Article
Geriatrics & Gerontology
Jessica M. Ross, Emiliano Santarnecchi, Shu Jing Lian, Tamara G. Fong, Alexandra Touroutoglou, Michele Cavallari, Thomas G. Travison, Edward R. Marcantonio, Towia A. Libermann, Eva M. Schmitt, Sharon K. Inouye, Mouhsin M. Shafi, Alvaro Pascual-Leone
Summary: Post-surgical delirium is a serious complication that can lead to cognitive decline and loss of function. This study found that neurophysiologic measures, such as resting-state EEG and transcranial magnetic stimulation, could predict the risk of delirium in older patients undergoing surgery.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Review
Psychology, Multidisciplinary
Jun Liu, Kequn Huang, Binbin Zhu, Bin Zhou, Ahmad Khaled Ahmad Harb, Lin Liu, Xiang Wu
Summary: Post-operative cognitive dysfunction (POCD) is a common neurological complication in older individuals following anesthesia/surgery, characterized by memory loss and accompanying abnormal emotions, behaviors, and language without consciousness disorder. The diagnosis of POCD often involves the evaluation of perioperative cognitive function using neuropsychological tests.
FRONTIERS IN PSYCHOLOGY
(2021)
Article
Neurosciences
Jie Chen, Sumei Liu, Xueqin Wang, Jufang Huang, Jade Phillips, Daqing Ma, Wen Ouyang, Jianbin Tong
Summary: The study investigates the impact of anesthesia and surgery on the connectivity and cognition of the medial prefrontal cortex-hippocampus in aged rats. HDAC6 overexpression is found to be associated with impaired connectivity and cognition. Local HDAC6 knockdown and systemic HDAC6 inhibition can improve learning and memory impairment in aged rats.
MOLECULAR NEUROBIOLOGY
(2022)
Article
Immunology
Klaske Oberman, Iris Hovens, Jacco de Haan, Joana Falcao-Salles, Barbara van Leeuwen, Regien Schoemaker
Summary: A single injection of ibuprofen before surgery improved short-term spatial memory and increased hippocampal neurogenesis in rats, although associated with increased microglia activity. Plasma cytokine levels were not significantly affected, but VEGF levels increased and IFABP levels decreased after ibuprofen treatment. The gut microbiome was not significantly impacted by surgery or ibuprofen, with effects in aged rats similar to those in young rats, although less pronounced.
JOURNAL OF NEUROINFLAMMATION
(2021)
Article
Immunology
Jing Liu, Qiling Shen, Huiping Zhang, Xueying Xiao, Changming Lv, Yueyue Chu, Yujun Shen, Dong Wang, Qiying Shen
Summary: This study found that endogenous MANF decreases with age in both humans and mice. Pre-operative serum MANF levels were lower in POD patients compared to non-POD patients, and the post-operative increase in MANF was also less in POD patients. Recombinant human MANF showed protective effects against surgery-induced behavior changes in mice and inhibited surgery-induced inflammation.
JOURNAL OF INFLAMMATION RESEARCH
(2021)
Editorial Material
Anesthesiology
Elie Matar, Robert D. Sanders
Summary: Postoperative delirium is a significant complication of surgery that is linked to long-term cognitive decline, although the neural mechanisms behind this relationship are not well understood. Neuroimaging studies and network-based approaches are important tools for unraveling the link between delirium and cognitive decline. A recent study using resting state functional MRI revealed reduced global connectivity for up to 3 months after delirium, supporting current models of delirium and providing potential insight into the complex relationship between delirium and dementia.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Biochemistry & Molecular Biology
Johanna Ruhnau, Jonas Mueller, Stephan Nowak, Sarah Strack, Denise Sperlich, Anna Pohl, Jasmin Dilz, Angelika Saar, Yannick Veser, Frederik Behr, Sebastian Rehberg, Taras Usichenko, Klaus Hahnenkamp, Johannes Ehler, Agnes Floeel, Henry W. S. Schroeder, Jan-Uwe Mueller, Robert Fleischmann, Antje Vogelgesang
Summary: Advances in spine surgery allow for safe interventions in older patients, but postoperative delirium (POD) remains a major concern. This study investigates biomarkers that may help identify the pre-operative risk for POD, and finds higher levels of sTREM2 and Gasdermin D as potential markers for POD.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Immunology
Niels Hansen, Iryna Krasiuk, Tobias Titsch
Summary: The presence of neural autoantibodies in patients with delirium is highly relevant in terms of diagnosis, therapy, and pathogenesis. It is important to differentiate delirium with neural autoantibodies from other psychiatric excitation states such as mania during diagnosis. More large-scale studies are needed to evaluate the significance and prevalence of neural autoantibodies in delirium.
