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postoperative cognitive decline

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https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#1
Elizabeth E Devore, Tamara G Fong, Edward R Marcantonio, Eva M Schmitt, Thomas G Travison, Richard N Jones, Sharon K Inouye
Background: Increasing evidence suggests that postoperative delirium may result in long-term cognitive decline among older adults. Risk factors for such cognitive decline are unknown. Methods: We studied 126 older participants without delirium or dementia upon entering the Successful AGing After Elective Surgery (SAGES) study, who developed postoperative delirium and completed repeated cognitive assessments (up to 36 months of follow-up). Pre-surgical factors were assessed preoperatively and divided into nine groupings of related factors ("domains")...
March 15, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28317003/peri-operative-inflammatory-cytokines-in-plasma-of-the-elderly-correlate-in-prospective-study-with-postoperative-changes-in-cognitive-test-scores
#2
R Kline, E Wong, M Haile, S Didehvar, S Farber, A Sacks, E Pirraglia, M J de Leon, A Bekker
Increasingly, postoperative cognitive dysfunction (POCD) is recognized as a complication after surgery in the elderly; but it's etiology remains unclear. Here we examine changes in cytokine levels during both the pre-operative and postoperative period, comparing them with long term variation in cognitive test scores. Forty-one patients aged 65 and older undergoing major surgery with general anesthesia were recruited after written consent in this IRB approved study. Thirty went on to complete this prospective, non-interven-tional and non-randomized study...
August 2016: Int J Anesthesiol Res
https://www.readbyqxmd.com/read/28298244/frailty-related-to-anesthesia-guided-by-the-index-bispectral-frail-study-study-protocol-for-a-randomized-controlled-trial
#3
Morgan Le Guen, Marie Herr, Antoine Bizard, Caroline Bichon, Nathalie Boichut, Thierry Chazot, Ngai Liu, Joel Ankri, Marc Fischler
BACKGROUND: Currently, patients older than 60 years of age represent 25% of the population and are at an increased risk during surgery. Therefore, reducing postoperative morbidity and mortality is a major concern in medical research and practice. Dependence on caregivers and cognitive impairment represent two major risk factors in the elderly, especially in frail patients after surgery under general anesthesia. In this context, continuous monitoring of the depth of anesthesia using a bispectral index (BIS) sensor may reduce the occurrence of impairments by gaining better control of the anesthetic depth...
March 16, 2017: Trials
https://www.readbyqxmd.com/read/28256333/-the-effect-of-two-different-glycemic-management-protocols-on-postoperative-cognitive-dysfunction-in-coronary-artery-bypass-surgery
#4
Pinar Kurnaz, Zerrin Sungur, Emre Camci, Nukhet Sivrikoz, Gunseli Orhun, Mert Senturk, Omer Sayin, Emin Tireli, Hakan Gurvit
INTRODUCTION: Postoperative cognitive dysfunction (POCD) is an adverse outcome of surgery that is more common after open heart procedures. The aim of this study is to investigate the role of tightly controlled blood glucose levels during coronary artery surgery on early and late cognitive decline. METHODS: 40 patients older than 50 years undergoing elective coronary surgery were randomized into two groups. In the "Tight Control" group (GI), the glycemia was maintained between 80 and 120mgdL(-1) while in the "Liberal" group (GII), it ranged between 80-180mgdL(-1)...
February 27, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28253549/the-immune-response-of-the-human-brain-to-abdominal-surgery
#5
Anton Forsberg, Simon Cervenka, Malin Jonsson Fagerlund, Lars S Rasmussen, Henrik Zetterberg, Helena Erlandsson Harris, Pernilla Stridh, Eva Christensson, Anna Granström, Anna Schening, Karin Dymmel, Nina Knave, Niccolò Terrando, Mervyn Maze, Jacqueline Borg, Andrea Varrone, Christer Halldin, Kaj Blennow, Lars Farde, Lars I Eriksson
OBJECTIVE: Surgery launches a systemic inflammatory reaction that reaches the brain and associates with immune activation and cognitive decline. While preclinical studies have in part described this systemic-to-brain signaling pathway, we lack information on how these changes appear in humans. This study examines the short- and long-term impact of abdominal surgery on the human brain immune system by Positron Emission Tomography (PET) in relation to blood immune reactivity, plasma inflammatory biomarkers and cognitive function...
