1. Cognitive Impairment Is Associated with Absolute Intraoperative Frontal α-Band Power but Not with Baseline α-Band Power: A Pilot Study
- Author
-
Koch, Susanne, Feinkohl, Insa, Chakravarty, Sourish, Windmann, Victoria, Lichtner, Gregor, Pischon, Tobias, Brown, Emery N., Spies, Claudia, BioCog Study Group, Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology. Institute for Medical Engineering & Science, Massachusetts Institute of Technology. Institute for Data, Systems, and Society, and Harvard University--MIT Division of Health Sciences and Technology
- Subjects
Male ,medicine.medical_specialty ,Intraoperative Neurophysiological Monitoring ,Cognitive Neuroscience ,Cognitive decline ,Pilot Projects ,Electroencephalography ,Article ,Aging and cognition ,03 medical and health sciences ,0302 clinical medicine ,Cognition ,Clinical trials ,Postoperative Cognitive Complications ,Internal medicine ,Preoperative Care ,Medicine ,Aging brain ,Humans ,Prospective Studies ,Elective surgery ,Geriatric Assessment ,Aged ,030214 geriatrics ,medicine.diagnostic_test ,business.industry ,Delirium ,Mental Status and Dementia Tests ,Brain Waves ,Cognitive test ,Psychiatry and Mental health ,Cardiology ,Female ,Intraoperative Period ,Geriatrics and Gerontology ,business ,Neurocognitive ,030217 neurology & neurosurgery ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit - Abstract
Background: Cognitive abilities decline with aging, leading to a higher risk for the development of postoperative delirium or postoperative neurocognitive disorders after general anesthesia. Since frontal α-band power is known to be highly correlated with cognitive function in general, we hypothesized that preoperative cognitive impairment is associated with lower baseline and intraoperative frontal α-band power in older adults. Methods: Patients aged ≥65 years undergoing elective surgery were included in this prospective observational study. Cognitive function was assessed on the day before surgery using six age-sensitive cognitive tests. Scores on those tests were entered into a principal component analysis to calculate a composite "g score" of global cognitive ability. Patient groups were dichotomized into a lower cognitive group (LC) reaching the lower 1/3 of "g scores" and a normal cognitive group (NC) consisting of the upper 2/3 of "g scores." Continuous pre- and intraoperative frontal electroencephalograms (EEGs) were recorded. EEG spectra were analyzed at baseline, before start of anesthesia medication, and during a stable intraoperative period. Significant differences in band power between the NC and LC groups were computed by using a frequency domain (δ0.5-3 Hz, θ 4-7 Hz, α 8-12 Hz, β 13-30 Hz)-based bootstrapping algorithm. Results: Of 38 included patients (mean age 72 years), 24 patients were in the NC group, and 14 patients had lower cognitive abilities (LC). Intraoperative α-band power was significantly reduced in the LC group compared to the NC group (NC -1.6 [-4.48/1.17] dB vs. LC -6.0 [-9.02/-2.64] dB), and intraoperative α-band power was positively correlated with "g score" (Spearman correlation: r = 0.381; p = 0.018). Baseline EEG power did not show any associations with "g." Conclusions: Preoperative cognitive impairment in older adults is associated with intraoperative absolute frontal α-band power, but not baseline α-band power., Seventh Framework Programme (European Commission) (FP7/2007-2013) (Grant HEALTH-F2-2014-60246)
- Published
- 2019
- Full Text
- View/download PDF