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postoperative cognitive decline

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https://www.readbyqxmd.com/read/27884107/association-between-changes-in-cerebral-grey-matter-volume-and-postoperative-cognitive-dysfunction-in-elderly-patients-study-protocol-for-a-prospective-observational-cohort-study
#1
Nicolai Goettel, Panagiota Mistridis, Manfred Berres, Julia Reinhardt, Christoph Stippich, Andreas U Monsch, Luzius A Steiner
BACKGROUND: Cognitive decline is frequently observed in elderly patients after major surgery. The pathophysiology of postoperative cognitive dysfunction (POCD) remains unclear. The aim of our investigation is to identify potential associations between brain volume change and POCD in elderly patients undergoing major surgery. METHODS: This is a prospective observational cohort study approved by the regional ethics board. We intend to compare specific brain volumes (hippocampus, lateral ventricle, total grey matter volume, regional cortical thickness) on magnetic resonance imaging and cognitive functions determined by a neuropsychological assessment battery in 70 study participants aged ≥65 years before and 3 and 12 months after major noncardiac surgery...
November 25, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27836394/pre-and-postoperative-neurocognitive-deficits-in-brain-tumor-patients-assessed-by-a-computer-based-screening-test
#2
Markus Hoffermann, Lukas Bruckmann, Kariem Mahdy Ali, Karla Zaar, Alexander Avian, Gord von Campe
Neurocognitive assessment becomes increasingly important in neuro-oncology. The presence and degree of neurocognitive deficits in patients with brain tumors appear to be important not only as outcome measures but also in treatment planning and as possible prognostic markers for tumor-progression. Common screening methods for neurocognitive deficits are often insufficient in uncovering subtle changes or harbor the risk of being observer-dependent and time-consuming. We present data of brain tumor patients screened by a computer-based neurocognitive assessment tool before and after surgery...
November 8, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27833495/postoperative-pain-management-of-liver-transplantation-in-cystic-fibrosis-is-it-time-to-start-us-guided-neuraxial-blocks
#3
M Piazza, G Martucci, A Arcadipane
Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27815406/estimating-risk-of-word-finding-problems-in-adults-undergoing-epilepsy-surgery
#4
Robyn M Busch, Darlene P Floden, Brigid Prayson, Jessica S Chapin, Kevin H Kim, Lisa Ferguson, William Bingaman, Imad M Najm
OBJECTIVE: This retrospective, observational study examined the frequency and magnitude of change in naming ability as a function of side/site of epilepsy surgery and identified predictive factors to assist clinicians in identifying patients at low, moderate, or high risk of postoperative naming decline. METHODS: A total of 875 adults with pharmacoresistant epilepsy (454 left/421 right; 763 temporal/87 frontal/25 posterior quadrant) met inclusion criteria and completed the Boston Naming Test before and after surgery...
November 4, 2016: Neurology
https://www.readbyqxmd.com/read/27809575/a-systematic-review-of-postoperative-cognitive-decline-following-open-and-endovascular-aortic-aneurysm-surgery
#5
R A Benson, B A Ozdemir, D Matthews, I M Loftus
OBJECTIVES Postoperative cognitive decline (POCD) is a well-recognised neurological phenomenon following major surgery. Most commonly seen in elderly patients, it has direct links to increased long-term morbidity and reduced quality of life. Its incidence following open and endovascular abdominal and thoracic aneurysm surgery is unclear. The purpose of this systematic review is to collate available evidence for POCD following abdominal and thoracic aortic surgery, and to identify continuing controversies directing future research...
November 4, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27790135/nox-2-mediated-phenotype-loss-of-hippocampal-parvalbumin-interneurons-might-contribute-to-postoperative-cognitive-decline-in-aging-mice
#6
Li-Li Qiu, Dan Luo, Hui Zhang, Yun S Shi, Yan-Jun Li, Dan Wu, Jiang Chen, Mu-Huo Ji, Jian-Jun Yang
Postoperative cognitive decline (POCD) is a common complication following anesthesia and surgery, especially in elderly patients; however, the precise mechanisms of POCD remain unclear. Here, we investigated whether nicotinamide adenine dinucleotide phosphate (NADPH) oxidase mediated-abnormalities in parvalbumin (PV) interneurons play an important role in the pathophysiology of POCD. The animal model was established using isoflurane anesthesia and exploratory laparotomy in 16-month-old male C57BL/6 mice. For interventional experiments, mice were chronically treated with the NADPH oxidase inhibitor apocynin (APO)...
