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An exploratory research report on brain mineralization in postoperative delirium and cognitive decline.

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Title: An exploratory research report on brain mineralization in postoperative delirium and cognitive decline.
Authors: Lammers‐Lietz, Florian (AUTHOR), Borchers, Friedrich (AUTHOR), Feinkohl, Insa (AUTHOR), Hetzer, Stefan (AUTHOR), Kanar, Cicek (AUTHOR), Konietschke, Frank (AUTHOR), Lachmann, Gunnar (AUTHOR), Chien, Claudia (AUTHOR), Spies, Claudia (AUTHOR), Winterer, Georg (AUTHOR), Zaborszky, Laszlo (AUTHOR), Zacharias, Norman (AUTHOR), Paul, Friedemann (AUTHOR)
Source: European Journal of Neuroscience. May2024, Vol. 59 Issue 10, p2646-2664. 19p.
Subjects: Cognition disorders, Delirium, Brain research, Magnetic resonance imaging, Cholinergic mechanisms
Abstract: Delirium is a severe postoperative complication associated with poor overall and especially neurocognitive prognosis. Altered brain mineralization is found in neurodegenerative disorders but has not been studied in postoperative delirium and postoperative cognitive decline. We hypothesized that mineralization‐related hypointensity in susceptibility‐weighted magnetic resonance imaging (SWI) is associated with postoperative delirium and cognitive decline. In an exploratory, hypothesis‐generating study, we analysed a subsample of cognitively healthy patients ≥65 years who underwent SWI before (N = 65) and 3 months after surgery (N = 33). We measured relative SWI intensities in the basal ganglia, hippocampus and posterior basal forebrain cholinergic system (pBFCS). A post hoc analysis of two pBFCS subregions (Ch4, Ch4p) was conducted. Patients were screened for delirium until the seventh postoperative day. Cognitive testing was performed before and 3 months after surgery. Fourteen patients developed delirium. After adjustment for age, sex, preoperative cognition and region volume, only pBFCS hypointensity was associated with delirium (regression coefficient [90% CI]: B = −15.3 [−31.6; −0.8]). After adjustments for surgery duration, age, sex and region volume, perioperative change in relative SWI intensities of the pBFCS was associated with cognitive decline 3 months after surgery at a trend level (B = 6.8 [−0.9; 14.1]), which was probably driven by a stronger association in subregion Ch4p (B = 9.3 [2.3; 16.2]). Brain mineralization, particularly in the cerebral cholinergic system, could be a pathomechanism in postoperative delirium and cognitive decline. Evidence from our studies is limited because of the small sample and a SWI dataset unfit for iron quantification, and the analyses presented here should be considered exploratory. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: An exploratory research report on brain mineralization in postoperative delirium and cognitive decline.
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  Data: <searchLink fieldCode="AR" term="%22Lammers‐Lietz%2C+Florian%22">Lammers‐Lietz, Florian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Borchers%2C+Friedrich%22">Borchers, Friedrich</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Feinkohl%2C+Insa%22">Feinkohl, Insa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hetzer%2C+Stefan%22">Hetzer, Stefan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kanar%2C+Cicek%22">Kanar, Cicek</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Konietschke%2C+Frank%22">Konietschke, Frank</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lachmann%2C+Gunnar%22">Lachmann, Gunnar</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chien%2C+Claudia%22">Chien, Claudia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Spies%2C+Claudia%22">Spies, Claudia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Winterer%2C+Georg%22">Winterer, Georg</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zaborszky%2C+Laszlo%22">Zaborszky, Laszlo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zacharias%2C+Norman%22">Zacharias, Norman</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Paul%2C+Friedemann%22">Paul, Friedemann</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neuroscience%22">European Journal of Neuroscience</searchLink>. May2024, Vol. 59 Issue 10, p2646-2664. 19p.
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  Data: <searchLink fieldCode="DE" term="%22Cognition+disorders%22">Cognition disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Delirium%22">Delirium</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+research%22">Brain research</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Cholinergic+mechanisms%22">Cholinergic mechanisms</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Delirium is a severe postoperative complication associated with poor overall and especially neurocognitive prognosis. Altered brain mineralization is found in neurodegenerative disorders but has not been studied in postoperative delirium and postoperative cognitive decline. We hypothesized that mineralization‐related hypointensity in susceptibility‐weighted magnetic resonance imaging (SWI) is associated with postoperative delirium and cognitive decline. In an exploratory, hypothesis‐generating study, we analysed a subsample of cognitively healthy patients ≥65 years who underwent SWI before (N = 65) and 3 months after surgery (N = 33). We measured relative SWI intensities in the basal ganglia, hippocampus and posterior basal forebrain cholinergic system (pBFCS). A post hoc analysis of two pBFCS subregions (Ch4, Ch4p) was conducted. Patients were screened for delirium until the seventh postoperative day. Cognitive testing was performed before and 3 months after surgery. Fourteen patients developed delirium. After adjustment for age, sex, preoperative cognition and region volume, only pBFCS hypointensity was associated with delirium (regression coefficient [90% CI]: B = −15.3 [−31.6; −0.8]). After adjustments for surgery duration, age, sex and region volume, perioperative change in relative SWI intensities of the pBFCS was associated with cognitive decline 3 months after surgery at a trend level (B = 6.8 [−0.9; 14.1]), which was probably driven by a stronger association in subregion Ch4p (B = 9.3 [2.3; 16.2]). Brain mineralization, particularly in the cerebral cholinergic system, could be a pathomechanism in postoperative delirium and cognitive decline. Evidence from our studies is limited because of the small sample and a SWI dataset unfit for iron quantification, and the analyses presented here should be considered exploratory. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Journal of Neuroscience is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ejn.16282
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        Text: English
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        PageCount: 19
        StartPage: 2646
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      – SubjectFull: Cognition disorders
        Type: general
      – SubjectFull: Delirium
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      – SubjectFull: Brain research
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      – SubjectFull: Magnetic resonance imaging
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      – SubjectFull: Cholinergic mechanisms
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              Text: May2024
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