Early Warning Value of ASL-MRI to Estimate Premorbid Variations in Patients With Early Postoperative Cognitive Dysfunctions

Frontiers in Aging Neuroscience

Diksha Basnet¹  Xue Du¹  Jingya Zhang¹  Yijie Deng¹  Jiehui Liu¹  Jianhui Liu¹  Su Liu¹  Junjun Yang¹  Jiayong Hu¹  Yan Gao²  Peijun Wang² 

[1] Department of Anesthesiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China;Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China;

关键词: arterial spin labeling;    magnetic resonance imaging;    postoperative cognitive dysfunction;    cerebral blood flow;    pre-operative changes in brain;   

DOI  :  10.3389/fnagi.2021.670332

来源: DOAJ

【 摘 要 】

Background: Postoperative cognitive dysfunction (POCD) is a general complication following cardiac and major non-cardiac surgery amongst the elderly, yet its causes and mechanisms are still unknown. The present study aimed to detect whether regional cerebral blood flow (CBF) is altered in the brain before surgery in POCD patients compared with non-POCD (NPOCD) patients, thus, CBF variation may potentially predict the occurrence of early POCD.Methods: Fifty patients scheduled for spinal stenosis surgery were enrolled in the study. All study participants completed a battery of neuropsychological tests (NPTs) by a well-trained neuropsychologist before the surgery and 1 week after the surgery. POCD was defined when the preoperative to postoperative difference of at least two of the NPTs’ |Z|-scores with reference to a control group exceeded 1.96. Pulsed arterial spin-labeling (ASL) MRI was scanned at least 1 day before surgery. The ASLtbx toolkit and SPM12 were applied to preprocess and correct the images, which were then normalized to the MNI brain template space to obtain standardized cerebral perfusion images.Results: POCD was identified in 11 out of 50 patients (22%). The CBF of the right superior temporal lobe, right and left middle cingulate gyrus, and the right hippocampus, and parahippocampal gyrus in POCD group was lower than that in NPOCD group (P < 0.001). The CBF of the pars triangularis of inferior frontal gyrus in POCD group was higher than that in NPOCD group (P < 0.001).Conclusions: These preliminary findings suggest that CBF premorbid alterations may happen in cognitively intact elderly patients that develop early POCD. Alterations of preoperative CBF might be a bio-marker for early POCD that can be detected by noninvasive MRI scans.

【 授权许可】

Unknown