Document Detail


Surgery and brain atrophy in cognitively normal elderly subjects and subjects diagnosed with mild cognitive impairment.
MedLine Citation:
PMID:  22293721     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Structural magnetic resonance imaging is used to longitudinally monitor the progression of Alzheimer disease from its presymptomatic to symptomatic phases. Using magnetic resonance imaging data from the Alzheimer's Disease Neuroimaging Initiative, we tested the hypothesis that surgery would impact brain parameters associated with progression of dementia.
METHODS: Brain images from the neuroimaging initiative database were used to study normal volunteer subjects and patients with mild cognitive impairment for the age group 55 to 90 inclusive. We compared changes in regional brain anatomy for three visits that defined two intervisit intervals for a surgical cohort (n = 41) and a propensity matched nonsurgical control cohort (n = 123). The first interval for the surgical cohort contained the surgical date. Regional brain volumes were determined with Freesurfer and quantitatively described with J-image software (University of California at San Francisco, San Francisco, California). Statistical analysis used Repeated Measures ANCOVA (SPSS, v.18.0; Chicago, IL).
RESULTS: We found that surgical patients, during the first follow-up interval (5-9 months), but not subsequently, had increased rates of atrophy for cortical gray matter and hippocampus, and lateral ventricle enlargement, as compared with nonsurgical controls. A composite score of five cognitive tests during this interval showed reduced performance for surgical patients with mild cognitive impairment.
CONCLUSIONS: Elderly subjects after surgery experienced an increased rate of brain atrophy during the initial evaluation interval, a time associated with enhanced risk for postoperative cognitive dysfunction. Although there was no difference in atrophy rate by diagnosis, subjects with mild cognitive impairment suffered greater subsequent cognitive effects.
Authors:
Richard P Kline; Elizabeth Pirraglia; Hao Cheng; Susan De Santi; Yi Li; Michael Haile; Mony J de Leon; Alex Bekker;
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  116     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-23     Completed Date:  2012-04-10     Revised Date:  2012-05-23    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  603-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, New York University Langone Medical Center, New York, New York 10016, USA. richard.kline@nyumc.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atrophy
Brain / pathology*
Cognition / physiology*
Cohort Studies
Databases, Factual
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mild Cognitive Impairment / pathology*,  psychology
Postoperative Complications / pathology*,  psychology
Grant Support
ID/Acronym/Agency:
1 UL1 RR029893/RR/NCRR NIH HHS; AG008051/AG/NIA NIH HHS; AG022374/AG/NIA NIH HHS; AG032554/AG/NIA NIH HHS; AG035137/AG/NIA NIH HHS; AG036502/AG/NIA NIH HHS; AG12101/AG/NIA NIH HHS; AG13616/AG/NIA NIH HHS; K01 AG030514/AG/NIA NIH HHS; P30 AG008051/AG/NIA NIH HHS; P30 AG010129/AG/NIA NIH HHS; R01 AG012101/AG/NIA NIH HHS; R01 AG013616/AG/NIA NIH HHS; R01 AG022374/AG/NIA NIH HHS; R01 AG035137/AG/NIA NIH HHS; U01 AG024904/AG/NIA NIH HHS
Comments/Corrections
Comment In:
Anesthesiology. 2012 Mar;116(3):510-2   [PMID:  22258020 ]

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