Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

Li, Ximing; Shao, Ming-tao; Wang, Jian-juan; Wang, Yuelan

doi:10.1631/jzus.b1400130

Cited by 22 publications

(17 citation statements)

References 34 publications

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“…The diagnoses of POCD now mainly rely on neuropsychological testing, but there is not yet a unified standard for a POCD neuropsychological test (Li et al, 2014). The commonly used tests are MMSE, the Wechsler Adult Intelligence Scale (WAIS), and the Wechsler Memory Scale (WMS).…”

Section: Discussionmentioning

confidence: 99%

Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Liu

et al. 2015

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To explore the relationship of postoperative cognitive dysfunction (POCD) in one-lung ventilation (OLV) patients and regional cerebral oxygen saturation (rSO 2 ). Methods: Twenty-nine male and twenty-one female cases of OLV received thoracic surgery, with American Standards Association (ASA) physical status being at Grades I-III. Neuropsychological tests were performed on the day before operation and 7 d after operation, and there was an intraoperative continuous monitoring of rSO 2 . The values of rSO 2 before anesthesia induction (t 1 ), at the beginning of OLV (t 2 ), and at the time of OLV 30 min (t 3 ), OLV 60 min (t 4 ), the end of OLV (t 5 ), and the end of surgery (t 6 ) were recorded. The intraoperative average of rSO 2 ( 2 rSO ), the intraoperative minimum value of rSO 2 (rSO 2, min ), and the reduced maximum percentage of rSO 2 (rSO 2, %max ) when compared with the baseline value were calculated. The volume of blood loss, urine output, and the amount of fluid infusion was recorded. Results: A total of 14 patients (28%) in the 50 cases suffered from POCD. The values of mini-mental state examination (MMSE), the digit span and the digit symbol on the 7th day after the operation for POCD in OLV patients were found to be significantly lower than those before the operation (P<0.05). The values of MMSE and vocabulary fluency scores were significantly lower than those in the non-POCD group (P<0.05). The values of rSO 2 in the POCD group of OLV patients at t 2 and t 3 and the values of rSO 2 in the non-POCD group at t 2 were found to be significantly higher than those at t 1 (P<0.05). The values of rSO 2, %max in the POCD group were significantly higher than those in the non-POCD group (P<0.05). When the value of rSO 2, %max is more than 10.1%, it may act as an early warning index for cognitive function changes. Conclusions: POCD after OLV may be associated with a decline in rSO 2 .

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Section: Discussionmentioning

confidence: 99%

Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Liu

et al. 2015

J. Zhejiang Univ. Sci. B

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“…In recent years, researchers have tried to find ideal biological markers associated with the POD to reduce its occurrence. Aβ and Tau proteins, as biochemical indicators, are the main markers in the pathogenesis of POCD ( Li et al, 2014 ). Some studies have also confirmed that preoperative CSF Aβ and Tau in patients with geriatrics are significantly correlated with the changes in postoperative cognitive function ( Wu et al, 2018 ), consistent with this study.…”

Section: Discussionmentioning

confidence: 99%

Potential Value of Cerebrospinal Fluid Progranulin in the Identification of Postoperative Delirium in Geriatrics Patients Undergoing Knee Replacement: The Perioperative Neurocognitive Disorder and Biomarker LifestylE Study

Wang

Sun

Wang

et al. 2022

Front. Aging Neurosci.

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Objective: The aim of this study was to investigate whether progranulin (PGRN) levels in cerebrospinal fluid (CSF) were associated with postoperative delirium (POD) in geriatric patients undergoing knee replacement.Method: A total of 600 Han Chinese patients aged 65–90 years and who underwent unilateral total knee arthroplasty were included in the Perioperative Neurocognitive Disorder And Biomarker LifestylE (PNDABLE) study from June 2020 to November 2020. All participants were assessed using the Confusion Assessment Method and the Memorial Delirium Assessment Scale on postoperative days 1–7 (or before discharge) by an anesthesiologist. CSF PGRN and CSF biomarkers of POD were measured by ELISA. We analyzed the risk and protective factors of POD using the multivariate logistic regression, and the associations between CSF PGRN and CSF biomarkers of POD using multiple linear regression. We also explored whether the influence of CSF PGRN on POD was mediated by POD core pathology in linear regression models.Results: Postoperative delirium incidence was 9.7% (53/545). There were significant differences in preoperative CSF PGRN between patients with POD and non-POD (NPOD). As for CSF biomarkers, CSF Aβ40, T-tau, and P-tau were risk factors for POD, while CSF PGRN, Aβ42, and Aβ42/Aβ40 were protective factors for POD, as shown by the multivariate logistic regression analysis. CSF PGRN was positively associated with CSF Aβ42 and was negatively associated with CSF Aβ40, T-tau, and P-tau in patients with POD. We found that the AUC was 0.795 (95% CI = 0.706, 0.867) for PGRN between POD and NPOD groups. We found the influence of CSF PGRN on POD was mediated by POD core pathology. The effect was considered partial mediation with the proportion of mediation varying from 44.92 to 62.07%.Conclusion: Cerebrospinal fluid PGRN may be a reasonably good prognostic factor for POD development. Overall, amyloid pathology and tau protein might partially mediate the influence of PGRN on POD.Clinical Trial Registration:www.clinicaltrials.gov, identifier ChiCTR2000033439.