2016: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/27764047/the-future-of-postoperative-quality-of-recovery-assessment-multidimensional-dichotomous-and-directed-to-individualize-care-to-patients-after-surgery
#7
Andrea Bowyer, Colin F Royse
PURPOSE OF REVIEW: Recovery after surgery is a complex interplay of the patient, the surgery, and the perioperative anaesthesia management. Assessment of recovery should address the needs of multiple stakeholders, including the institutions and healthcare providers, but primarily should be focused on the patients and their perception of quality of recovery and return to normalcy. This review will summarize the development of assessment of recovery to a multidimensional dichotomous construct that requires a real-time assessment tool validated for repeat measures and containing cognitive assessment...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27755058/fragmented-sleep-enhances-postoperative-neuroinflammation-but-not-cognitive-dysfunction
#8
Susana Vacas, Vincent Degos, Mervyn Maze
BACKGROUND: Sleep is integral to biologic function, and sleep disruption can result in both physiological and psychologic dysfunction including cognitive decline. Surgery activates the innate immune system, inducing neuroinflammatory changes that interfere with cognition. Because surgical patients with sleep disorders have an increased likelihood of exhibiting postoperative delirium, an acute form of cognitive decline, we investigated the contribution of perioperative sleep fragmentation (SF) to the neuroinflammatory and cognitive responses of surgery...
October 11, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27733186/deferoxamine-regulates-neuroinflammation-and-iron-homeostasis-in-a-mouse-model-of-postoperative-cognitive-dysfunction
#9
Yuping Li, Ke Pan, Lin Chen, Jiao-Lin Ning, Xiaojun Li, Ting Yang, Niccolò Terrando, Jianteng Gu, Guocai Tao
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a common complication after surgery, especially amongst elderly patients. Neuroinflammation and iron homeostasis are key hallmarks of several neurological disorders. In this study, we investigated the role of deferoxamine (DFO), a clinically used iron chelator, in a mouse model of surgery-induced cognitive dysfunction and assessed its neuroprotective effects on neuroinflammation, oxidative stress, and memory function. METHODS: A model of laparotomy under general anesthesia and analgesia was used to study POCD...
October 12, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27681586/impact-of-surgical-wound-dehiscence-on-health-related-quality-of-life-and-mental-health
#10
N F M Corrêa, M J A de Brito, M M de Carvalho Resende, M F P Duarte, F S Santos, G M Salomé, L M Ferreira
OBJECTIVE: To assess the impact of surgical wound dehiscence on health-related quality of life and mental health. Dehiscence of surgical wounds is a serious postoperative complication associated with high morbidity and mortality. METHOD: Sixty-one adult patients, who had undergone neurological, general, colorectal, orthopaedic, gynaecological, plastic, cardiovascular, urological or neurological surgery in a university hospital in Brazil, were assessed between 30 and 180 days after surgery...
October 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27676314/postoperative-cognitive-dysfunction-and-its-relationship-to-cognitive-reserve-in-elderly-total-joint-replacement-patients
#11
J E Scott, J L Mathias, A C Kneebone, J Krishnan
Whether total joint replacement (TJR) patients are susceptible to postoperative cognitive dysfunction (POCD) remains unclear due to inconsistencies in research methodologies. Moreover, cognitive reserve may moderate the development of POCD after TJR, but has not been investigated in this context. The current study investigated POCD after TJR, and its relationship with cognitive reserve, using a more rigorous methodology than has previously been utilized. Fifty-three older adults (aged 50+) scheduled for TJR were assessed pre and post surgery (6 months)...
