Early reactivation of medial temporal lobe neurons during emergence from propofol anesthesia in neurosurgical patients

Joel I Berger; Matthew I Banks; Emily R Dappen; Urszula J Gorska-Klimowska; Rashmi N Mueller; Hiroto Kawasaki; Corey A Amlong; Melanie Boly; Wendell B Lake; Woodrow L Shew; Kirill V Nourski

doi:10.64898/2026.05.22.727285

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Early reactivation of medial temporal lobe neurons during emergence from propofol anesthesia in neurosurgical patients

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Early reactivation of medial temporal lobe neurons during emergence from propofol anesthesia in neurosurgical patients

Joel I Berger, Matthew I Banks, Emily R Dappen, Urszula J Gorska-Klimowska, Rashmi N Mueller, Hiroto Kawasaki, Corey A Amlong, Melanie Boly, Wendell B Lake, Woodrow L Shew, …

bioRxiv

Cold Spring Harbor Laboratory

05/26/2026

DOI: 10.64898/2026.05.22.727285

PMCID: PMC13232289

PMID: 42244534

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https://doi.org/10.64898/2026.05.22.727285View

Preprint (Author's original) This preprint has not been evaluated by subject experts through peer review. Preprints may undergo extensive changes and/or become peer-reviewed journal articles. Open Access

Abstract

Although much is known about the molecular and cellular effects of general anesthetics, the neural mechanisms underlying loss and recovery of consciousness during anesthesia remain elusive. We provide the first report of human single neuron activity recorded throughout emergence from general anesthesia. Following cessation of propofol infusion, emergence was assessed as motor response to verbal command (RC). In most cells, firing rates increased during the course of emergence. Analysis of pooled firing rate changes indicated a shift towards criticality during emergence and attractor states during and immediately following anesthesia and immediately after RC. Changes in activity in some regions occurred prior to overt RC, with shortest latencies in the hippocampus, parahippocampal gyrus, and amygdala, followed by cingulate and then insular cortex. This work reveals that brain activity in medial temporal regions may presage restoration of responsiveness in humans following general anesthesia.

Details

Title: Subtitle: Early reactivation of medial temporal lobe neurons during emergence from propofol anesthesia in neurosurgical patients
Creators: Joel I Berger - University of Iowa
Matthew I Banks - University of Wisconsin–Madison
Emily R Dappen - University of Iowa
Urszula J Gorska-Klimowska - University of Wisconsin–Madison
Rashmi N Mueller - University of Iowa
Hiroto Kawasaki - University of Iowa
Corey A Amlong - University of Wisconsin–Madison
Melanie Boly - University of Wisconsin–Madison
Wendell B Lake - University of Wisconsin–Madison
Woodrow L Shew - University of Arkansas at Fayetteville
Kirill V Nourski - University of Iowa
Resource Type: Preprint
Publication Details: bioRxiv
DOI: 10.64898/2026.05.22.727285
PMID: 42244534
PMCID: PMC13232289
NLM abbreviation: bioRxiv
ISSN: 2692-8205
eISSN: 2692-8205
Publisher: Cold Spring Harbor Laboratory; United States
Language: English
Date posted: 05/26/2026
Academic Unit: Iowa Neuroscience Institute; Anesthesia; Neurosurgery
Record Identifier: 9985174499802771

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