March 2, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28240096/role-of-%C3%AE-2-microglobulin-in-postoperative-cognitive-decline
#6
Marta Załęska-Kocięcka, Paweł Jezierski, Maciej Grabowski, Krzysztof Kuśmierski, Maciej Dąbrowski, Katarzyna Piotrowska, Marek Banaszewski, Jacek Imiela, Janina Stępińska
AIM: β2-microglobulin (β2M) was proved to affect hippocampal functions in mice. MATERIALS & METHODS: Seventy-one patients undergoing aortic valve replacement were analyzed in prospective observational study. Kidney biomarkers and Mini Mental State Examinations (MMSEs) were performed before procedure, at discharge and after 6 months. RESULTS: Patients with β2M increase over the median change (>0.42 mg/l) experienced a significant in-hospital drop in MMSE (p = 0...
March 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28237537/neurocognitive-and-psychiatric-issues-post-cardiac-surgery
#7
REVIEW
Ben Indja, Michael Seco, Richard Seamark, Jason Kaplan, Paul G Bannon, Stuart M Grieve, Michael P Vallely
Neurocognitive and psychiatric complications are common following cardiac surgery and impact on patient quality of life, recovery from surgery, participation in rehabilitation and long-term mortality. Postoperative cognitive decline, depressive disorders, post-traumatic stress disorder and neurocognitive impairment related to silent brain infarcts have all been linked to the perioperative period of cardiac surgery, and potentially have serious consequences. The accurate assessment of these conditions, particularly in determining the aetiology, and impact on patients is difficult due to the poorly recognised nature of these complications as well as similarities in presentation with postoperative delirium...
February 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28212172/cognitive-decline-associated-with-anesthesia-and-surgery-in-the-elderly-does-this-contribute-to-dementia-prevalence
#8
Lisbeth Evered, David A Scott, Brendan Silbert
PURPOSE OF REVIEW: To provide an update on the current state of research investigating the effects of anesthesia and surgery on cognition in the elderly, including consideration of overlap with cognitive disorders in the community. RECENT FINDINGS: The studies reviewed here identify detrimental effects of anesthesia and surgery on cognition in a proportion of elderly individuals. Animal models demonstrate an association between anesthetic agents and Alzheimer's disease pathology...
February 15, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28176003/assessment-of-individual-cognitive-changes-after-deep-brain-stimulation-surgery-in-parkinson-s-disease-using-the-neuropsychological-test-battery-vienna-short-version
#9
Thomas Foki, Daniela Hitzl, Walter Pirker, Klaus Novak, Gisela Pusswald, Eduard Auff, Johann Lehrner
Long-term therapy of Parkinson's disease with L‑DOPA is associated with a high risk of developing motor fluctuations and dyskinesia. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can improve these motor complications. Although the positive effect on motor symptoms has been proven, postoperative cognitive decline has been documented. To tackle the impact of DBS on cognition, 18 DBS patients were compared to 25 best medically treated Parkinson's patients, 24 patients with mild cognitive impairment (MCI) and 12 healthy controls using the Neuropsychological Test Battery Vienna short version (NTBV-short) for cognitive outcome 12 months after the first examination...
February 7, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28169349/dynamic-hub-load-predicts-cognitive-decline-after-resective-neurosurgery
#10
Ellen W S Carbo, Arjan Hillebrand, Edwin van Dellen, Prejaas Tewarie, Philip C de Witt Hamer, Johannes C Baayen, Martin Klein, Jeroen J G Geurts, Jaap C Reijneveld, Cornelis J Stam, Linda Douw
Resective neurosurgery carries the risk of postoperative cognitive deterioration. The concept of 'hub (over)load', caused by (over)use of the most important brain regions, has been theoretically postulated in relation to symptomatology and neurological disease course, but lacks experimental confirmation. We investigated functional hub load and postsurgical cognitive deterioration in patients undergoing lesion resection. Patients (n = 28) underwent resting-state magnetoencephalography and neuropsychological assessments preoperatively and 1-year after lesion resection...
