Cognitive Impairment Is Associated with Absolute Intraoperative Frontal α-Band Power but Not with Baseline α-Band Power: A Pilot Study.
BACKGROUND
Cognitive abilities decline with aging, leading to a higher risk for the development of postoperative delirium or postoperative neurocognitive disorders after general anesthesia. Since frontal α-band power is known to be highly correlated with cognitive function in general, we hypothesized that preoperative cognitive impairment is associated with lower baseline and intraoperative frontal α-band power in older adults.


METHODS
Patients aged ≥65 years undergoing elective surgery were included in this prospective observational study. Cognitive function was assessed on the day before surgery using six age-sensitive cognitive tests. Scores on those tests were entered into a principal component analysis to calculate a composite "g score" of global cognitive ability. Patient groups were dichotomized into a lower cognitive group (LC) reaching the lower 1/3 of "g scores" and a normal cognitive group (NC) consisting of the upper 2/3 of "g scores." Continuous pre- and intraoperative frontal electroencephalograms (EEGs) were recorded. EEG spectra were analyzed at baseline, before start of anesthesia medication, and during a stable intraoperative period. Significant differences in band power between the NC and LC groups were computed by using a frequency domain (δ 0.5-3 Hz, θ 4-7 Hz, α 8-12 Hz, β 13-30 Hz)-based bootstrapping algorithm.


RESULTS
Of 38 included patients (mean age 72 years), 24 patients were in the NC group, and 14 patients had lower cognitive abilities (LC). Intraoperative α-band power was significantly reduced in the LC group compared to the NC group (NC -1.6 [-4.48/1.17] dB vs. LC -6.0 [-9.02/-2.64] dB), and intraoperative α-band power was positively correlated with "g score" (Spearman correlation: r = 0.381; p = 0.018). Baseline EEG power did not show any associations with "g."


CONCLUSIONS
Preoperative cognitive impairment in older adults is associated with intraoperative absolute frontal α-band power, but not baseline α-band power.
['Koch|Susanne|S|', 'Feinkohl|Insa|I|', 'Chakravarty|Sourish|S|', 'Windmann|Victoria|V|', 'Lichtner|Gregor|G|', 'Pischon|Tobias|T|', 'Brown|Emery N|EN|', 'Spies|Claudia|C|', '|||']
D000368:Aged D058256:Brain Waves D003071:Cognition D003693:Delirium D004569:Electroencephalography D005260:Female D015577:Geriatric Assessment D006801:Humans D064795:Intraoperative Neurophysiological Monitoring D008297:Male D000073216:Mental Status and Dementia Tests D010865:Pilot Projects D000079690:Postoperative Cognitive Complications D011300:Preoperative Care D011446:Prospective Studies
Aging and cognition Aging brain Clinical trials Cognitive decline Electroencephalography