POCD - Postoperative Cognitive Dysfunction
Conditions
Brief summary
Postoperative cognitive dysfunction (POCD) refers to the difficulties of orientation, cognition, communication, memory and abstract thinking of patients after anesthesia and surgery. And/or accompanied by the decline of the ability in social activities, such as the change of personality, social ability of language and behavior, cognitive function and life skills. POCD is a common complication of central nervous system in elderly patients after operation, with an early incidence of about 21% and a long-term incidence of about 35% . According to the current research on Alzheimer's disease (AD) and POCD in the elderly, it has been found that they have similar pathological basis and some homologous related genes. Altogether, POCD is closely related to molecular pathway neuropsychiatric diseases (such as dementia, depression and Alzheimer's disease). Researchers have come up with various hypotheses to reveal the underlying mechanisms of POCD, including neuritis, oxidative stress, autophagy disorder, synaptic dysfunction, and lack of neurotrophic support. To date, apart from evaluating with scales, CT Scan and EEG analysis, there is neither exact biomarkers for monitoring and diagnosing POCD, nor clear relationships between specific Brain Metabolomic Characteristics, EEG changes and diagnosis of POCD, so that the diagnosis of early POCD only stays in the evaluation of clinical symptoms and scales. Therefore, our study aims to provide an effective basis for early diagnosis and treatment of clinical POCD through multivariate analyses of clinical scales combined with Brain Metabolomic Characteristics, EEG analysis of patients.
Interventions
OTHERCollecting clinical data, EGG，Brain Metabolomic Characteristics(with Magnetic Resonance Spectroscopy), blood gas data and blood sample
Collecting clinical data(before induction of anesthesia and first day after surgery), EGG（first day after surgery），Magnetic Resonance Spectroscopy data (before induction of anesthesia and first day after surgery)blood gas data(before induction of anesthesia and first day after surgery) and blood sample （before induction of anesthesia and first day, third day and 7th day after surgery）
Sponsors
Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 65 years or older . * Complete the operation in our hospital * ASA classification I-II level * Agree to participate in this research and agree to sign an informed consent form
Exclusion criteria
* History of preoperative psychosis and psychotropic drug use * The subject is diagnosed with AD; * Abnormal preoperative mental scale assessment * Have a history of emergency rescue during the perioperative period * metal implants * Postoperative immobilization patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MMSE (mini-mental state examiniation) | 1 day after surgery | MMSE scale score, If the MMSE assessment is positive at any time point, and there is a positive MMSE at any time point (no need for both MOCA and MMSE to be positive at the same time), it is defined as the occurrence of POCD. |
| MOCA (Montreal Cognitive Assessment) | 1 day after surgery | MOCA sacle score, If the MOCA assessment is positive at any time point, and there is a positive MMSE at any time point (no need for both MOCA and MMSE to be positive at the same time), it is defined as the occurrence of POCD. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 3D-CAM | 1 day after surgery | 3D-CAM score |
| Self-Rating Anxiety Scale | immediately before surgery | Self-Rating Anxiety Scale score |
| Self-rating depression scale | immediately before surgery | Self-rating depression scale score |
Countries
China
Contacts
Primary ContactRen Zhou, PhD
Outcome results
None listed