JOURNAL OF AUTOIMMUNITY
(2021)
Review
Medicine, General & Internal
Danielle Ni Chroinin, Evan Alexandrou, Steven A. Frost
Summary: The burden of delirium in the intensive care setting is a global priority, as it affects up to 80% of patients in intensive care units and is associated with poor outcomes. These poor outcomes include longer stays in ICU and hospital, increased risk of complications and mortality, and cognitive impairment and functional dependency in the long term. A multi-faceted approach is likely needed for delirium prevention and management in the ICU setting.
FRONTIERS IN MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Joanna S. Semrau, Mehras Motamed, Amanda Ross-White, J. Gordon Boyd
Summary: The relationship between intraoperative regional cerebral oxygen saturation and neurological complications after cardiac surgery remains inconsistent. Monitoring cerebral oximetry during surgery may not clearly reduce the risk of neurological outcomes. Standardized assessments are needed to determine the benefits of cerebral oximetry monitoring in this context.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Neurosciences
Leah Acker, Christine Ha, Junhong Zhou, Brad Manor, Charles M. Giattino, Ken Roberts, Miles Berger, Mary Cooter Wright, Cathleen Colon-Emeric, Michael Devinney, Sandra Au, Marty G. Woldorff, Lewis A. Lipsitz, Heather E. Whitson
Summary: The study found that the complexity of preoperative and intraoperative frontal EEG signals varies at different scales. While average EEG complexity increases intra-operatively, it is not associated with delirium or attention. The crossover point may be an important factor in predicting delirium.
FRONTIERS IN SYSTEMS NEUROSCIENCE
(2021)
Article
Medicine, General & Internal
Rodrigo B. Serafim, Felipe Dal-Pizzol, Vicente Souza-Dantas, Marcio Soares, Fernando A. Bozza, Pedro Povoa, Ronir Raggio Luiz, Jose R. Lapa E. Silva, Jorge I. F. Salluh
Summary: Despite recent advances in the field, the association between subsyndromal delirium (SSD) in the ICU and poor outcomes is not entirely clear. Our findings support the association of SSD with increased ICU length of stay (LOS), but not with ICU mortality. Monitoring the trajectory of SSD early at ICU admission can help to identify patients with increased risk of conversion from SSD to delirium or coma.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Medicine, General & Internal
Danielle Ni Chroinin, Alwin Chuan
Summary: Delirium is a common complication following hip fracture and requires prevention and management strategies such as multidisciplinary care, regular screening, and multimodal interventions. Early recognition and identification of the cause are crucial. Partnering with patients and carers improves care outcomes.
