Editorial Views  |   July 2019
Pharmacologic Unmasking of Neurologic Deficits: A Stress Test for the Brain
Author Notes
  • From the Department of Anesthesiology, Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, Michigan.
  • This editorial accompanies the article on p. 36 and has a related Infographic on p. 17A.
    This editorial accompanies the article on p. 36 and has a related Infographic on p. 17A.×
  • Accepted for publication April 3, 2019.
    Accepted for publication April 3, 2019.×
  • Address correspondence to Dr. Vlisides: pvliside@med.umich.edu
Article Information
Editorial Views / Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Respiratory System
Editorial Views   |   July 2019
Pharmacologic Unmasking of Neurologic Deficits: A Stress Test for the Brain
Anesthesiology 7 2019, Vol.131, 5-6. doi:10.1097/ALN.0000000000002775
Anesthesiology 7 2019, Vol.131, 5-6. doi:10.1097/ALN.0000000000002775
Neuroplasticity remains one of the most intriguing aspects of modern neuroscience and is of clinical relevance to anesthesiology. Indeed, the brain possesses a remarkable ability to adapt to various perturbations via structural and functional alterations. For example, patients who have experienced stroke demonstrate signs of adaptation by regaining neurologic function after injury, without regeneration of the original lesion per se. However, such adaptations can be reversed pharmacologically, with relative selectivity by agents that potentiate the transmission of γ-aminobutyric acid (GABA) compared with agents that antagonize the cholinergic system.1  Understanding the interactions of brain dysfunction, adaptive changes, and pharmacology is important for the field of anesthesiology. Studying the effects of our drugs on neurologic function in surgical patients may provide a unique window into previous neurologic injury, subsequent neuroplastic changes, and associated clinical vulnerability, particularly in those with known or suspected neuropathology.