February 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28151820/associations-between-impaired-cerebral-blood-flow-autoregulation-cerebral-oxygenation-and-biomarkers-of-brain-injury-and-postoperative-cognitive-dysfunction-in-elderly-patients-after-major-noncardiac-surgery
#11
Nicolai Goettel, Christoph S Burkhart, Ariane Rossi, Brenno C T Cabella, Manfred Berres, Andreas U Monsch, Marek Czosnyka, Luzius A Steiner
BACKGROUND: Increasing evidence links postoperative cognitive dysfunction (POCD) to surgery and anesthesia. POCD is recognized as an important neuropsychological adverse outcome in surgical patients, particularly the elderly. This prospective cohort study aimed to investigate whether POCD is associated with impaired intraoperative cerebral autoregulation and oxygenation, and increased levels of biomarkers of brain injury. METHODS: Study subjects were patients ≥65 years of age scheduled for major noncardiac surgery...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28104728/early-and-long-term-cognitive-outcome-after-conventional-cardiac-valve-surgery
#12
Stephan C Knipp, Christian Weimar, Marc Schlamann, Sebastian Schweter, Daniel Wendt, Matthias Thielmann, Jaroslav Benedik, Heinz Jakob
OBJECTIVES: Adverse cognitive outcome is well recognized after coronary artery bypass grafting (CABG) while little is known about the extent and duration of decline after cardiac valve surgery. We investigated changes in cognitive function following conventional cardiac valve surgery over up to 4 years. METHODS: Among 36 patients (65.2 ± 9.2 years, 36% women) who received valve surgery, we assessed serial cognitive function with a battery of 11 standardized tests across 3-4 years...
January 18, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28089142/bedside-monitoring-of-cerebral-energy-state-during-cardiac-surgery-a-novel-approach-utilizing-intravenous-microdialysis
#13
Simon Mölström, Troels H Nielsen, Claus Andersen, Carl H Nordström, Palle Toft
OBJECTIVES: This study investigated whether the lactate-to-pyruvate (LP) ratio obtained by microdialysis (MD) of the cerebral venous outflow reflected a derangement of global cerebral energy state during cardiopulmonary bypass (CPB). DESIGN: Interventional, prospective, randomized study. SETTING: Single-center, university teaching hospital. PARTICIPANTS: The study included 10 patients undergoing primary, elective coronary artery bypass grafting...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28087827/neuropsychological-outcome-following-frontal-lobectomy-for-pharmacoresistant-epilepsy-in-adults
#14
Robyn M Busch, Darlene P Floden, Lisa Ferguson, Shamseldeen Mahmoud, Audrina Mullane, Stephen Jones, Lara Jehi, William Bingaman, Imad M Najm
OBJECTIVE: This retrospective cohort study characterized cognitive and motor outcomes in a large sample of adults who underwent frontal lobe resections for treatment of pharmacoresistant epilepsy. METHODS: Ninety patients who underwent unilateral frontal lobe resection for epilepsy (42 language-dominant hemisphere/48 nondominant hemisphere) between 1989 and 2014 completed comprehensive preoperative and postoperative neuropsychological evaluations that included measures of verbal and nonverbal intellectual functioning, attention/working memory, processing speed, language, executive functioning, verbal and visual memory, and motor functioning...
February 14, 2017: Neurology
https://www.readbyqxmd.com/read/28086911/enhanced-neuroinflammation-mediated-by-dna-methylation-of-the-glucocorticoid-receptor-triggers-cognitive-dysfunction-after-sevoflurane-anesthesia-in-adult-rats-subjected-to-maternal-separation-during-the-neonatal-period
#15
Yangzi Zhu, Yu Wang, Rui Yao, Ting Hao, Junli Cao, He Huang, Liwei Wang, Yuqing Wu
BACKGROUND: Mounting evidence indicates that children who experience abuse and neglect are prone to chronic diseases and premature mortality later in life. One mechanistic hypothesis for this phenomenon is that early life adversity alters the expression or functioning of the glucocorticoid receptor (GR) throughout the course of life and thereby increases sensitivity to inflammatory stimulation. An exaggerated pro-inflammatory response is generally considered to be a key cause of postoperative cognitive dysfunction (POCD)...
