Correlation Between Postoperative Cognitive-related Adverse Reactions and Brain Metabolomic Characteristics in Elderly Patients
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Collecting clinical data, EGG，Brain Metabolomic Characteristics(with Magnetic Resonance Spectroscopy), blood gas data and blood sample.
- Who it may be relevant to
- Registry conditions: POCD - Postoperative Cognitive Dysfunction. Basic parameters: from 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- China
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Postoperative cognitive dysfunction (POCD) refers to the difficulties of orientation, cognition, communication, memory and abstract thinking of patients after anesthesia and surgery. And/or accompanied by the decline of the ability in social activities, such as the change of personality, social ability of language and behavior, cognitive function and life skills. POCD is a common complication of central nervous system in elderly patients after operation, with an early incidence of about 21% and a long-term incidence of about 35% . According to the current research on Alzheimer's disease (AD) and POCD in the elderly, it has been found that they have similar pathological basis and some homologous related genes. Altogether, POCD is closely related to molecular pathway neuropsychiatric diseases (such as dementia, depression and Alzheimer's disease). Researchers have come up with various hypotheses to reveal the underlying mechanisms of POCD, including neuritis, oxidative stress, autophagy disorder, synaptic dysfunction, and lack of neurotrophic support. To date, apart from evaluating with scales, CT Scan and EEG analysis, there is neither exact biomarkers for monitoring and diagnosing POCD, nor clear relationships between specific Brain Metabolomic Characteristics, EEG changes and diagnosis of POCD, so that the diagnosis of early POCD only stays in the evaluation of clinical symptoms and scales. Therefore, our study aims to provide an effective basis for early diagnosis and treatment of clinical POCD through multivariate analyses of clinical scales combined with Brain Metabolomic Characteristics, EEG analysis of patients.
Interventions
- Other Collecting clinical data, EGG，Brain Metabolomic Characteristics(with Magnetic Resonance Spectroscopy), blood gas data and blood sample
Collecting clinical data(before induction of anesthesia and first day after surgery), EGG（first day after surgery），Magnetic Resonance Spectroscopy data (before induction of anesthesia and first day after surgery)blood gas data(before induction of anesthesia and first day after surgery) and blood sample （before induction of anesthesia and first day, third day and 7th day after surgery）
Primary outcome measures
- MMSE (mini-mental state examiniation) [Time frame: 1 day after surgery]
- MMSE (mini-mental state examiniation) [Time frame: immediately before surgery]
- MMSE (mini-mental state examiniation) [Time frame: 3 day after surgery]
- MMSE (mini-mental state examiniation) [Time frame: 7 day after surgery]
- MOCA (Montreal Cognitive Assessment) [Time frame: 1 day after surgery]
- MOCA (Montreal Cognitive Assessment) [Time frame: 3 day after surgery]
- MOCA (Montreal Cognitive Assessment) [Time frame: 7 day after surgery]
- MOCA (Montreal Cognitive Assessment) [Time frame: immediately before surgery]
Secondary outcome measures (3)
- 3D-CAM [Time frame: 1 day after surgery]
- Self-Rating Anxiety Scale [Time frame: immediately before surgery]
- Self-rating depression scale [Time frame: immediately before surgery]
Eligibility criteria
Inclusion criteria
- 65 years or older .
- Complete the operation in our hospital
- ASA classification I-II level
- Agree to participate in this research and agree to sign an informed consent form
Exclusion criteria
- History of preoperative psychosis and psychotropic drug use
- The subject is diagnosed with AD;
- Abnormal preoperative mental scale assessment
- Have a history of emergency rescue during the perioperative period
- metal implants
- Postoperative immobilization patients
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
China · 1 center
- Shanghai 9Th Hospital — Shanghai
Identifiers
NCT: NCT05555693 · SH9H-2022-T133-2