September 27, 2016: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/27633169/microembolization-is-associated-with-transient-cognitive-decline-in-patients-undergoing-carotid-interventions
#12
Elizabeth Hitchner, Brittanie D Baughman, Salil Soman, Becky Long, Allyson Rosen, Wei Zhou
OBJECTIVE: Carotid interventions are important in helping to reduce the risk of stroke for patients with high-grade carotid artery stenosis; however, subclinical cerebral microemboli can occur during these procedures. Associations have been found between the incidence of microemboli and postoperative decline in memory. We therefore sought to determine whether this decline persisted long-term and to assess changes in other cognitive domains. METHODS: Patients were prospectively recruited under an Institutional Review Board-approved protocol at a single academic center...
September 12, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27599409/activation-of-mtor-signaling-leads-to-orthopedic-surgery-induced-cognitive-decline-in-mice-through-%C3%AE-amyloid-accumulation-and-tau-phosphorylation
#13
Wenzhen Shen, Keliang Lu, Jiawan Wang, Anshi Wu, Yun Yue
Postoperative cognitive dysfunction (POCD) is a serious complication following surgery, however, the mechanism of POCD remains to be elucidated. Previous evidence has revealed that POCD may be associated with the pathogenesis of neurodegenerative processes. The mammalian target of rapamycin (mTOR) signaling pathway has been reported to be crucial in the pathophysiology of neurodegenerative diseases. However, the implications of mTOR in POCD remains to be fully elucidated. In the present study, western blotting and enzyme‑linked immunosorbent assay were used to determine the expression of mTOR and any associated downstream targets; contextual fear conditioning was used to estimate the learning and memory ability of mice...
October 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27564562/postoperative-delirium-in-elderly-patients-undergoing-major-spinal-surgery-role-of-cerebral-oximetry
#14
Sarah Soh, Jae-Kwang Shim, Jong-Wook Song, Keung-Nyun Kim, Hyun-Young Noh, Young-Lan Kwak
BACKGROUND: Perioperative cerebral hypoperfusion/ischemia is a major inciting factor of postoperative delirium, which is coupled with adverse outcome in elderly patients. Cerebral oximetry enables noninvasive assessment of the regional cerebral oxygen saturation (rSO2). This study aimed to investigate whether perioperative rSO2 variations were linked to delirium in elderly patients after spinal surgery. MATERIALS AND METHODS: Postoperative delirium was assessed for 48 hours postsurgery in 109 patients aged over 60 years without a prior history of cerebrovascular or psychiatric diseases by the Confusion Assessment Method for the intensive care unit and the intensive care delirium screening checklist...
August 25, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27552801/cerebral-perfusion-monitoring-in-acute-care-surgery-current-and-perspective-use
#15
Hsin-I Tsai, Peter Chi-Ho Chung, Chao-Wei Lee, Huang-Ping Yu
INTRODUCTION: The technology near infrared spectroscopy (NIRS) has been utilized extensively in several clinical settings and one of which is in cerebral oximetry. This review will provide information on the technology, clinical applications and algorithm to follow when desaturation occurs. AREAS COVERED: The review will cover the technology of near infrared spectroscopy, cerebral oximetry and the utilization of cerebral oximetry in each clinical setting. Expert commentary: Cerebral oximetry provides a noninvasive measure of cerebral oxygenation, which when persistently declining, can serve as a warning sign of hemodynamic or metabolic compromise intraoperatively or a predictor of postoperative cognitive dysfunction...
September 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27540727/voluntary-exercise-rescues-sevoflurane-induced-memory-impairment-in-aged-male-mice
#16
Dan Tian, Miao Tian, Zhiming Ma, Leilei Zhang, Yunfeng Cui, Jinlong Li
Postoperative cognitive impairment is especially common in older patients following major surgery. Although exposure to sevoflurane is known to cause memory deficits, few studies have examined the putative approaches to reduce such impairments. This study tested the hypotheses that sevoflurane exposure can decrease NR2B subunit-containing NMDA receptor activity in hippocampus of aged mice, and voluntary exercise may counteract the declining hippocampal functions. We found that long exposure (3 h/day for 3 days), but not short exposure (1 h/day for 3 days), to 3 % sevoflurane produced a long-lasting spatial memory deficits up to 3 weeks in aged mice, and such an effect was not due to the neuronal loss in the hippocampus, but was correlated with a long-term decrease in Fyn kinase expression and NR2B subunit phosphorylation in the hippocampus...
