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Changes in plasma and cerebrospinal fluid biomarkers in aged patients with early postoperative cognitive dysfunction following total hip-replacement surgery.
J Anesth. 2013 Apr; 27(2):236-42.JA

Abstract

PURPOSE

We hypothesized that different patterns of biomarkers of brain injury and inflammation exist in aged patients with postoperative cognitive dysfunction (POCD) after total hip-replacement with spinal anesthesia.

METHODS

Eighty-three patients older than 65 years undergoing elective total hip-replacement surgery were enrolled in this prospective observational study. The CSF levels of Tau, phosphorylated-tau (pTau), amyloidβ1-42 (Aβ1-42), Tau/Aβ1-42, pTau/Aβ1-42, BDNF, IL-6, and IL-1β were measured preoperatively. Perioperative plasma levels of IL-1β, IL-6, brain-derived neurotrophic factor (BDNF), C-reactive protein (CRP), and malonaldehyde (MDA) as well as neurocognitive tests were determined preoperatively and seven days postoperatively.

RESULTS

Sixty-one patients completed both the CSF and blood samples collection and the neurocognitive tests. POCD occurred in 24.6 % of patients at seven days after surgery. Patients with POCD had significantly higher IL-1β, Tau/Aβ1-42, pTau/Aβ1-42, and a lower level of Aβ1-42 in CSF when compared with the Non-POCD group (P < 0.05). Furthermore, POCD patients displayed significantly higher plasma levels of MDA when compared with Non-POCD patients at seven days after surgery (P < 0.05). There was no difference in preoperative CSF levels of Tau, IL-6, and pTau as well as plasma levels of IL-1β, IL-6, BDNF and CRP between POCD and Non-POCD groups (P > 0.05).

CONCLUSION

The POCD patients were associated with higher postoperative plasma levels of MDA, and higher IL-1β and lower Aβ1-42 levels in preoperative CSF that might predispose the development of POCD in aged patients following total hip-replacement surgery with spinal anesthesia.

Authors+Show Affiliations

Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, 305 East Zhongshan Road, Nanjing 210002, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23085747

Citation

Ji, Mu-Huo, et al. "Changes in Plasma and Cerebrospinal Fluid Biomarkers in Aged Patients With Early Postoperative Cognitive Dysfunction Following Total Hip-replacement Surgery." Journal of Anesthesia, vol. 27, no. 2, 2013, pp. 236-42.
Ji MH, Yuan HM, Zhang GF, et al. Changes in plasma and cerebrospinal fluid biomarkers in aged patients with early postoperative cognitive dysfunction following total hip-replacement surgery. J Anesth. 2013;27(2):236-42.
Ji, M. H., Yuan, H. M., Zhang, G. F., Li, X. M., Dong, L., Li, W. Y., Zhou, Z. Q., & Yang, J. J. (2013). Changes in plasma and cerebrospinal fluid biomarkers in aged patients with early postoperative cognitive dysfunction following total hip-replacement surgery. Journal of Anesthesia, 27(2), 236-42. https://doi.org/10.1007/s00540-012-1506-3
Ji MH, et al. Changes in Plasma and Cerebrospinal Fluid Biomarkers in Aged Patients With Early Postoperative Cognitive Dysfunction Following Total Hip-replacement Surgery. J Anesth. 2013;27(2):236-42. PubMed PMID: 23085747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in plasma and cerebrospinal fluid biomarkers in aged patients with early postoperative cognitive dysfunction following total hip-replacement surgery. AU - Ji,Mu-Huo, AU - Yuan,Hong-Mei, AU - Zhang,Guang-Fen, AU - Li,Xiao-Min, AU - Dong,Lin, AU - Li,Wei-Yan, AU - Zhou,Zhi-Qiang, AU - Yang,Jian-Jun, Y1 - 2012/10/22/ PY - 2012/07/23/received PY - 2012/10/09/accepted PY - 2012/10/23/entrez PY - 2012/10/23/pubmed PY - 2013/10/22/medline SP - 236 EP - 42 JF - Journal of anesthesia JO - J Anesth VL - 27 IS - 2 N2 - PURPOSE: We hypothesized that different patterns of biomarkers of brain injury and inflammation exist in aged patients with postoperative cognitive dysfunction (POCD) after total hip-replacement with spinal anesthesia. METHODS: Eighty-three patients older than 65 years undergoing elective total hip-replacement surgery were enrolled in this prospective observational study. The CSF levels of Tau, phosphorylated-tau (pTau), amyloidβ1-42 (Aβ1-42), Tau/Aβ1-42, pTau/Aβ1-42, BDNF, IL-6, and IL-1β were measured preoperatively. Perioperative plasma levels of IL-1β, IL-6, brain-derived neurotrophic factor (BDNF), C-reactive protein (CRP), and malonaldehyde (MDA) as well as neurocognitive tests were determined preoperatively and seven days postoperatively. RESULTS: Sixty-one patients completed both the CSF and blood samples collection and the neurocognitive tests. POCD occurred in 24.6 % of patients at seven days after surgery. Patients with POCD had significantly higher IL-1β, Tau/Aβ1-42, pTau/Aβ1-42, and a lower level of Aβ1-42 in CSF when compared with the Non-POCD group (P < 0.05). Furthermore, POCD patients displayed significantly higher plasma levels of MDA when compared with Non-POCD patients at seven days after surgery (P < 0.05). There was no difference in preoperative CSF levels of Tau, IL-6, and pTau as well as plasma levels of IL-1β, IL-6, BDNF and CRP between POCD and Non-POCD groups (P > 0.05). CONCLUSION: The POCD patients were associated with higher postoperative plasma levels of MDA, and higher IL-1β and lower Aβ1-42 levels in preoperative CSF that might predispose the development of POCD in aged patients following total hip-replacement surgery with spinal anesthesia. SN - 1438-8359 UR - https://www.unboundmedicine.com/medline/citation/23085747/Changes_in_plasma_and_cerebrospinal_fluid_biomarkers_in_aged_patients_with_early_postoperative_cognitive_dysfunction_following_total_hip_replacement_surgery_ L2 - https://dx.doi.org/10.1007/s00540-012-1506-3 DB - PRIME DP - Unbound Medicine ER -