January 7, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28078842/remission-effect-of-vitamin-c-on-isoflurane-induced-apoptosis-and-its-mechanism
#16
J Hu, B F Gao, H Q Li, Z Z Zhang, Y L Lei, G Q Sun, D M Guo
This study aims to discuss the remission effect of vitamin C on isoflurane-induced apoptosis of rats and its possible mechanism of action, to provide a theoretical basis for postoperative cognitive impairment. Reactive oxygen species (ROS) detection, adenosine triphosphate (ATP) test, MTT method and Morris water maze were applied for detection tests. For data statistics, double factor analysis of variance (ANOVA) and post hoc Bonferroni test were adopted. It was found that vitamin C could slow down the isoflurane-induced accumulation of ROS in H4-APP cells; moreover, it could relieve the activation of caspase-3 and increase cell survival rate to inhibit the occurrence of apoptosis, indicating that ROS was the source of cell toxicity...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28039082/intraoperative-cerebral-oxygenation-oxidative-injury-and-delirium-following-cardiac-surgery
#17
Marcos G Lopez, Pratik Pandharipande, Jennifer Morse, Matthew S Shotwell, Ginger L Milne, Mias Pretorius, Andrew D Shaw, L Jackson Roberts, Frederic T Billings
BACKGROUND: Delirium affects 20-30% of patients after cardiac surgery and is associated with increased mortality and persistent cognitive decline. Hyperoxic reperfusion of ischemic tissues increases oxidative injury, but oxygen administration remains high during cardiac surgery. We tested the hypothesis that intraoperative hyperoxic cerebral reperfusion is associated with increased postoperative delirium and that oxidative injury mediates this association. METHODS: We prospectively measured cerebral oxygenation with bilateral oximetry monitors in 310 cardiac surgery patients, quantified intraoperative hyperoxic cerebral reperfusion by measuring the magnitude of cerebral oxygenation above baseline after any ischemic event, and assessed patients for delirium twice daily in the ICU following surgery using the confusion assessment method for ICU (CAM-ICU)...
February 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28033253/postoperative-cognitive-changes-after-total-knee-arthroplasty-under-regional-anesthesia
#18
Young-Tae Jeon, Byung-Gun Kim, Young Ho Park, Hye-Min Sohn, Jungeun Kim, Seung Chan Kim, Seong Soo An, SangYun Kim
BACKGROUND: The type of postoperative cognitive decline after surgery under spinal anesthesia is unknown. We investigated the type of postoperative cognitive decline after total knee arthroplasty (TKA). Neuropsychological testing was conducted and the changes in cerebrospinal fluid (CSF) biomarkers after surgery were evaluated. METHODS: Fifteen patients who required bilateral TKA at a 1-week interval under spinal anesthesia were included. Neuropsychological tests were performed twice, once the day before the first operation and just before the second operation (usually 1 week after the first test) to determine cognitive decline...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28024850/volume-of-subclinical-embolic-infarct-correlates-to-long-term-cognitive-changes-after-carotid-revascularization
#19
Wei Zhou, Brittanie D Baughman, Salil Soman, Max Wintermark, Laura C Lazzeroni, Elizabeth Hitchner, Jyoti Bhat, Allyson Rosen
OBJECTIVE: Carotid intervention is safe and effective in stroke prevention in appropriately selected patients. Despite minimal neurologic complications, procedure-related subclinical microemboli are common and their cognitive effects are largely unknown. In this prospective longitudinal study, we sought to determine long-term cognitive effects of embolic infarcts. METHODS: The study recruited 119 patients including 46% symptomatic patients who underwent carotid revascularization...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28006786/neuropsychological-outcome-in-subthalamic-nucleus-stimulation-surgeries-with-electrodes-passing-through-the-caudate-nucleus
#20
Cihan Isler, Angela Albi, Frédéric L W V J Schaper, Yasin Temel, Annelien Duits
BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson disease (PD) is associated with postoperative cognitive decline. One of the proposed underlying mechanisms is the surgical procedure with the lead trajectory penetrating the caudate nucleus. OBJECTIVE: To study whether penetration of the caudate nucleus affects neuropsychological outcome. METHODS: Neuropsychological and imaging data of 30 PD patients who underwent bilateral STN DBS were analysed...
2016: Stereotactic and Functional Neurosurgery
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