Intraoperative frontal alpha-band power correlates with preoperative neurocognitive function in older adults

The MADCO-PC Investigators

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, increased 1-year mortality, and long-term cognitive decline. Multiple investigators have thus suggested that anesthesia and surgery place severe stress on the aging brain, and that patients with less ability to withstand this stress will be at increased risk for developing postoperative delirium and POCD. Delirium and POCD risk are increased in patients with lower preoperative cognitive function, yet preoperative cognitive function is not routinely assessed, and no intraoperative physiological predictors have been found that correlate with lower preoperative cognitive function. Since general anesthesia causes alpha-band (8–12 Hz) electroencephalogram (EEG) power to decrease occipitally and increase frontally (known as “anteriorization”), and anesthetic-induced frontal alpha power is reduced in older adults, we hypothesized that lower intraoperative frontal alpha power might correlate with lower preoperative cognitive function. Here, we provide evidence that such a correlation exists, suggesting that lower intraoperative frontal alpha power could be used as a physiological marker to identify older adults with lower preoperative cognitive function. Lower intraoperative frontal alpha power could thus be used to target these at-risk patients for possible therapeutic interventions to help prevent postoperative delirium and POCD, or for increased postoperative monitoring and follow-up. More generally, these results suggest that understanding interindividual differences in how the brain responds to anesthetic drugs can be used as a probe of neurocognitive function (and dysfunction), and might be a useful measure of neurocognitive function in older adults.

Original languageEnglish (US)
Article number24
JournalFrontiers in Systems Neuroscience
Volume11
DOIs
StatePublished - May 8 2017

Fingerprint

Delirium
Cognition
General Anesthesia
Anesthetics
Power (Psychology)
Aptitude
Retirement
Brain
Cognitive Dysfunction
Electroencephalography
Anesthesia
Quality of Life
Research Personnel
Mortality

Keywords

  • Aging
  • Alpha oscillations
  • Anteriorization
  • Cognitive function
  • EEG
  • General anesthesia
  • Isoflurane
  • Propofol

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental Neuroscience
  • Cognitive Neuroscience
  • Cellular and Molecular Neuroscience

Cite this

Intraoperative frontal alpha-band power correlates with preoperative neurocognitive function in older adults. / The MADCO-PC Investigators.

In: Frontiers in Systems Neuroscience, Vol. 11, 24, 08.05.2017.

Research output: Contribution to journalArticle

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abstract = "Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40{\%} develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, increased 1-year mortality, and long-term cognitive decline. Multiple investigators have thus suggested that anesthesia and surgery place severe stress on the aging brain, and that patients with less ability to withstand this stress will be at increased risk for developing postoperative delirium and POCD. Delirium and POCD risk are increased in patients with lower preoperative cognitive function, yet preoperative cognitive function is not routinely assessed, and no intraoperative physiological predictors have been found that correlate with lower preoperative cognitive function. Since general anesthesia causes alpha-band (8–12 Hz) electroencephalogram (EEG) power to decrease occipitally and increase frontally (known as “anteriorization”), and anesthetic-induced frontal alpha power is reduced in older adults, we hypothesized that lower intraoperative frontal alpha power might correlate with lower preoperative cognitive function. Here, we provide evidence that such a correlation exists, suggesting that lower intraoperative frontal alpha power could be used as a physiological marker to identify older adults with lower preoperative cognitive function. Lower intraoperative frontal alpha power could thus be used to target these at-risk patients for possible therapeutic interventions to help prevent postoperative delirium and POCD, or for increased postoperative monitoring and follow-up. More generally, these results suggest that understanding interindividual differences in how the brain responds to anesthetic drugs can be used as a probe of neurocognitive function (and dysfunction), and might be a useful measure of neurocognitive function in older adults.",
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AU - Grant, Stuart

AU - Guercio, Jason

AU - Gupta, Dhanesh

AU - Habib, Ashraf

AU - Harpole, David H.

AU - Hartwig, Mathew G.

AU - Iboaya, Ehimemen

AU - Inman, Brant A.

AU - Khan, Anver

AU - Lagoo-Deenadayalan, Sandhya

AU - Lee, Paula S.

AU - Lee, Walter T.

AU - Lemm, John

AU - Levinson, Howard

AU - Mantyh, Christopher

AU - Mathew, Joseph

AU - McDonagh, David L.

AU - Migaly, John

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KW - Aging

KW - Alpha oscillations

KW - Anteriorization

KW - Cognitive function

KW - EEG

KW - General anesthesia

KW - Isoflurane

KW - Propofol

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