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“…In recent years, the study of POCD biochemical markers has become a focus issue. Aβ and Tau protein, as one of the biochemical indicators, are the main markers of the pathogenesis of POCD [20].Some studies have also con rmed that the preoperative cerebrospinal uid Aβ and Tau in elderly patients are signi cantly correlated with the changes of postoperative cognitive function [21].Progranulin (PGRN) is a multifunctional growth factor expressed in a variety of tissues and involved in many physiological and pathological processes [22]. It is widely expressed in various cells of the body.…”

Section: Discussionmentioning

confidence: 99%

CSF PGRN May be Associated With Postoperative Delirium After Knee Replacement in Elderly Patients: A Prospective Nested Case-Control Study in the PNDABLE Study

Wang¹,

Lin²,

Sun³

et al. 2021

Preprint

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Background: Postoperative delirium (POD) represents a serious complication following anesthesia and surgical procedures for patients undergoing surgical intervention. At present, there is no effective index to predict the occurrence of POD ,so the aim of this study was to validate whether cerebrospinal fluid (CSF) PGRN could predict the occurrence of POD.Methods: We conducted a prospective nested case-control and 1:1 matched (on age, diagnosis, American Society of Anesthesiologist’ (ASA) physical status, duration of surgery, and intraoperative blood loss) study. A total of 600 Han Chinese patients over the age of 65~ 90 who underwent unilateral total knee arthroplasty were included in the PNDABLE study from June 2020 to November 2020. POD cases and non-POD controls were selected from using Confusion Assessment Method (CAM) on the first, second, third and seventh (or before discharge) postoperative days. Delirium severity was measured by the Memorial Delirium Assessment Scale (MDAS). In the six month, cognitive function was assessed with the modified Telephone Interview for Cognitive Status (TICS-m) and the World Health Organization Quality of Life brief version (WHOQOLBREF). CSF PGRN and core biomarkers were measured by ELISA using the microplate reader. The associations of CSF PGRN levels with POD risk and CSF core biomarkers (Aβ1–42, Aβ1–40 ,T-tau and P-tau)were assessed. The effect of CSF PGRN on predicting POD occurrence was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC).Results: POD incidence was 9.7% (53/545). There were significant differences in preoperative CSF PGRN concentration between POD patients and non-POD (P<0.001), and CSF PGRN levels decreased with age, as demonstrated by a significantly negative correlation. CSF PGRN levels decrease with CAM scores and MDAS scores, as demonstrated by significantly negative correlations(r=-0.692, P=0.001; r=-0.435, P=0.001). There were positive associations of CSF PGRN with Aβ1–42 (β = 0.756, P < 0.001) , Aβ1–40 (β =0.637, P < 0.001) and negative associations of CSF PGRN with T-tau (β = -0.716, P < 0.001) and P-tau (β = -0.739, P < 0.001) in POD patients. The ROC curve analysis of PGRN showed that PGRN concentrations had high diagnostic value for POD.Conclusions: Aβ pathology is associated with increasing in CSF PGRN whereas Tau pathology and neurodegeneration is associated with decreasing in CSF PGRN in POD patients.CSF PGRN can predict the occurrence of POD in elderly patients．Clinical Trial Registration: www.clinicaltrials.gov, identifier ChiCTR2000033439.

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Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

Cited by 22 publications

References 34 publications

Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Potential Value of Cerebrospinal Fluid Progranulin in the Identification of Postoperative Delirium in Geriatrics Patients Undergoing Knee Replacement: The Perioperative Neurocognitive Disorder and Biomarker LifestylE Study

CSF PGRN May be Associated With Postoperative Delirium After Knee Replacement in Elderly Patients: A Prospective Nested Case-Control Study in the PNDABLE Study

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