FRONTIERS IN MEDICINE
(2022)
Article
Medicine, General & Internal
Maria Carolina Paulino, Catarina Conceicao, Joana Silvestre, Maria Ines Lopes, Hernani Goncalves, Claudia Camila Dias, Rodrigo Serafim, Jorge I. F. Salluh, Pedro Povoa
Summary: Subsyndromal delirium (SSD) in the Intensive Care Unit (ICU) is associated with increased morbidity and unknown post-discharge functional and cognitive outcomes. A multicenter study found that early SSD patients experienced a decline in cognitive abilities at 3 months after discharge, but showed improvement at 6 months. Therefore, preventing and identifying SSD during ICU stays is crucial.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Dmitriy Viderman, Mina Aubakirova, Fatima Nabidollayeva, Nurgul Yegembayeva, Federico Bilotta, Rafael Badenes, Yerkin Abdildin
Summary: This study aimed to evaluate the effect of ketamine on neurocognitive dysfunction after anesthesia. A meta-analysis of randomized controlled trials comparing ketamine use with placebo was conducted. The results showed that the control group had a higher frequency of hallucinations, fewer readmissions within 30 days, and fewer adverse events compared to the experimental group. However, the experimental group had lower morphine consumption. There was no significant difference in incidences of postoperative delirium, vasopressor requirement, and fentanyl consumption between the ketamine and control groups.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Valerie J. Page, Leiv Otto Watne, Amanda Heslegrave, Allan Clark, Daniel F. McAuley, Robert Sanders, Henrik Zetterberg
Summary: This study aims to explore the association between plasma neurofilament light protein (NfL) and delirium in critically ill patients. The findings indicate that critically ill patients have high NfL levels upon admission, and patients with higher plasma NfL levels experience more delirium or deep sedation days. Additionally, measuring plasma NfL levels on the first day can predict mortality within six months.
Letter
Geriatrics & Gerontology
Sean Tanabe, Maggie Parker, Richard Lennertz, Robert A. Pearce, Matthew Banks, Robert D. Sanders
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2022)
Article
Anesthesiology
Jennifer Taylor, Thomas Payne, Cameron Casey, David Kunkel, Maggie Parker, Cameron Rivera, Henrik Zetterberg, Kaj Blennow, Robert A. Pearce, Richard C. Lennertz, Tim McCulloch, Amy Gaskell, Robert D. Sanders
Summary: Recent trials have conflicting results on whether titration of anaesthetic dose using electroencephalography monitoring reduces postoperative delirium. This study aimed to clarify the dose ranges for trials of anaesthetic dose and the biological plausibility of anaesthetic dose influencing delirium by analyzing an observational cohort.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Neurosciences
Arman P. Kulkarni, Gyujoon Hwang, Cole J. Cook, Rosaleena Mohanty, Akhil Guliani, Veena A. Nair, Barbara B. Bendlin, Elizabeth Meyerand, Vivek Prabhakaran
Summary: In this study, a unique approach based on variance analyses was proposed to investigate the genetic influence on individual differences in brain functional connectivity. The findings suggest that genetic factors play a larger role in brain functional connectivity in males, while environmental factors have a greater impact in females. Moreover, the study reveals that environmental influences on individual differences may outweigh genetic influences in the frontal and overall brain regions.
HUMAN BRAIN MAPPING
(2023)
Article
Clinical Neurology
P. A. Rowley, M. J. Paukner, L. B. Eisenmenger, A. S. Field, R. J. Davidson, S. C. Johnson, S. Asthana, N. A. Chin, V. Prabhakaran, B. B. Bendlin, B. R. Postle, H. H. Goldsmith, C. M. Carlsson, M. A. Brooks, N. H. Kalin, L. E. Williams, H. A. Rowley
Summary: This study investigated 16,400 brain MRIs and found that incidental findings are common, ranging from trivial to life-threatening. Formal neuroradiologist interpretation yielded more reliable results compared to spontaneous detection by nonradiology scanning staff.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2023)
Editorial Material
Clinical Neurology
Richard C. Lennertz, Robert D. Sanders
Article
Anesthesiology
Thomas Payne, Jennifer Taylor, Cameron Casey, David Kunkel, Maggie Parker, Kaj Blennow, Henrik Zetterberg, Robert A. Pearce, Richard C. Lennertz, Robert D. Sanders
Summary: The study aimed to investigate the relationship between surgery, delirium, and changes in amyloid pathways. Results showed that the increase in plasma A(3R was not associated with delirium incidence or severity. Additionally, the change in plasma A(3R was not related to intraoperative variables.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Clinical Neurology
Bradley J. Hindman, Colin J. Gold, Emanuel Ray, Linder H. Wendt, Patrick Ten Eyck, Joel I. Berger, Catherine R. Olinger, Matthew I. Banks, Robert D. Sanders, Matthew A. Howard III, Royce W. Woodroffe
Summary: In this study, it was found that the treatment effects reported in retrospective observational studies should be as reliable as possible. A spurious result was obtained in a retrospective analysis of spine surgery patients, showing that tranexamic acid had no effect on intraoperative blood loss. This study emphasizes the importance of considering the effects of individual surgeons in statistical analyses of observational studies.