August 19, 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/27537541/mind-over-matter-the-hidden-epidemic-of-cognitive-dysfunction-in-the-older-surgical-patient
#17
Helen O' Brien, Helen Mohan, Celia O' Hare, John Vincent Reynolds, Rose Anne Kenny
OBJECTIVE: The aim of this study was to highlight the vulnerability of the aging brain to surgery and anesthesia, examine postoperative cognitive outcomes, and recommend possible interventions. BACKGROUND: Surgeons are facing increasingly difficult ethical and clinical decisions given the rapidly expanding aging demographic. Cognitive function is not routinely assessed either preoperatively or postoperatively. Potential short and long-term cognitive implications are rarely discussed with the patient despite evidence that postoperative cognitive impairment occurs in up to 65% of older patients...
August 17, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27515198/extracellular-rnas-as-a-chemical-initiator-for-postoperative-cognitive-dysfunction
#18
Chan Chen, Xu Cheng, Ji Li, Hai Chen, Shu Zhang, Yuanlin Dong, Lu Gan, Jin Liu, Tao Zhu
Postoperative cognitive dysfunction (POCD) is a common complication that presents in the postoperative stage, especially in elderly patients. Despite years of considerable progress, the detailed molecular mechanisms of POCD remain largely unknown. Neuroinflammation has been increasingly pointed out as one of the core mechanisms for the pathogenesis of POCD. However, application of anti-inflammatory drugs failed to show consistent beneficial effect in patients with cognitive decline. Hence, it might be of great importance to identify the inflammatory initiators that are involved in the mediation, amplification and perpetuation of postoperative neuroinflammatory reactions...
September 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27502769/the-post-anaesthesia-n-acetylcysteine-cognitive-evaluation-panacea-trial-study-protocol-for-a-randomised-controlled-trial
#19
David R Skvarc, Olivia M Dean, Linda K Byrne, Laura J Gray, Kathryn Ives, Stephen E Lane, Matthew Lewis, Cameron Osborne, Richard Page, Douglas Stupart, Alyna Turner, Michael Berk, Andrew J Marriott
BACKGROUND: Some degree of cognitive decline after surgery occurs in as many as one quarter of elderly surgical patients, and this decline is associated with increased morbidity and mortality. Cognition may be affected across a range of domains, including memory, psychomotor skills, and executive function. Whilst the exact mechanisms of cognitive change after surgery are not precisely known, oxidative stress and subsequent neuroinflammation have been implicated. N-acetylcysteine (NAC) acts via multiple interrelated mechanisms to influence oxidative homeostasis, neuronal transmission, and inflammation...
2016: Trials
https://www.readbyqxmd.com/read/27497924/hyperphosphorylated-tau-in-patients-with-refractory-epilepsy-correlates-with-cognitive-decline-a-study-of-temporal-lobe-resections
#20
Xin You Tai, Matthias Koepp, John S Duncan, Nick Fox, Pamela Thompson, Sallie Baxendale, Joan Y W Liu, Cheryl Reeves, Zuzanna Michalak, Maria Thom
SEE BERNASCONI DOI101093/AWW202 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Temporal lobe epilepsy, the most prevalent form of chronic focal epilepsy, is associated with a high prevalence of cognitive impairment but the responsible underlying pathological mechanisms are unknown. Tau, the microtubule-associated protein, is a hallmark of several neurodegenerative diseases including Alzheimer's disease and chronic traumatic encephalopathy. We hypothesized that hyperphosphorylated tau pathology is associated with cognitive decline in temporal lobe epilepsy and explored this through clinico-pathological study...
September 2016: Brain: a Journal of Neurology
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