA) is the most common cause of non-infectious joint inflammation in children. Synovial inflammation results in pain, swelling and stiffness. Animal and adult human studies indicate that localized joint-associated inflammation may produce generalized changes in pain sensitivity. The aim was to characterize pain sensitivity…

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