WORLD NEUROSURGERY
(2023)
Article
Anesthesiology
Jordan J. Wehrman, Cameron Casey, Sean Tanabe, Sounak Mohanta, William Filbey, Lilian Weber, Matthew I. Banks, Robert A. Pearce, Yuri Saalmann, Robert D. Sanders
Summary: The study found that subanaesthetic dosing of ketamine reduced correlates of predictive coding but did not eliminate them. Prediction errors associated with the transition of one tone to the next were reduced at blood concentrations of 0.2-0.3 mg ml-1, but electroencephalographic activity still showed evidence of prediction errors. Prediction errors related to environmental volatility were observed before and during ketamine administration at the same dose.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Letter
Anesthesiology
Jennifer Taylor, Thomas Payne, Robert D. Sanders, Richard C. Lennertz
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Editorial Material
Anesthesiology
Andrew J. F. Turner, Jordan Wehrman, Robert D. Sanders
Summary: A recent study found that the frequency and content of recalled experiences were similar after non-rapid eye movement sleep and target-controlled infusions of propofol or dexmedetomidine titrated to verbal unresponsiveness. The study suggests that the phenomenological similarities between consciousness during sleep and sedation reflect their physiological similarities. Interestingly, conscious experience did not show a dose-dependent response in this small sample, suggesting that other factors may be important in determining consciousness under sedation.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Editorial Material
Anesthesiology
Elie Matar, Robert D. Sanders
Summary: Postoperative delirium is a significant complication of surgery that is linked to long-term cognitive decline, although the neural mechanisms behind this relationship are not well understood. Neuroimaging studies and network-based approaches are important tools for unraveling the link between delirium and cognitive decline. A recent study using resting state functional MRI revealed reduced global connectivity for up to 3 months after delirium, supporting current models of delirium and providing potential insight into the complex relationship between delirium and dementia.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Neurosciences
Alliot Nagle, Josh P. Gerrelts, Bryan M. Krause, Aaron D. Boes, Joel E. Bruss, Kirill Nourskid, Matthew I. Banks, Barry Van Veen
Summary: The estimation of multivariate autoregressive (MVAR) models enables the assessment of causal interactions in brain networks, but it is challenging for high-dimensional electrophysiological recordings due to extensive data requirements. This study proposes incorporating prior information, such as resting state functional connectivity from functional magnetic resonance imaging, into MVAR model estimation using a weighted group least absolute shrinkage and selection operator (LASSO) regularization strategy. The approach reduces data requirements while resulting in more parsimonious and accurate models, demonstrated through simulation studies of intracranial electroencephalography (iEEG) data.
Article
Anesthesiology
Richard Lennertz, Kane O. Pryor, Aeyal Raz, Maggie Parker, Vincent Bonhomme, Peter Schuller, Gerhard Schneider, Matt Moore, Mark Coburn, James C. Root, Jacqueline M. Emerson, Alexandra L. Hohmann, Haya Azaria, Neta Golomb, Aline Defresne, Javier Montupil, Stefanie Pilge, David P. Obert, Hanna van Waart, Marta Seretny, Rolf Rossaint, Ana Kowark, Alexander Blair, Bryan Krause, Alex Proekt, Max Kelz, Jamie Sleigh, Amy Gaskell, Robert D. Sanders
Summary: Connected consciousness can occur after tracheal intubation in young adults, with females being at a higher risk. Further research is needed to understand the differences in risk between sexes.
BRITISH JOURNAL OF ANAESTHESIA
(2023)