Cognitive Impairment, Obesity, Post-Operative Confusion
Conditions
Keywords
Obesity, Post-operative cognitive dysfunction, Inflammation, Inflammatory cytokines
Brief summary
This research aims at describing the relationship between white adipose tissue inflammation and post-operative cognitive dysfunctions.The possible link between inflammatory cytokines secretions of the white adipose tissue of a surgical wound and the arising of patient's cognitive dysfunction in the post-operative course will be investigated. The hypothesis is that obese patient's inflammation of the white adipose tissue leads to cognitive dysfunction.
Detailed description
The postoperative cognitive dysfunctions (POCD) are characterized by delirium and cognitive impairment. The delirium is defined by an acute altered attention with a fluctuating course. The post-operative cognitive impairment involves the early alteration of different functions including memory, attention and cognitive flexibility. POCD have a major impact in patient's morbidity. They are linked to the systemic inflammation induced by the surgical wound. The systemic inflammation leads to the rupture of the brain-blood barrier and to hippocampal inflammation. As hippocampus mediates the principal cognitive functions, hippocampal inflammation leads to POCD. Orthopedic and cardiac surgery are particularly concerned. Obesity is growing condition in the French population. It is linked to chronic systemic inflammation and altered cognitive functions. We think that obese people may present a susceptibility to POCD because of the pre-operative systemic inflammation.
Interventions
BIOLOGICALBlood sampling
4 tubes of 7 mL of blood will be collected
BIOLOGICALwhite adipose tissue sampling
At the beginning of the surgery, samples of white adipose tissue from the surgical wound will be collected.
Sponsors
University Hospital, Toulouse
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* patient about to receive a hip arthroplasty under general anesthesia, elective cardiac surgery with cardiopulmonary bypass, * patient with a MMSE score \> or = 20(/30), * patient able to give informed consent
Exclusion criteria
* emergency surgery, or surgery in a septic context, * patient with a known dementia or altered MMSE score (under 20)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Arising of POCD measured by a composite criterion | day 5 after surgery | 2 points Mini-Mental State Examination (MMSE) score decrease compared to the pre-operative score, and/or appearance of a delirium tracked down every day by the Confusion Assessment Method (CAM) during the hospital course. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Variation of inflammatory cytokine levels from patient's plasma and patient's white adipose tissue (extract from a controlled medium). | Day 0 and day 5 after surgery | inflammatory cytokine levels will be measured in plasma and adipose tissue, and compared. |
| Identification of a linked between inflammatory cytokine levels and the appearance of POCD. | day 5 after surgery | inflammatory cytokine levels will be measured in plasma and adipose tissue, and correlated with appearance of POCD |
| Peri-operative variations of the protein S100B, an autonomy scale (IADL) and a quality of life scale (EQ5D). | day 5 after surgery | protein S100B levels will be measured in plasma and adipose tissue, and correlated with scores of autonomy scale (IADL) and quality of life scale (EQ5D). |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORFrançois Labaste, MD, PhD
University Hospital, Toulouse
Outcome results
None listed