Alpha-synucleinopathy Related Non-motor Symptom, Post-operation Delirium
Conditions
Keywords
delirium, alpha synucleinopathy, spine surgery
Brief summary
Hypothesis is that the presence of a-synucleinopathy related non motor symptoms could be predictive factor for post-operative delirium. During 72hrs after spine surgery, investigator will observe occurrence of post-operative delirium, and analysis difference of a-synucleinopathy related non motor symptoms between 2 groups.
Detailed description
Postoperative delirium appear approximately 10-70% of patients older than 65 yrs undergoing surgery and it is strongly associated with poor surgical outcome. The clinical characteristics of postoperative delirium are fluctuating attention, visual hallucination, disorganized thought and alter sleep-wake cycles. This is quite similar to core features of α-synuclein-related cognitive disorders such as parkinson's disease dementia and dementia with lewy body. At that point, investigator thought that postoperative delirium is preclinical stage of a-synucleinopathy. In other words, a-synuclein related disorders and postoperative delirium may share an underlying neurochemical change in their pathogenesis. investigator will recruit age 65 and older patients scheduled to perform spine surgery. The pre-operative evaluation include neurologic exam, baseline cognitive function and a-synucleinopathy related non motor symptoms through Questionnaires.
Interventions
None listed
Sponsors
Yonsei University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Age 65 and older patients 2. Scheduled to perform spine surgery in severance hospital
Exclusion criteria
1. Previous delirium history 2. Previous chemotherapy or radiotherapy within 1yr due to underlying cancer. 3. Severe hepatic/renal dysfunction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| existence of anosomia | A day before operation | During 72hrs after spine surgery, investigator will observe occurrence of post-operative delirium, and analysis difference of anosmia symptoms before operation between 2 groups. The cross-cultural smell identification test will be used for measure of anosmia. investigator define anosmia as less than 4 score on the cross-cultural smell identification test. This study is not interventional study, because measure of anosmia by smell kit will not develop post-operation delirium more. (investigator will classify our patients into normosmia if the CCSIT score is 9 or higher, and hyposmia if the CCSIT score is 6 or less. Patients whose CCSIT scores are 7 or 8 will be regarded as borderline.). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| existence of orthostatic hypotension | A day before operation | Check 3 position BP (define orthostatic hypotension - sustained reduction of systolic blood pressure of at least 20 mmHg or diastolic blood pressure of 10 mmHg within 3 min of standing, / Questionnaire (orthostatic hypotension symptom assessment & Orthostatic hypotension daily activities scale) (orthostatic hypotension: Yes/No) |
| existence of insomnia | A day before operation | Questionnaire (Epworth Sleepiness Scale (ESS) : total score 0-24) |
| existence of constipation | A day before operation | Questionnaire (Constipation scoring system (Agachanet al., 1996) & Rome III Questionnaire (Constipation : Yes/No) |
| existence of anxiety | A day before operation | Questionnaire (The Parkinson Anxiety Scale, total score 0-48) |
| existence of REM sleep behavior disorder | A day before operation | Questionnaire (RBD screening questionnaire, total score 0-13) :These questionnaires & checking 3-position BP will not effect the occurence of post-operation delirium |
| existence of depression | A day before operation | Questionnaire (Beck depression inventory, total score 0-63) |
Countries
South Korea
Outcome results
None listed