Premium
F3‐01‐03: ISSUES ASSOCIATED WITH THE ASSESSMENT OF COGNITION IN PERIOPERATIVE SETTINGS
Author(s) -
Maruff Paul
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.2742
Subject(s) - delirium , psychomotor learning , evening , morning , medicine , cognition , perioperative , physical therapy , cognitive test , confusion , anesthesia , psychology , psychiatry , physics , astronomy , psychoanalysis
Background: Postoperative cognitive dysfunction (POCD) has been theorized to result from a postoperative acceleration of AD neuropathology. We recently showed that there are acute increases in CSF tau levels and in the CSF tau/AB ratio within 24 hours after surgery. Yet, little is known about the relationships between postoperative changes in these AD-related CSF biomarkers, cerebrovascular damage and postoperative changes in brain activity. Methods: In the Markers of Alzheimer’s Disease and neuroCognitive Outcomes after Perioperative Care (MADCO-PC) study, older surgical patients (age 60)] underwent 3T fMRI scans before and 6 weeks after surgery. CSF samples were obtained from these patients via lumbar puncture before, 24 hours and 6-weeks after surgery, and assayed for tau, phosphorylated tau (pTau), and amyloid beta 1-42 (AB) levels, and the tau/AB and pTau/AB ratios were calculated. Here we analyze the association between pre to 24 hr postoperative changes in these CSF AD biomarkers with pre to 6-week postoperative changes in eyes-open resting-state functional connectivity (RSFC) data signal power (i.e., amplitude of low frequency fluctuations; ALFF). Analyses were controlled for sex, age, APOE e4 allele presence, and baseline CSF values, using a cluster threshold of p<0.001 and multiple comparison correction with family wise error rate (p-FWE<0.05). Results: 45 MADCO-PC trial patients had preand post-operative CSF and RSFC neuroimaging data. The preto 24 hr post-operative change in CSF tau and the CSF tau/AB ratio were negatively associated with the preto 6 week post-operative ALFF change within the right supramarginal gyrus (rSMG, k176, p-FWE1⁄40.0019 and k137, p-FWE1⁄40.0089, respectively). The preto 24 hr post-operative change in CSF pTau and the pTau/AB ratio were negatively associated with preto 6 week post-operative ALFF change in the left lingual gyrus/occipital cortex (k615, p-FWE1⁄40.0000, and k1525, p-FWE1⁄40.0000, respectively). Additional data is presented on the contribution of preand perioperative cerebrovascular damage to these CSF and ALFF associations. Conclusions: Our results suggest that acute 24-hour postoperative changes in ADassociated CSF biomarkers are associated with 6-week regional changes in BOLD low-frequency power in the rSMG and lingual gyrus/occipital cortex; two regions that have shown ALFF changes in AD patients.