Anesthesia, Cognitive Disorders, Neurogenic Inflammation, Surgery
Conditions
Keywords
Neuroinflammation, Postoperative cognitive dysfunction
Brief summary
The main purpose of this study is to assess the induction of neuroinflammation in brain regions of interest for learning and memory in adult patients undergoing urological surgery under general anesthesia
Detailed description
The investigators aim to study immune cell activation as a biomarker for neuroinflammation using the cell specific \[11C\]PBR28 probe as detected by PET imaging techniques.
Interventions
RADIATIONPositron emission tomography (PET) using [11C]PBR28
Sponsors
University of Copenhagen
Karolinska University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Patients 60-75 years of age. American Society for Anesthesiologist' criteria (ASA) physical status I-III 2. Lower abdominal surgery (hysterectomy/prostatectomy) under general anaesthesia 3. Obtained consent within 3 months before execution of the study.
Exclusion criteria
1. Patient's refusal to participate in the trial 2. Ongoing smoking, snuff or other nicotine compound treatment 3. Disabling neuropsychiatrical disorder (a Mini mental State Examination (MMSE) score ≤ 24, diagnosis of dementia, Mb Alzheimer, Mb Parkinson, schizophrenia, or mental depression) or other signs of significant cognitive decline. 4. History of stroke with neurological sequelae 5. Surgical procedure scheduled for regional anaesthesia. 6. Severe cardia and/or renal and/or hepatic impairment. 7. Coagulopathy. 8. Terminal phase of a chronic disease. 9. Patient on steroidal or non-steroidal anti-inflammatory drugs. 10. Admission B-Glucose \> 15 mmol/litre or poorly controlled diabetes mellitus. 11. Presumed uncooperativeness or legal incapacity. 12. Preoperative or later postoperative B-hemoglobin \< 90 g/L.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Binding of the PET probe [11C]PBR28 | Preoperatively, once at postoperative day 2-5 and after 3 month | PET imaging of brain regions of relevance for memory and learning will be compared between the pre- and postoperative states. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cognitive testing | Preoperatively and after 3 month | Postoperative cognitive test battery according to the ISPOCD protocol, see Moller JT et al, Lancet 1998. |
| Inflammatory biomarkers | Preoperatively, once at postoperative day 2-5 and after 3 month, i.e. at the same time as the PET investigation | Inflammatory biomarkers and genetic analysis of inflammatory biomarkers in blood. |
Outcome results
None listed