Analogy tests and psychopathology at follow-up after open heart surgery

Willner, Allen E.; Rabiner, Charles J.; Wisoff, B. George; Fishman, Jodie; Rosen, Bernard; Hartstein, Marvin L.; Klein, D F

doi:10.1037/e668292012-505

Cited by 15 publications

(16 citation statements)

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“…It must also be emphasized that when only clinical criteria have been used to evaluate the CNS outcome, the appraisal of the results seems to have been too optimistic. 43 Clinical measures have been shown to provide only a narrow view over the actual CNS events, for the involvement of the subclinical levels has been revealed in electroencephalographical (EEG), 6 " 10 neuropsychological,"" 18 psychiatric 19 and radiological 20 studies.…”

mentioning

confidence: 99%

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Sotaniemi¹,

Mononen²,

Hokkanen³

1986

Stroke

189

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SUMMARY A prospective 5 years' neuropsychological, neurological, cardiological and electroencephalographkal follow-up study was carried out in 44 patients who had undergone open-heart surgery for valve replacement. A distinct interrelationship was found between the clinical outcome immediately after operation and the neuropsychological long-term course despite the rapid recovery of occasional clinical disorders related to operative procedures. In fact, the psychometric performance scores of those who did not develop clinical signs of cerebral dysfunction induced in operation showed a significant difference only years after operation. Similarly, the harmful effects of long perfusion time (ertracorporeal circulation) in operation were reflected in the long-term neuropsychological performance. Some evidence seemed to suggest that the correction of the prolonged circulatory disorder might possibly afford real enhancement of higher cerebral functions. The long-term results not only emphasize the importance of a careful clinical evaluation but also emphasize the necessity of considering the subclinteal level of events both before and after operation when assessing the overall outcome and cerebral safety of cardiac surgery patients.Stroke Vol 17, No 3, 1986CENTRAL NERVOUS SYSTEM (CNS) dysfunction has occasionally cast a shadow over the results of cardiac surgery. The development of surgical and anaesthesiological equipment has notably improved cerebral safety, and the occurrence of severe complications has become rare.'" 4 The well-being of the CNS, however, has not become self-evident and secure because several potentially harmful factors always remain in such complicated procedures as open-heart operations. It must also be emphasized that when only clinical criteria have been used to evaluate the CNS outcome, the appraisal of the results seems to have been too optimistic. 43 Clinical measures have been shown to provide only a narrow view over the actual CNS events, for the involvement of the subclinical levels has been revealed in electroencephalographical (EEG), 6 " 10 neuropsychological,"" 18 psychiatric 19 and radiological 20 studies.Previous studies investigating the long-term outcome of open-heart operations have concentrated their attention on cardiological and surgical aspects. "29 By contrast, the outcome of the higher cerebral functions has been given little attention, the earlier investigations having focused on describing the prevalence, nature and determinants of immediate postoperative disturbances using follow-up times limited to a few weeks or months."' l3 ' 16 Frank et al 16 performed a 6 months' study after operation and reported improvement in all the measured areas of intellectual performance. Preoperative anxiety seemed to worsen the improvement, probably by rendering the patients less apt to recall the test items. The intellectual changes were independent of cardiac functional measures. It was concluded that the observed improvement was only due to practice effects and that improved cerebral perf...

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mentioning

confidence: 99%

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Sotaniemi¹,

Mononen²,

Hokkanen³

1986

Stroke

189

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“…Unfortunately, clinical and EEG assessments prior to operation generally have failed to predict the after surgery course13 22 although some prognostic information seems to be provided from neuropsychological studies.2' 24 In the present investigation, non-complicated and complicated patient groups displayed some EEG differences before operation which were found to have prognostic importance. Preonerative occurrence of bilateral and continuous abnormalities, low frequency of dominant activity, delta range disturbances and sharp wave abnormalities seemed to be associated with clinical complications after operation.…”

Section: Discussionmentioning

confidence: 54%

Clinical and prognostic correlates of EEG in open-heart surgery patients.

Sotaniemi¹

1980

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY Sixty-five patients undergoing cardiac valve replacement were followed for one year by electroencephalography (EEG). Occurrence Patients and methodsPatients and operative procedures Sixty-five consecutive patients undergoing cardiac valve replacement surgery were investigated. There were 22 women and 43 men aged from 15 to 65 years, the mean age being 43-0 + 10-4 years.Aortic valve replacement was done in 44 cases, mitral in 16 cases and both of the valves were repaired in five cases. The prostheses were of the Bjork-Shiley type. All the patients were operated upon with moderate hypothermia (oesophageal temperature 30-32°C). A Rygg-Kyvsgard bubble oxygenator was used and extracorporeal circulation was carried out with moderate haemodilution and non-pulsatile flow. The patients were divided into two groups according to the clinical findings at the first follow up: Group NC (no cerebral complications, N=33) and Group CC (cerebral complications present, N=28). The groups were similar for age, sex and the main cardiological diagnoses. Design of the study The protocol of the study is presented in fig 1. Every patient underwent two preoperative (coded PRE-OP) neurological and EEG investigations on the fifth and second day before operation. The investigations were repeated five times (10 days, two months, five months, eight months and one year after operation) during the follow-up period of one year. The examinations after operation are coded using the ordinal of the investigation (from I to V) together with the abbreviation FU (follow-up): For example the first postoperative EEG is coded I FU EEG. Neurological evaluation A full neurological investigation was performed immediately before or after the EEG recordings. Signs present before operation were not listed as new findings after operation. EEG The EEGs were recorded using a 16-channel machine (Mingograph EEG 16, Elema-Schonander) under standard conditions (time constant 0*3 s, 941

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“…This implies very poor cognitive functioning and places the patient within the lowest 1% of the normative sample for this test. The statistically significant positive relationships between devastated CLAT performance and poor post open heart surgery outcome [36][37][38][39] found in other studies, suggested that a similar categorization of CLAT results might be useful in the present study.…”

Section: Discrete Involuntary Movementsmentioning

confidence: 82%

“…Willner and associates [36][37][38] have reported associations between devastated CLAT performance obtained preoperatively and subsequent ©1983 VOL. 14, NO.4 emergence of psychiatric symptoms or catastrophic results (death or stroke) at various followup periods after open heart surgery.…”

Section: Persistent Tardive Dyskinesiaelectroencephalographic Correlatesmentioning

confidence: 99%

A Long Term Prospective Study of Electroencephalographic and Neuropsychological Correlates of Tardive Dyskinesia: Initial Findings at Five Year Follow-Up

Struve¹,

Willner²

1983

Clinical Electroencephalography

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Analogy tests and psychopathology at follow-up after open heart surgery

Cited by 15 publications

References 0 publications

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Clinical and prognostic correlates of EEG in open-heart surgery patients.

A Long Term Prospective Study of Electroencephalographic and Neuropsychological Correlates of Tardive Dyskinesia: Initial Findings at Five Year Follow-Up

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