Abstract
BACKGROUND
Structural disconnectivity was found to precede dementia. Global white matter abnormalities might also be associated with postoperative delirium (POD).
METHODS
We recruited older patients (≥65 years) without dementia that were scheduled for major surgery. Diffusion kurtosis imaging metrics were obtained preoperatively, after 3 and 12 months postoperatively. We calculated fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), and free water (FW). A structured and validated delirium assessment was performed twice daily.
RESULTS
Of 325 patients, 53 patients developed POD (16.3%). Preoperative global MD (standardized beta 0.27 [95% confidence interval [CI] 0.21–0.32] p < 0.001) was higher in patients with POD. Preoperative global MK (−0.07 [95% CI −0.11 to (−0.04)] p < 0.001) and FA (0.07 [95% CI −0.10 to (−0.04)] p < 0.001) were lower. When correcting for baseline diffusion, postoperative MD was lower after 3 months (0.05 [95% CI −0.08 to (−0.03)] p < 0.001; n = 183) and higher after 12 months (0.28 [95% CI 0.20–0.35] p < 0.001; n = 45) among patients with POD.
DISCUSSION
Preoperative structural disconnectivity was associated with POD. POD might lead to white matter depletion 3 and 12 months after surgery.
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This post is Copyright: Marinus Fislage,
Stefan Winzeck,
Rebecca Woodrow,
Florian Lammers‐Lietz,
Emmanuel A. Stamatakis,
Marta M. Correia,
Jacobus Preller,
Insa Feinkohl,
Jeroen Hendrikse,
Tobias Pischon,
Claudia D. Spies,
Arjen J. C. Slooter,
Georg Winterer,
David K. Menon,
Norman Zacharias,
BioCog Consortium,
Alissa Wolf,
Anika Müller,
Daniel Hadzidiakos,
Fatima Yürek,
Friedrich Borchers,
Gunnar Lachmann,
Kwaku Ofosu,
Maria Heinrich,
Rudolf Mörgeli,
Jürgen Gallinat,
Simone Kühn,
Edwin van Dellen,
Ilse Kant,
Jeroen de Bresser,
Simone van Montfort,
Laura Moreno‐López,
Daniela Melillo,
Diana Boraschi,
Giacomo Della Camera,
Paola Italiani,
Reinhard Schneider,
Roland Krause,
Karsten Heidtke,
Peter Nürnberg,
Anja Helmschrodt,
Axel Böcher,
Bettina Hafen,
Franz Paul Armbruster,
Ina Diehl,
Jana Ruppert,
Katarina Hartmann,
Marion Kronabel,
Marius Weyer,
Thomas Bernd Dschietzig,
Malte Pietzsch,
Simon Weber,
Bernd Ittermann,
Ariane Fillmer | March 8, 2024