Premorbid Alterations of Spontaneous Brain Activity in Elderly Patients With Early Post-operative Cognitive Dysfunction: A Pilot Resting-State Functional MRI Study

Frontiers in Neurology

Wei Wang²  Qi Lu²  Guangwu Lin³  Xiaoyong Shen⁴  Zhenghong Zhu⁴  Zhaoxin Wang⁵  Lvjun Yang⁸  Zhaoshun Jiang⁸  Weidong Gu⁸  Xixue Zhang⁸  Hui Li⁸  Yating Lv⁹ 

[1] Department of Anesthesiology, Huadong Hospital, Fudan University, Shanghai, China;Department of General Surgery, Huadong Hospital, Fudan University, Shanghai, China;Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China;Department of Thoracic Surgery, Huadong Hospital, Fudan University, Shanghai, China;Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China;Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China;Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai, China;Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China;Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China;

关键词: resting-state fMRI;    pre-operative changes in brain;    cognitive decline;    early post-operative period;    functional connectivity;    regional homogeneity;   

DOI  :  10.3389/fneur.2019.01062

来源: DOAJ

【 摘 要 】

Background: Elderly patients with pre-existing cognitive impairment are susceptible to post-operative cognitive dysfunction (POCD). In this study, we investigated whether there is pre-existing local homogeneity and functional connectivity alteration in the brain before surgery for POCD patients as compared to that in non-POCD patients.Methods: Eighty elderly patients undergoing major thoracic or abdominal surgeries were recruited. Resting-state functional MRI was scanned at least 1 day before surgery. Neuropsychological tests (NPTs) were performed before surgery and at discharge, respectively. Pre-operative regional homogeneity (ReHo) and resting-state functional connectivity (RSFC) were compared between POCD patients and non-POCD patients, respectively. Partial correlation between NPTs and ReHo or RSFC was analyzed by adjusting for confounding factors.Results: Significant difference (P < 0.001, Gaussian Random Field (GRF) correction which is a multiple comparisons correction method at cluster level, cluster size > 49) in ReHo between POCD patients and non-POCD patients was detected in right hippocampus/parahippocampus. Pre-operative RSFC between right hippocampus/parahippocampus and right middle/inferior temporal gyrus increased in POCD patients (P < 0.001, GRF correction for multiple comparisons) when compared with that in non-POCD patients.RSFC significantly correlated with composite Z-score (r = 0.46, 95% CI [0.234, 0.767], P = 0.002) or Digit Symbol Substitution Test Z-scores (r = 0.31, 95% CI [0.068, 0.643], P = 0.046) after adjusting for confounding factors.Conclusions: The results suggest that premorbid alterations of spontaneous brain activity might exist in elderly patients who develop early POCD. The neural mechanism by which patients with pre-operative abnormal spontaneous activity are susceptible to POCD requires further study.

【 授权许可】

Unknown