Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.
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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.
Published Version (Please cite this version)10.3389/fnsys.2017.00024
Publication InfoBerger, Miles; Browndyke, Jeffrey Nicholas; Cooter, Mary; Gardner, JE; Giattino, CM; Mathew, Joseph P; ... Woldorff, Marty G (2017). Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults. Front Syst Neurosci, 11. pp. 24. 10.3389/fnsys.2017.00024. Retrieved from http://hdl.handle.net/10161/14971.
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Assistant Professor of Anesthesiology
My research team focuses on understanding the cause of postoperative cognitive dysfunction (POCD) and delirium, and whether these disorders are caused by perioperative changes in Alzheimer's disease pathways. We are also interested in whether delirium or POCD are associated with an increased long term risk of developing Alzheimer's disease. Towards these ends, we use a combination of methods including cognitive testing, CSF and blood sampling, functional neuroimaging, and rigorous biochemical as
Associate Professor in Psychiatry and Behavioral Sciences
Dr. Browndyke is an Associate Professor of Geriatric Behavioral Health in the Department of Psychiatry & Behavioral Sciences. He also holds affiliate faculty appointments with the Duke Brain Imaging & Analysis Center (BIAC), Duke Institute for Brain Science (DIBS), Center for Cognitive Neuroscience (CCN), and the Duke Center for Geriatric Surgery. He has dual appointment to the Duke University Medical Center and the Durham VA Medical Center, the latter of which is where his c
Jerry Reves, M.D. Professor of Cardiac Anesthesiology
Current research interests include:1. The relationship between white matter patency, functional connectivity (fMRI) and neurocognitive function following cardiac surgery.2. The relationship between global and regional cortical beta-amyloid deposition and postoperative cognitive decline.3. The effect of lidocaine infusion upon neurocognitive function following cardiac surgery.4. The association between genotype and outcome after cardiac surgery.5. Atrial fibrillation
Professor of Psychiatry and Behavioral Sciences
Dr. Woldorff's main research interest is in the cognitive neuroscience of attention. At each and every moment of our lives, we are bombarded by a welter of sensory information coming at us from a myriad of directions and through our various sensory modalities -- much more than we can fully process. We must continuously select and extract the most important information from this welter of sensory inputs. How the human brain accomplishes this is one of the core challenges of modern cognitive neuro
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