期刊
ANESTHESIOLOGY
卷 116, 期 3, 页码 603-612出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ALN.0b013e318246ec0b
关键词
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资金
- Alzheimer's Disease Neuroimaging Initiative (ADNI) [U01 AG024904]
- National Institutes of Health, Bethesda, Maryland
- National Institute on Aging
- National Institute of Biomedical Imaging and Bioengineering
- NIH [P30 AG010129, K01 AG030514]
- Dana Foundation
- New York University Medical Center's Alzheimer's Disease Core Center, New York, New York [AG08051-19]
- Foundation for Perioperative Research and Education
- National Institute on Aging at NIH (Bethesda, Maryland) [AG13616, AG12101, AG036502, AG035137, AG008051, AG032554, AG022374]
- National Center for Research Resources at NIH (Bethesda, Maryland) [1 UL1 RR029893]
- Alzheimer's Association
- Abbott
- AstraZeneca AB
- Bayer Schering Pharma AG
- Bristol-Myers Squibb
- Eisai Global Clinical Development
- Elan Corporation
- Genentech
- GE Healthcare
- GlaxoSmithKline
- Innogenetics
- Johnson and Johnson
- Eli Lilly and Co.
- Medpace, Inc.
- Merck and Co., Inc
- Novartis AG
- Pfizer Inc.
- F. Hoffman-La Roche
- Schering-Plough
- Synarc, Inc.
- Alzheimer's Drug Discovery Foundation
- U. S. Food and Drug Administration
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.
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