Details

Autor(en) / Beteiligte

• Browndyke, Jeffrey N.
• Wright, Mary C.
• Yang, Rosa
• Syed, Ayesha
• Park, John
• Hall, Ashley
• Martucci, Katherine
• Devinney, Michael J.
• Shaw, Leslie
• Waligorska, Teresa
• Moretti, Eugene W.
• Whitson, Heather E.
• Cohen, Harvey J.
• Mathew, Joseph P.
• Berger, Miles
• Bengali, S.
• Bennett, E.
• Brassard, R.
• Brigman, B.
• Bullock, M.
• Carter, J.
• Chapman, J.
• Colin, B.
• D'Amico, T.
• DeOrio, J.
• Esclamado, R.
• Ferrandino, M.
• Gadsden, J.
• Gardner, J.
• Garrigues, G.
• Giattino, C.
• Grant, S.
• Guercio, J.
• Gupta, D.
• Habib, A.
• Harpole, D.
• Hartwig, M.
• Hu, J.
• Iboaya, E.
• Inman, B.
• Khan, A.
• Lagoo-Deenadayalan, S.
• Laskowitz, D.
• Lee, P.
• Lee, W.
• Lemm, J.
• Levinson, H.
• Mantyh, C.
• McDonagh, D.
• Migaly, J.
• Mithani, S.
• Moul, J.
• Newman, M.
• Ohlendorf, B.
• Perez, A.
• Peterson, A.
• Preminger, G.
• Quinones, Q.
• Ray, A.
• Roberts, K.
• Robertson, C.
• Roman, S.
• Runyon, S.
• Sandler, A.
• Sbahi, F.
• Scheri, R.
• Smith, K.
• Talbot, L.
• Thacker, J.
• Thomas, J.
• Tong, B.
• Toulgoat-Dubois, Y.
• Tu, A.
• Vaslef, S.
• Woldorff, M.
• Waldron, N.
• Wang, X.
• Young, C.

Titel

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study

Ist Teil von

• British journal of anaesthesia : BJA, 2021-12, Vol.127 (6), p.917-928

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. We enrolled 140 English-speaking patients ≥60 yr old scheduled for noncardiac surgery under general anaesthesia in an observational cohort study, of whom 52 underwent neuroimaging. We measured cognition; Aβ, tau, p-tau levels in CSF; and resting-state intrinsic functional connectivity in six Alzheimer's disease-risk regions before and 6 weeks after surgery. There were no significant APOE4-related differences in cognition or CSF biomarkers, except APOE4 carriers had lower CSF Aβ levels than non-carriers (preoperative median CSF Aβ [median absolute deviation], APOE4 305 pg ml−1 [65] vs 378 pg ml−1 [38], respectively; P=0.001). Controlling for age, APOE4 carriers had significantly greater preoperative functional connectivity than non-carriers between several brain regions implicated in Alzheimer's disease, including between the left posterior cingulate cortex and left angular gyrus (β [95% confidence interval, CI], 0.218 [0.137–0.230]; PFWE=0.016). APOE4 carriers, but not non-carriers, experienced significant connectivity decreases from before to 6 weeks after surgery between several brain regions including between the left posterior cingulate cortex and left angular gyrus (β [95% CI], –0.196 [–0.256 to –0.136]; PFWE=0.001). Most preoperative and postoperative functional connectivity differences did not change after controlling for preoperative CSF Aβ levels. Postoperative change trajectories for cognition and CSF Aβ, tau or p-tau levels did not differ between community dwelling older APOE4 carriers and non-carriers. APOE4 carriers showed greater preoperative functional connectivity and greater postoperative decreases in functional connectivity in key Alzheimer's disease-risk regions, which occur via Aβ-independent mechanisms.