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https://www.readbyqxmd.com/read/28431424/sleep-disordered-breathing-postoperative-delirium-and-cognitive-impairment
#1
Enoch W K Lam, Frances Chung, Jean Wong
Sleep-disordered breathing (SDB) is highly prevalent in the general population and has been associated with cognitive impairment in older individuals. Delirium is an acute decline in cognitive function and attention that often occurs after surgery, especially in older individuals. Several recent studies suggest an association between SDB and postoperative delirium. The aim of this systematic review is to examine the current literature on SDB, postoperative delirium, and cognitive impairment and to discuss the pathophysiology and perioperative considerations...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430628/critical-role-of-matrix-metallopeptidase-9-in-postoperative-cognitive-dysfunction-and-age-dependent-cognitive-decline
#2
Jiangjiang Bi, Weiran Shan, Ailin Luo, Zhiyi Zuo
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a significant clinical syndrome. Neuroinflammation is an important pathological process for POCD. However, it is not clear how systemic inflammation induced by surgery on peripheral tissues or organs is transmitted into the brain. We determined whether matrix metallopeptidase 9 (MMP9), a protein that can increase blood-brain barrier permeability, is critical in this transmission. The role of MMP9 in age-dependent cognitive decline was also determined...
February 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28414034/age-exacerbates-surgery-induced-cognitive-impairment-and-neuroinflammation-in-sprague-dawley-rats-the-role-of-il-4
#3
Zhe Li, Fang Liu, Hong Ma, Paul F White, Roya Yumul, Yanhua Jiang, Na Wang, Xuezhao Cao
Age is the most prominent risk factor for the development of postoperative cognitive dysfunction. This study investigated the potential role of anti-inflammatory interleukin (IL)-4 in age-related differences of surgery-induced cognitive deficits and neuroinflammatory responses. Both adult and aged Sprague-Dawley male rats were subjected to partial hepatectomy or partial hepatectomy with a cisterna magna infusion of IL-4. On postoperative days 1, 3, and 7, the rats were subjected to a reversed Morris water maze test...
April 14, 2017: Brain Research
https://www.readbyqxmd.com/read/28412051/-impact-of-postoperative-cognitive-decline-in-quality-of-life-a-prospective-study
#4
Joana Borges, Joana Moreira, Adriano Moreira, Alice Santos, Fernando J Abelha
BACKGROUND: Regardless the progress in perioperative care postoperative cognitive decline (PCD) has been accepted unequivocally as a significant and frequent complication of surgery in older patients. The aim of this study was to evaluate the incidence of postoperative cognitive decline and its influence on quality of life three months after surgery. METHODS: Observational, prospective study in a Post-Anesthesia Care Unit (PACU) in patients aged above 45 years, after elective major surgery...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28405620/microglia-mediate-postoperative-hippocampal-inflammation-and-cognitive-decline-in-mice
#5
Xiaomei Feng, Martin Valdearcos, Yosuke Uchida, David Lutrin, Mervyn Maze, Suneil K Koliwad
Surgery can induce cognitive decline, a risk that increases with advancing age. In rodents, postoperative cognitive decline (POCD) is associated with the inflammatory activation of hippocampal microglia. To examine the role of microglia in POCD, we inhibited the colony-stimulating factor 1 receptor (CSF1R) in adult mice, effectively depleting CNS microglia. Surgical trauma (tibial fracture) reduced the ability of mice to remember a conditioned response learned preoperatively, a deficit more pronounced and persistent in mice with diet-induced obesity (DIO)...
April 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28399506/timing-and-type-of-hemispherectomy-for-rasmussen-s-encephalitis-analysis-of-45-patients
#6
Yuguang Guan, Sichang Chen, Changqing Liu, Xiuyu Du, Yao Zhang, Shuai Chen, Jie Wang, Tianfu Li, Guoming Luan
OBJECTIVE: To describe the surgery outcomes of RE patients in one centerto identify the indication for surgical treatment that results in the most favorable outcome. METHOD: Forty-five RE patients from a single center were retrospectively reviewed. Preoperative evaluations included assessments of clinical manifestations, cognitive status, a physical examination, MRI, positron emission tomography (PET), electroencephalography (EEG), and magnetoencephalography (MEG)...
March 22, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28393770/forbidden-word-entropy-of-cerebral-oximetric-values-predicts-postoperative-neurocognitive-decline-in-patients-undergoing-aortic-arch-surgery-under-deep-hypothermic-circulatory-arrest
#7
Anna Dubovoy, Peter Chang, Carol Persad, Wei Lau, Elizabeth Jewell, Daniel Cox, Milo Engoren
PURPOSE: Up to 53% of cardiac surgery patients experience postoperative neurocognitive decline. Cerebral oximetry is designed to detect changes in cerebral tissue saturation and therefore may be useful to predict which patients are at risk of developing neurocognitive decline. METHODS: This is a retrospective analysis of a prospective study originally designed to determine if treatment of cerebral oximetry desaturation is associated with improvement in postoperative cognitive dysfunction in patients undergoing aortic reconstruction under deep hypothermic circulatory arrest...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28383293/peripheral-nerve-block-as-a-supplement-to-light-or-deep-general-anesthesia-in-elderly-patients-receiving-total-hip-arthroplasty-a-prospective-randomized-study
#8
Bin Mei, Hanning Zha, Xiaolong Lu, Xinqi Cheng, Shishou Cheng, Xuesheng Liu, Yuanhai Li, Erwei Gu
BACKGROUND: Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we aimed to investigate the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. METHODS: Patients aged 65 years and older undergoing total hip arthroplasty were randomized into three groups: a general anesthesia without lumbosacral plexus block group, and two general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep)...
April 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#9
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
#10
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: International Journal of Anesthesiology & Research
https://www.readbyqxmd.com/read/28298244/frailty-related-to-anesthesia-guided-by-the-index-bispectral-frail-study-study-protocol-for-a-randomized-controlled-trial
#11
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
#12
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
#13
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. Although 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
#14
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
#15
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
#16
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...
May 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
#17
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
#18
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
#19
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
#20
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...
April 1, 2017: Interactive Cardiovascular and Thoracic Surgery
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