Most studies examining the effect of extended exposure to general anesthetic agents (GAAs) have demonstrated that extended exposure induces both structural and functional changes in the central nervous system. These changes are frequently accompanied by neurobehavioral changes that include impulse control disorders that are generally characterized by deficits in behavioral inhibition and executive function. In this review, we will: • Examine recent advances in elucidating the association between GAAs and impulsive behavior. • Describe how impulsivity-related brain areas and neuronal circuits are altered after exposure to GAAs. • Evaluate anesthetic-induced changes in neurotransmitters and glial cells that contribute to impulse control disorders. • Discuss the effects of adjuncts to general anesthesia on impulsivity. • Provide a critical appraisal of new neuromodulation technologies and their application as promising therapeutic strategies for the treatment of neurological disorders. • Propose areas for future laboratory and clinical investigations to determine the mechanistic relationship between GAAs-related neurotoxicity and impulsive behavior.
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