Brown and colleagues are establishing a new paradigm for waking patients up following general anesthesia. They have shown that the anesthetic state can be rapidly reversed by administering methylphenidate (Ritalin) or activation of dopaminergic systems. This suggests a new, feasible way to actively restore cognitive function in patients after anesthesia and sedation. They have received FDA approval to undertake a clinical trial to test this idea in humans (NCT 02051452). They have also shown that burst-suppression, a state of profound brain inactivation seen in deep general anesthesia, hypothermia, coma and developmental brain disorders, can be simply explained by a unifying neural-metabolic model. Brown's group have also shown that burst suppression can be precisely controlled to maintain a therapeutic, medically induced coma. This research uses a closed-loop control system based on his SSPP paradigm. This could have important implications for treating patients, such as Gabby Giffords, Michael Schumaker, Malala Yousafzai, and Joan Rivers, who sustain brain injuries or have intracranial hypertension and require a medically induced coma to facilitate brain recovery.
