神经认知
医学
围手术期
认知
神经心理学
无症状的
生物标志物
骨科手术
内科学
外科
精神科
生物化学
化学
作者
Carmen Lage,Andrea González-Suárez,María Puerto Alcalde-Hierro,María Isabel Sampedro-González,María Ángeles Villanueva-Eguaras,Manuel Rubén Sánchez-Crespo,Catherine Widmann,Frederic Brosseron,Ana Pozueta,Sara López-García,María D. García-Martínez,Martha Kazimierczak,María Cristina Bravo-González,Andrea Fernández-Rodríguez,Marta Drake-Pérez,Juan Irure-Ventura,Marcos López-Hoyos,Eloy Rodríguez-Rodríguez,Michael T. Heneka,Pascual Sánchez-Juan
摘要
Background: Major surgery has been associated with perioperative neurocognitive disorders (PND), but the contributing factors and long-term prognosis are uncertain. We hypothesize that preclinical Alzheimer’s disease (AD) might predispose to cognitive deterioration after surgery. Objective: To analyze the effect of amyloid-β on the cognitive trajectory after orthopedic surgery in a sample of non-demented subjects. Methods: Non-demented individuals older than 65 years that were on the waiting list for orthopedic surgery with spinal anesthesia underwent a neuropsychological assessment before and after surgery. During surgery, cerebrospinal fluid samples were obtained to determine AD biomarkers. Results: Cumulative incidence of PND was 55.2%during a mean follow-up of nine months. The most affected cognitive domains were executive function and constructional praxis. The presence of abnormal levels of amyloid-β was associated to a postoperative impairment in verbal and visual memory tests. According to their AD biomarker profile, participants were categorized as either Amyloid Positive (A+) or Amyloid Negative (A-). The incidence of PND did not differ between both groups. The A- group showed a tendency similar to the global sample, worsening in executive function tests and improving on memory scales due to practice effects. In contrast, the A + group showed a notable worsening on memory performance. Conclusion: Our findings support the hypothesis that surgery may promote or accelerate memory decline in cognitively asymptomatic subjects with brain amyloid-β deposits.
科研通智能强力驱动
Strongly Powered by AbleSci AI