We are focused on answering fundamental questions about cognition that are central to the practice of anesthesiology and pain medicine. Our research predominantly investigates how brain activity and cognition function is affected by anesthetic and analgesic interventions, including pharmacologic agents, and neuromodulation strategies. Through the diverse portfolio of current projects, below, there is great potential to further our understanding of complex brain interaction during anesthetic, surgical, and pain-related conditions.
Systems-neuroscience of anesthetic effects in human subjects
One important focus of Dr. Vogt’s research centers on comparative studies of commonly used sedative-hypnotic and analgesic drugs. This work is funded by the NIH’s National Institute of General Medical Sciences (R35GM146822). Using functional MRI and behavioral paradigms, we aim to characterize the systems-level brain changes resulting from administration of anesthetic agents, particularly during the experience of pain. This models the clinical setting in which anesthetics are used – during otherwise unbearably painful experiences. The jig-saw image depicts agents that have been previously studied or that are the focus of ongoing investigations.
Currently ongoing clinical research studies are focused on the inhaled anesthetics Sevoflurane (NCT06044740) and Nitrous Oxide (NCT06702631), which represent other pieces that can be assembled as integral parts of a clinical anesthetic. We are actively seeking volunteer participants (see the Participants page) to be a part in this paid investigation of how brain activity and connectivity are affected by both of these commonly used anesthetics.
Notably, even patients having a relatively routine surgery (e.g. appendectomy) could very well receive all of the agents depicted in the figure. Though it is not a puzzle for a practicing anesthesiologist to assemble a clinical anesthetic, there are many unknowns about the way these drugs interact. Thus, the scientific “puzzle” reflects the significant gap in our understanding of systems-level anesthetic neuroscience: although anesthetic agents are ubiquitously combined in clinical practice, agents are rarely studied in combinations in the experimental setting. We plan to address this critical gap in knowledge with future combinatorial work funded under this program of research.
Peri-operative imaging of neurocognitive disorders
A core thread of Dr. Ibinson’s research interest is leveraging neuroimaging to better understand the development of perioperative neurocognitive disorders. These phenomena span the spectrum of acute delirium to the less common phenomenon of persistent postoperative neurocognitive disorders. In recent pilot work, we have demonstrated that changes in hippocampal connectivity to the rest of the brain may be seen shortly after cardiac surgery.
Thes changes trend towards resolution at 3 months post-op. We seek to better characterize how these, and other, perioperative brain changes may affect cognitive function after surgery. Through the use of advanced structural and functional neuroimaging paradigms, we will elucidate the mechanisms of these disorders. This work leverages our strong collaborative partnership with the 7T Bioengineering Research Program here at the University of Pittsburgh, which has the unique ability to characterize brain changes at high-field, using custom hardware.
Neural Correlates of auricular stimulation and auriculotherapy
We are currently undertaking a multidisciplinary study of how stimulation of the ear may modulate brain activity. Funded by NCCIH (R01AT013058) two studies are currently recruiting participants. One of these is a study of non-therapeutic auricular stimulation in pain-free volunteer subjects and will noninvasively measure brain responses with functional near-infrared spectroscopy (fNIRS). The second study is focused on understanding the neural correlates of cryo-auriculotherapy, which will compare functional connectivity (with fMRI) and auricular responses (using fNIRS) before and after treatment with auriculotherapy in patients with chronic low back pain, to understand the brain changes that accompany pain relief with this complimentary neuromodulatory technique. This study leverages a double-blind, sham-controlled, within-subject, crossover design to maximize experimental rigor.
This collaborative effort involves several researchers in the Department of Anesthesiology and Perioperative Medicine, including Jacques Chelly, Ben Alter, Ajay Wasan, and Trent Emerick. Ted Huppert from the Department of Electrical Engineering and Bedda Rosario from Epidemiology are external faculty co-investigators.
Collaborations
An emerging collaboration with Tobias Teichert, PhD from the Departments of Psychiatry and Bioengineering will leverage a unique approach using non-human primates with indwelling electrodes throughout one hemisphere of their brain. This study seeks to better understand how opioids, non-opioid analgesics, and opioid-sparing anesthetic-adjuncts affect the brain circuits for pain and reward processing.
An ongoing collaboration, with Caroline Oppenheimer, PhD from RTI, who studies suicide prevent in adolescents, is focused on identifying near-term risk for suicidal ideation, with a focus on physical and emotional pain as a trigger. Previous work has sought to understand the overlap between social rejection and experimental pain.