Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults

被引:105
作者
Giattino, Charles M. [1 ,2 ]
Gardner, Jacob E. [1 ]
Sbahi, Faris M. [1 ,3 ]
Roberts, Kenneth C. [1 ]
Cooter, Mary [3 ]
Moretti, Eugene [3 ]
Browndyke, Jeffrey N. [4 ]
Mathew, Joseph P. [3 ]
Woldorff, Marty G. [1 ,2 ,4 ,5 ]
Berger, Miles [3 ]
机构
[1] Duke Univ, Ctr Cognit Neurosci, Durham, NC 27708 USA
[2] Duke Univ, Dept Psychol & Neurosci, Durham, NC 27708 USA
[3] Duke Univ, Med Ctr, Dept Anesthesiol, Durham, NC 27710 USA
[4] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC 27708 USA
[5] Duke Univ, Med Ctr, Dept Neurobiol, Durham, NC 27710 USA
基金
美国国家卫生研究院;
关键词
cognitive function; aging; alpha oscillations; anteriorization; EEG; general anesthesia; isoflurane; propofol; POSTOPERATIVE COGNITIVE DYSFUNCTION; QUALITY-OF-LIFE; JOINT REPLACEMENT; SURGICAL-PATIENTS; VISUAL-CORTEX; DELIRIUM; SURGERY; MECHANISMS; ATTENTION; HUMANS;
D O I
10.3389/fnsys.2017.00024
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, increased 1-year mortality, and long-term cognitive decline. Multiple investigators have thus suggested that anesthesia and surgery place severe stress on the aging brain, and that patients with less ability to withstand this stress will be at increased risk for developing postoperative delirium and POCD. Delirium and POCD risk are increased in patients with lower preoperative cognitive function, yet preoperative cognitive function is not routinely assessed, and no intraoperative physiological predictors have been found that correlate with lower preoperative cognitive function. Since general anesthesia causes alpha-band (8-12 Hz) electroencephalogram (EEG) power to decrease occipitally and increase frontally (known as "anteriorization"), and anesthetic-induced frontal alpha power is reduced in older adults, we hypothesized that lower intraoperative frontal alpha power might correlate with lower preoperative cognitive function. Here, we provide evidence that such a correlation exists, suggesting that lower intraoperative frontal alpha power could be used as a physiological marker to identify older adults with lower preoperative cognitive function. Lower intraoperative frontal alpha power could thus be used to target these at-risk patients for possible therapeutic interventions to help prevent postoperative delirium and POCD, or for increased postoperative monitoring and follow-up. More generally, these results suggest that understanding interindividual differences in how the brain responds to anesthetic drugs can be used as a probe of neurocognitive function (and dysfunction), and might be a useful measure of neurocognitive function in older adults.
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页数:11
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